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Robinson MA, Purcell JB, Ward L, Winternitz S, Kaufman ML, Baranowski KA, Lebois LAM. Advancing Research on and Treatment of Dissociative Identity Disorder With People With Lived Experience. Am J Psychother 2024:appipsychotherapy20230024. [PMID: 38711402 DOI: 10.1176/appi.psychotherapy.20230024] [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] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Dissociative identity disorder is a posttraumatic, psychobiological syndrome that develops over time during childhood. Despite empirical evidence supporting the validity of this diagnosis and its relation to trauma, the disorder remains a misunderstood and stigmatized condition. This article highlights expert consensus guidelines and current empirical research on the treatment of dissociative identity disorder. In addition, the authors describe the Lived Experience Advisory Panel (LEAP), which was designed to leverage the expertise of individuals with dissociative identity disorder to combat stigma and improve research, clinical programming, professional education, and public outreach related to the disorder. This article also describes how LEAP members have partnered with other researchers to create new knowledge through participatory action research in order to advance equitable service provision and effect positive change.
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Affiliation(s)
- Matthew A Robinson
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
| | - Juliann B Purcell
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
| | - Laura Ward
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
| | - Sherry Winternitz
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
| | - Milissa L Kaufman
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
| | - Kim A Baranowski
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
| | - Lauren A M Lebois
- Trauma Continuum, Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts (all authors); Department of Psychiatry, Harvard Medical School, Boston (Robinson, Purcell, Winternitz, Kaufman, Lebois)
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Tay AK. Hope in hardship: charting a new course for mental health in Afghanistan. BJPsych Open 2024; 10:e102. [PMID: 38712622 DOI: 10.1192/bjo.2024.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
The long legacy of upheavals and deprivations in Afghanistan and the associated mental health impacts on its people are well documented. A systematic review undertaken by Alemi et al (2023) presents the most comprehensive synthesis to date on this topic. Drawing on their findings, this editorial examines the complex mental health and psychosocial challenges confronted by neglected vulnerable groups such as pregnant and postnatal women, LGBTQ individuals, older adults, ethnic minority groups and Afghan refugees living overseas. It explores the potential challenges in rebuilding a resilient mental health system following the mass exodus of Afghanis. It calls for a whole-of-society approach that extends beyond clinical interventions to address the broader sociocultural and economic factors influencing mental health.
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Affiliation(s)
- Alvin Kuowei Tay
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
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Neal DP, Kucera M, van Munster BC, Ettema TP, Dijkstra K, Muller M, Dröes RM, Bosmans JE. Cost-effectiveness of the FindMyApps eHealth intervention vs. digital care as usual: results from a randomised controlled trial. Aging Ment Health 2024:1-14. [PMID: 38708873 DOI: 10.1080/13607863.2024.2345128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/12/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES Despite growing interest, the cost-effectiveness of eHealth interventions for supporting quality of life of people with dementia and their caregivers remains unclear. This study evaluated the cost-effectiveness of the FindMyApps intervention, compared to digital care-as-usual. FindMyApps aims to help people with dementia and their caregivers find and learn to use tablet apps that may support social participation and self-management of people with dementia and sense of competence of caregivers. METHOD A randomised controlled trial (Netherlands Trial Register NL8157) was conducted, including people with mild cognitive impairment (MCI) or mild dementia and their informal caregivers (FindMyApps n = 76, digital care-as-usual n = 74). Outcomes for people with MCI/dementia were Quality-Adjusted Life-Years (QALYs), calculated from EQ-5D-5L data and the Dutch tariff for utility scores, social participation (Maastricht Social Participation Profile) and quality of life (Adult Social Care Outcomes Toolkit), and for caregivers, QALYs and sense of competence (Short Sense of Competence Questionnaire). Societal costs were calculated using data collected with the RUD-lite instrument and the Dutch costing guideline. Multiple imputation was employed to fill in missing cost and effect data. Bootstrapped multilevel models were used to estimate incremental total societal costs and incremental effects between groups which were then used to calculate Incremental Cost-Effectiveness Ratios (ICERs). Cost-effectiveness acceptability curves were estimated. RESULTS In the FindMyApps group, caregiver SSCQ scores were significantly higher compared to care-as-usual, n = 150, mean difference = 0.75, 95% CI [0.14, 1.38]. Other outcomes did not significantly differ between groups. Total societal costs for people with dementia were not significantly different, n = 150, mean difference = €-774, 95%CI [-2.643, .,079]. Total societal costs for caregivers were significantly lower in the FindMyApps group compared to care-as-usual, n = 150, mean difference = € -392, 95% CI [-1.254, -26], largely due to lower supportive care costs, mean difference = €-252, 95% CI [-1.009, 42]. For all outcomes, the probability that FindMyApps was cost-effective at a willingness-to-pay threshold of €0 per point of improvement was 0.72 for people with dementia and 0.93 for caregivers. CONCLUSION FindMyApps is a cost-effective intervention for supporting caregivers' sense of competence. Further implementation of FindMyApps is warranted.
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Affiliation(s)
- David P Neal
- Department of Psychiatry, Amsterdam University Medical Centers, , Amsterdam, The Netherlands
| | - Matej Kucera
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
- National Institute of Mental Health, Klecany, Czech Republic
| | - Barbara C van Munster
- Department of Geriatric Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Teake P Ettema
- Department of Psychiatry, Amsterdam University Medical Centers, , Amsterdam, The Netherlands
| | - Karin Dijkstra
- School of Health, Saxion University of Applied Sciences, Deventer, The Netherlands
| | - Majon Muller
- Department of Internal Medicine section Geriatrics, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, , Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Barlati S, Nibbio G, Vita A. Evidence-based psychosocial interventions in schizophrenia: a critical review. Curr Opin Psychiatry 2024; 37:131-139. [PMID: 38410981 PMCID: PMC10990032 DOI: 10.1097/yco.0000000000000925] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness. RECENT FINDINGS Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice. SUMMARY Cognitive remediation, metacognitive training, social skills training, psychoeducation, family interventions, cognitive behavioral therapy, physical exercise and lifestyle interventions, supported employment and some other interventions can be fully considered as evidence-based treatments in SSD. Psychosocial interventions could be of particular usefulness in the context of early intervention services. Future research should focus on developing newer interventions, on better understanding the barriers and the facilitators of their implementation in clinical practice, and exploring the opportunities provided by novel technologies.
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Affiliation(s)
- Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Gabriele Nibbio
- Department of Clinical and Experimental Sciences, University of Brescia
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
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Kittridge C, Rob P, Fisher-Rogers A, Anis T, Attygalle U, Islam F, Sharma AN, Rodgers J. The development of the Helping your Anxious Child programme: a parent-mediated group intervention for parents of autistic children in South Asia. BJPsych Int 2024; 21:26-28. [PMID: 38693950 PMCID: PMC11035960 DOI: 10.1192/bji.2023.37] [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] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 05/03/2024] Open
Abstract
Autistic children are at increased risk of experiencing a range of mental health difficulties, including anxiety. A number of intervention programmes are now available in high-income countries to support autistic children. However, to date there are no evidence-based interventions to support families of such children in South Asia. Based on consultations with clinicians, researchers and parents in Bangladesh and Sri Lanka, we developed a culturally tailored two-session skills-based group programme for parents whose autistic children present with anxiety. This paper describes the process of creating this programme, to be delivered by mental health professionals.
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Affiliation(s)
- Caitlin Kittridge
- Research Assistant, School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Priyanka Rob
- Research Assistant, School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Amy Fisher-Rogers
- Research Assistant, School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Tarana Anis
- Senior Child Psychologist, Child Development Centre, Evercare Hospital, Dhaka, Bangladesh
| | - Udena Attygalle
- Consultant Child and Adolescent Psychiatrist, Sirimavo Bandaranayake Children's Hospital, Peradeniya, Sri Lanka
| | - Farzana Islam
- Specialist, Child Development Centre, Evercare Hospital, Dhaka, Bangladesh
| | - Aditya Narain Sharma
- Clinical Senior Lecturer and Honorary Consultant in Child and Adolescent Psychiatry, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jacqui Rodgers
- Professor of Psychology and Mental Health, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK. Email
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Zhang Y, Zhang W, Yu E. Systematic Review and Meta-Analysis: Pharmacological and Nonpharmacological Interventions for Disruptive Mood Dysregulation Disorder. J Child Adolesc Psychopharmacol 2024. [PMID: 38683583 DOI: 10.1089/cap.2024.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Objectives: Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnosis that comprises severe, nonepisodic irritability and recurrent outbursts of emotional instability in adolescents. This meta-analysis examined the efficacy of the available pharmacological and nonpharmacological interventions for DMDD. Methods: Literature searches were conducted in July 2023. To determine relevant articles, 330 abstracts were reviewed, and 39 articles were identified for full review. A random-effects model was used for the meta-analysis, and a subgroup analysis was performed to assess the effects of study design and intervention type. Results: Eleven studies were reviewed, including six pharmacological and five nonpharmacological. Despite high heterogeneity in effects (I2 = 85%), we showed statistically significant improvements in irritability symptoms following intervention. We showed statistically significant enhancements in symptoms of irritability following the intervention. The subgroup analysis revealed that, compared with randomized controlled trials (RCTs), open trials showed significant improvements in irritability. In addition, drug intervention significantly improved irritability compared to nondrug interventions. Atomoxetine (ATX), optimized stimulants, and stimulants combined with other drugs and behavioral therapy effectively improved irritability. Conclusions: With research indicating potential benefits for irritability from a combination of pharmacological interventions and therapy, including ATX, stimulants in conjunction with antipsychotic or antidepressant medications, and cognitive-behavioral techniques such as Dialectical Behavior Therapy for Children. Future large-scale RCTs are essential to further explore and refine these treatment approaches, especially focusing on the efficacy of combining pharmacological with effective nonpharmacological to improve irritability and overall outcomes in this population.
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Affiliation(s)
- Yuhan Zhang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Wenxuan Zhang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Enyan Yu
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
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Mwangala PN, Makandi M, Kerubo A, Nyongesa MK, Abubakar A. A scoping review of the literature on the application and usefulness of the Problem Management Plus (PM+) intervention around the world. BJPsych Open 2024; 10:e91. [PMID: 38650067 PMCID: PMC11060090 DOI: 10.1192/bjo.2024.55] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Given the high rates of common mental disorders and limited resources, task-shifting psychosocial interventions are needed to provide adequate care. One such intervention developed by the World Health Organization is Problem Management Plus (PM+). AIMS This review maps the evidence regarding the extent of application and usefulness of the PM+ intervention, i.e. adaptability, feasibility, effectiveness and scalability, since it was introduced in 2016. METHOD We conducted a scoping review of seven literature databases and grey literature from January 2015 to February 2024, to identify peer-reviewed and grey literature on PM+ around the world. RESULTS Out of 6739 potential records, 42 met the inclusion criteria. About 60% of the included studies were from low- and middle-income countries. Findings from pilot/feasibility trials demonstrated that PM+ is feasible, acceptable and safe. Results from definitive randomised controlled trials at short-term follow-up also suggested that PM+ is effective, with overall moderate-to-large effect sizes, in improving symptoms of common mental health problems. Although PM+ was more effective in reducing symptoms of common mental disorders, it was found to be costlier compared to usual care in the only study that evaluated its cost-effectiveness. CONCLUSIONS Our findings indicate that PM+, in its individual and group formats, can be adapted and effectively delivered by trained helpers to target a wide range of common mental health concerns. More effectiveness and implementation evidence is required to understand the long-term impact of PM+, its cost-effectiveness and scalability, and moderators of treatment outcomes such as gender and delivery formats.
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Affiliation(s)
- Patrick N. Mwangala
- Institute for Human Development, Aga Khan University, Kenya; Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya; and School of Public Health, University of the Witwatersrand, South Africa
| | | | - Anita Kerubo
- Institute for Human Development, Aga Khan University, Kenya
| | | | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Kenya; Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya; and Department of Psychiatry, University of Oxford, UK
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Allard J, Pollard A, Laugharne R, Coates J, Wildfire-Roberts J, Millward M, Shankar R. Evaluating the impact of a UK recovery college on mental well-being: pre- and post-intervention study. BJPsych Open 2024; 10:e87. [PMID: 38634329 PMCID: PMC11060092 DOI: 10.1192/bjo.2023.646] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 11/25/2023] [Accepted: 12/12/2023] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Recovery colleges provide personalised educational mental health support for people who self-refer. The research evidence supporting them is growing, with key components and the positive experiences of attendees reported. However, the quantitative outcome evidence and impact on economic outcomes is limited. AIMS To evaluate the impact of attending a UK recovery college for students who receive a full educational intervention. METHOD This is a pre- and post-intervention study, with predominantly quantitative methods. Participants recruited over an 18-month period (01.2020-07.2021) completed self-reported well-being (Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS)) and recovery (Process of Recovery (QPR)) surveys, and provided details and evidence of employment and educational status. Descriptive statistics for baseline data and Shapiro-Wilk, Wilcoxon signed-rank and paired t-tests were used to compare pre- and post-intervention scores, with Hedges' g-statistic as a measure of effect size. Medical records were reviewed and a brief qualitative assessment of changes reported by students was conducted. RESULTS Of 101 student research participants, 84 completed the intervention. Well-being (mean SWEMWBS scores 17.3 and 21.9; n = 80) and recovery (mean QPR scores 27.2 and 38.8; n = 75) improved significantly (P < 0.001; Hedges' g of 1.08 and 1.03). The number of economically inactive students reduced from 53 (69%) to 19 (24.4%). No research participants were referred for specialist mental health support while students. 'Within-self' and 'practical' changes were described by students following the intervention. CONCLUSIONS Findings detail the largest self-reported pre-post data-set for students attending a recovery college, and the first data detailing outcomes of remote delivery of a recovery college.
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Affiliation(s)
- Jon Allard
- Research Team, Cornwall Partnership NHS Foundation Trust, Bodmin, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK
| | - Adam Pollard
- Research Department, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - Richard Laugharne
- Research Team, Cornwall Partnership NHS Foundation Trust, Bodmin, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK
| | - Jamie Coates
- Recovery College Cornwall, Pentreath Ltd, Truro, UK
| | | | | | - Rohit Shankar
- Research Team, Cornwall Partnership NHS Foundation Trust, Bodmin, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK
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Wells I, G-Medhin A, Owen N, Thelwell ELR, Giacco D. Experiences of support received by carers of people who are involuntarily admitted to hospital under the Mental Health Act: qualitative study of carers' perspectives. BJPsych Open 2024; 10:e82. [PMID: 38622966 PMCID: PMC11060084 DOI: 10.1192/bjo.2024.44] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/09/2024] [Accepted: 02/27/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Carers of people who are involuntarily admitted to hospital report feeling isolated and unsupported by services. The Independent Review of the Mental Health Act (MHA) recommended that carers be supported. However, no research has directly explored what type of support carers would find most helpful when a relative/friend is involuntary admitted. AIMS To explore carers' experiences and views around the support they want to receive when their relative/friend is involuntarily admitted under the MHA. METHOD A total of 22 one-to-one interviews with carers were conducted online at three sites across England. Audio recordings of the interviews were transcribed, and data were analysed with thematic analysis. RESULTS Four main themes were identified: (a) heterogeneity in the current support for carers, (b) information about mental health and mental health services, (c) continuous support, and (d) peer support and guidance. Carers reported receiving support from professionals, peers and relatives, but this was unstructured, and the extent of support varied across carers. Carers reported wanting more information about mental health services, and for this information to be consistent. Carers also reported wanting emotional support from a single, continuous person, helping them establish a more personal and sincere connection. Peers were also identified as important in the provision of carer support, allowing carers to feel reassured and understood in their experience. CONCLUSIONS The support received by carers is currently unstructured. To meet the MHA review recommendations, carers of patients who are involuntarily admitted should be allocated a named contact person, ideally with lived experience, to offer information and personal continuity of support.
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Affiliation(s)
- Imogen Wells
- Warwick Medical School, University of Warwick, UK
| | | | - Nicole Owen
- Warwick Medical School, University of Warwick, UK
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Coronado-Montoya S, Abdel-Baki A, Crockford D, Côté J, Dubreucq S, Dyachenko A, Fischer B, Lecomte T, L'Heureux S, Ouellet-Plamondon C, Roy MA, Tibbo P, Villeneuve M, Jutras-Aswad D. Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale. Can J Psychiatry 2024:7067437241242395. [PMID: 38571478 DOI: 10.1177/07067437241242395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Cannabis use is common in people with early-phase psychosis (EP) and is associated with worse treatment outcomes. Few targeted interventions for cannabis use behaviour in this population exist, most focusing on abstinence, none focusing on harm reduction. Many people with EP will not seek treatment for their cannabis use with current therapeutic options. Understanding preferences for cannabis-focused harm reduction interventions may be key to improving outcomes. This study aimed to determine preferences of young adults with EP who use cannabis for cannabis-focused harm reduction interventions. METHODS Eighty-nine young adults across Canada with EP interested in reducing cannabis-related harms were recruited. An online questionnaire combining conventional survey methodology and two unique discrete choice experiments (DCEs) was administered. One DCE focused on attributes of core harm reduction interventions (DCE 1) and the second on attributes of boosters (DCE 2). We analysed these using mixed ranked-ordered logistic regression models. Preference questions using conventional survey methodology were analysed using summary statistics. RESULTS Preferred characteristics for cannabis-focused harm reduction interventions (DCE 1) were: shorter sessions (60 min vs. 10 min, odds ratio (OR): 0.72; P < 0.001); less frequent sessions (daily vs. monthly, OR: 0.68; P < 0.001); shorter interventions (3 months vs. 1 month, OR: 0.80; P < 0.01); technology-based interventions (vs. in-person, OR: 1.17; P < 0.05). Preferences for post-intervention boosters (DCE 2) included opting into boosters (vs. opting out, OR: 3.53; P < 0.001) and having shorter boosters (3 months vs. 1 month, OR: 0.79; P < 0.01). Nearly half of the participants preferred to reduce cannabis use as a principal intervention goal (vs. using in less harmful ways or avoiding risky situations). CONCLUSIONS Further research is required to see if technology-based harm reduction interventions for cannabis featuring these preferences translate into greater engagement and improved outcomes in EP patients.
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Affiliation(s)
- Stephanie Coronado-Montoya
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - David Crockford
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - José Côté
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Simon Dubreucq
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Alina Dyachenko
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Benedikt Fischer
- Centre for Applied Research in Addiction and Mental Health, Simon Fraser University, Vancouver, Canada
- Research & Graduate Studies Division, University of the Fraser Valley, Abbotsford, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- School of Population Health, University of Auckland, Auckland, New Zealand
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Tania Lecomte
- Department of Psychology, University of Montréal, Montréal, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Sophie L'Heureux
- Clinique Notre-Dame des Victoires, Institut Universitaire en Santé Mentale, Centre Intégré Universitaire de Soins et Services Sociaux de la Capitale Nationale, Québec, Canada
- Department of Psychiatry and Neurosciences, Laval University, Québec, Canada
| | - Clairélaine Ouellet-Plamondon
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Marc-André Roy
- Department of Psychiatry and Neurosciences, Laval University, Québec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, Canada
- Centre de Recherche CERVO, Québec, Canada
| | - Philip Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Marie Villeneuve
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- University Institute on Addictions, Montréal, Canada
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Plys E, Grunberg VA, Vranceanu AM. Advancing Methodological Rigor for Psychosocial Aspects of Neuropalliative Care Interventions. J Palliat Care 2024; 39:92-96. [PMID: 38343071 PMCID: PMC10986462 DOI: 10.1177/08258597241232490] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Background: Neurological disorders (NDs) have unique biopsychosocial-spiritual features that impact patients and their families. As a result, the subspeciality of neuropalliative care (NPC) emerged within the past decade and has grown exponentially in research and practice. Given the cognitive, emotional, and behavioral changes associated with NDs, psychosocial components (eg, coping skills) of NPC interventions are essential for improving the quality of life for patients and families. However, psychosocial components of NPC interventions warrant more rigorous testing to improve their evidence base and their likelihood of implementation and dissemination. Aim: In this commentary, we provide methodological recommendations with the goal of improving scientific knowledge and rigor for psychosocial components of multicomponent NPC interventions in clinical trials. Results: We emphasize the need for transparent reporting of psychosocial intervention components; using established models of intervention development to guide the development and testing of multicomponent NPC interventions; identifying mechanisms of action for psychosocial outcomes; and choosing psychometrically sound measures for mechanisms and outcomes. Conclusions: Given the importance of psychosocial care to the holistic NPC model, rigorous testing of psychosocial components of NPC interventions is a high priority for clinical investigators to advance the evidence base and practice of NPC.
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Affiliation(s)
- Evan Plys
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Victoria A. Grunberg
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Newborn Medicine, MassGeneral for Children, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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12
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Micklitz HM, Glass CM, Bengel J, Sander LB. Efficacy of Psychosocial Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis. Trauma Violence Abuse 2024; 25:1000-1017. [PMID: 37148270 DOI: 10.1177/15248380231169481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Survivors of intimate partner violence (IPV) face serious health-related, social and economic consequences. Prior meta-analyses indicate efficacy of psychosocial interventions for support of IPV survivors, but their results are affected by methodological limitations. Extensive subgroup analyses on the moderating effects of intervention and study characteristics are lacking. To address these limitations in an up-to-date and comprehensive meta-analytic review, four literature databases (PsycInfo, Medline, Embase, and CENTRAL, March 23, 2022) were searched for randomized-controlled trials examining the efficacy of psychosocial interventions compared to control groups in improving safety-related, mental health, and psychosocial outcomes in IPV survivors. Weighted effects on IPV, depression, posttraumatic stress disorder (PTSD), and psychosocial outcomes were calculated under random-effects assumption. Subgroup analyses were performed to investigate moderating effects of predefined intervention and study characteristics. Study quality was rated. In all, 80 studies were included in qualitative synthesis, and 40 studies in meta-analyses. Psychosocial interventions significantly reduced symptoms of depression (SMD: -0.15 [95% confidence interval, CI [-0.25, -0.04]; p = .006], I2 = 54%) and PTSD (SMD: -0.15 [95% CI [-0.29, -0.01]; p = .04], I2 = 52%), but not IPV reexperience (SMD: -0.02 [95% CI [ -0.09, 0.06]; p = .70], I2 = 21%) compared to control conditions at post. High-intensive and integrative interventions, combining advocacy-based and psychological components, were favorable subgroups. Yielded effects were modest and not maintained long term. The quality of evidence was low and potential harms remain unclear. Future research should adopt higher standards of research conduct and reporting and must account for the complexity and diversity of IPV experiences.
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Affiliation(s)
- Hannah M Micklitz
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carla M Glass
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Jürgen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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13
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Lu J, Yang Y, Chen H, Ma H, Tan Y. Effects of different psychosocial interventions on death anxiety in patients: a network meta-analysis of randomized controlled trials. Front Psychol 2024; 15:1362127. [PMID: 38562234 PMCID: PMC10982502 DOI: 10.3389/fpsyg.2024.1362127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This research intended to assess and compare influence of psychosocial interventions in death anxiety in patients, providing evidence-based guidance for both patients and healthcare providers. Design The present study exclusively gathered randomized controlled trials by comprehensively searching across multiple databases, comprising of PubMed, Embase, Cochrane Library, Web of Science, and Scopus. The methodological quality of the enrolled studies involved in the analysis was assessed using the Cochrane bias risk assessment tool, and data analysis was performed utilizing appropriate software. Results This research, encompassing 15 randomized controlled trials with a cumulative sample size of 926 patients, spanned from the earliest possible date to December 2023. The findings of network meta-analysis unveiled that the Rational-Emotive Hospice Care Therapy significantly reduced death anxiety among patients (Sequentially Updated Cumulative Ranking Analysis: 100%). Conclusion The ranking plot of the network suggested that the rational-emotive hospice care therapy exhibited superior efficacy as a psychological treatment for reducing the death anxiety of patients.Systematic review registration: [https://clinicaltrials.gov/], identifier: [CRD42023484767].
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Affiliation(s)
- Jinhong Lu
- Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Abstract
Dementia is a terminal and progressive condition which often brings with it a loss of hope, and feelings of hopelessness in those living with the condition and their family carers. Community nurses are in a unique position of being able to interact with people with dementia and their family carers in their own homes, or the care settings in which they reside, and in some case, will be the only professionals with regular contact with the family. Therefore, they have the opportunity to increase feelings of hope in those they work with. This article will discuss the concept of hope as it relates to dementia. It goes on to give an overview of Snyder's model of hope, which presents hope as a cognitive state, and therefore presents the opportunity for professionals to increase feelings of hope. An overview of the research evidence around hope-based interventions is then given, with the ideas applied to community nursing practice using a case study. This article aims to add some hope-based interventions to the toolkit of community nurses as they work with people and families affected by dementia.
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Affiliation(s)
- Amy Pepper
- Admiral Nurse Research Assistant; Dementia UK
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15
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Krysinska K, Andriessen K, Bandara P, Reifels L, Flego A, Page A, Schlichthorst M, Pirkis J, Mihalopoulos C, Khanh-Dao Le L. The Cost-Effectiveness of Psychosocial Interventions Following Self-Harm in Australia. Crisis 2024; 45:118-127. [PMID: 37904498 DOI: 10.1027/0227-5910/a000926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Background: Psychosocial interventions following self-harm in adults, in particular cognitive behavioral therapy (CBT), can be effective in lowering the risk of repeated self-harm. Aims: To evaluate the cost-effectiveness of CBT for reducing repeated self-harm in the Australian context. Method: The current study adopted the accessing cost-effectiveness (ACE) approach using return-on-investment (ROI) analysis. Uncertainty and sensitivity analyses (Sas) tested the robustness of the model outputs to changes in three assumptions: general practitioner referral pathway (SA1), private setting intervention delivery (SA2), and training costs (SA3). Results: The intervention produced cost savings of A$ 46M (95% UI -223.7 to 73.3) and A$ 18.3M (95% UI -86.2 to 24.6), subject to the effect of intervention lasting 2- or 1-year follow-up. The ROI ratio reduced to 5.22 in SA1 (95% UI -10.1 to 27.9), 2.5 in SA2 (95% UI -4.8 to 13.3), and 5.1 in SA3 (95% UI -9.8 to 27.8). Limitations: We assumed that the effectiveness would reduce 50% within 5 years in the base case, and we used Australian data and a partial social perspective. Conclusions: The current study demonstrated cost-effectiveness of CBT for adults who have self-harmed with the return-on-investment ratio of A$ 2.3 to $6.0 for every A$ 1 invested.
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Affiliation(s)
- Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Piumee Bandara
- Translational Health Research Institute, Western Sydney University, NSW, Australia
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Anna Flego
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, NSW, Australia
| | - Marisa Schlichthorst
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- Health Economics Division, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Long Khanh-Dao Le
- Health Economics Division, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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16
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Karabulut Gul S, Oruc AF, Gedik D, Mokresh ME, Alomari O, Kaya MA, Akincioglu D, Tepetam H, Gul HL. Factors Influencing Anxiety Levels in Oncology Patients: A Study on the Impact of Earthquakes. Cureus 2024; 16:e57230. [PMID: 38686232 PMCID: PMC11056651 DOI: 10.7759/cureus.57230] [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] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE This study aims to explore the multifaceted factors influencing anxiety levels in oncology patients, with a specific focus on the impact of earthquakes in the context of Turkey. Our objective is to identify and understand sociodemographic, clinical, and lifestyle determinants associated with anxiety in cancer patients, examining how traumatic events, such as earthquakes, contribute to heightened anxiety levels. MATERIALS AND METHODS A cross-sectional study was conducted, involving 149 oncology patients undergoing treatment at two prominent oncology centers in Turkey. The study collected comprehensive sociodemographic information and assessed anxiety levels using the Beck Anxiety Scale. The dataset was analyzed using SPSS 20.0 (IBM Corp., Armonk, NY), employing a range of statistical methods including descriptive statistics, independent t-tests, Mann-Whitney U tests, and Chi-square tests. RESULTS The findings underscore several factors significantly linked to anxiety levels in oncology patients. Notably, women, younger patients (age <65), and individuals with specific cancer types exhibited higher anxiety levels. Elevated anxiety was also associated with compromised physical functioning, experiences of earthquakes, irregular sleep patterns, dietary habits, fatigue, and the use of antidepressants. CONCLUSION This study provides insights into the intricate interplay of factors influencing anxiety levels in oncology patients. Understanding these determinants is paramount for tailoring effective psychosocial support and interventions. The results underscore the need for holistic approaches to enhance the overall quality of life for cancer patients. Gender, age, cancer type, physical well-being, lifestyle choices, and exposure to trauma all play pivotal roles in influencing anxiety levels. These findings hold practical implications for the development and implementation of targeted psychosocial interventions aimed at improving anxiety management and overall well-being for oncology patients.
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Affiliation(s)
- Sule Karabulut Gul
- Radiation Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, TUR
| | | | - Duygu Gedik
- Radiation Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, TUR
| | - Muhammed Edib Mokresh
- Radiation Oncology, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
| | - Omar Alomari
- Radiation Oncology, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
| | - Mehmet Alper Kaya
- Radiation Oncology, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
| | - Duygu Akincioglu
- Radiation Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, TUR
| | - Huseyin Tepetam
- Radiation Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, TUR
| | - Hakan Levent Gul
- Neurology, Maltepe Medical Park Hospital Neurology Clinic, University of Istanbul Rumeli, Faculty of Sports Sciences, Istanbul, TUR
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17
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Muralidhar M, Spector A, Hui EK, Liu L, Ali A. A systematic review of psychosocial interventions for people with intellectual disabilities and dementia. Aging Ment Health 2024; 28:385-395. [PMID: 37811724 DOI: 10.1080/13607863.2023.2265322] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES As the life expectancy of individuals with intellectual disabilities (ID) continues to increase, there is an increased risk of developing dementia. While psychosocial interventions are gaining prominence, evidence is limited for people with both dementia and ID. This review discusses the effectiveness of direct psychosocial interventions and adaptations to facilitate delivery within this population. METHODS The review followed the PRISMA guidelines. Five electronic databases, grey literature, and reference lists of included articles were searched for relevant studies. 10 eligible studies were appraised and analysed by narrative synthesis. RESULTS Ten distinct interventions were identified and categorised based on their purpose and delivery. All interventions were beneficial in improving a range of outcomes, though some studies were of low quality and most had small samples. Common adaptations included simplification of tasks and material, higher staff-to-client ratio, and alternative communication methods. CONCLUSION There is emerging evidence for several psychosocial interventions for people with ID and dementia, though further research is required on effectiveness and generalisability. The adaptations discussed may guide implementation into routine care and contribute to current policies and guidelines on improving ID and dementia care.
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Affiliation(s)
| | - Aimee Spector
- Clinical, Educational and Health Psychology, Division of Psychology and Language Science, University College London (UCL), London, UK
| | - Esther K Hui
- Division of Psychiatry, University College London (UCL), London, UK
| | - Lisa Liu
- Division of Psychiatry, University College London (UCL), London, UK
| | - Afia Ali
- Division of Psychiatry, University College London (UCL), London, UK
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18
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Rose T, Spencer-Davies C. The power of a cup of tea: psychosocial interventions in dementia. Br J Community Nurs 2024; 29:68-75. [PMID: 38300238 DOI: 10.12968/bjcn.2024.29.2.68] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Dementia is a condition that affects the psychological and emotional wellbeing of not only the person with the diagnosis but also those around them. Therefore, providing holistic support and care to the entire family is essential. Psychosocial interventions have a significant impact on families living with dementia. They are a broad category of strategies and approaches that support the whole person by recognising their inherent strengths, and acknowledging and addressing the challenges they face. These interventions can range from a simple conversation over a cup of tea to more structured forms of psychotherapy.
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Affiliation(s)
- Tom Rose
- Admiral Nurse Clinical Lead, St Barnabas Hospice, Lincolnshire
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19
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Stark VS, Williams EC, Tribin FE, Coto J, Carrico A, Carreño JM, Bielak D, Desai P, Krammer F, Hoffer ME, Pallikkuth S, Pahwa S. Examining the Effect of SARS-CoV-2 Pandemic-Induced Stress and Anxiety on Humoral Immunity in Health Care Workers. J Occup Environ Med 2024; 66:e48-e53. [PMID: 38013399 PMCID: PMC10872745 DOI: 10.1097/jom.0000000000003014] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE The effect of stress on vaccine-induced humoral immunity and therapeutic interventions to mitigate pandemic-related stress remain underexplored. METHOD Participants in a longitudinal cohort study ( n = 189) completed a validated measure, GAD-7, and 10-instrument stress measure to assess stress and anxiety after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Serum was collected to obtain SARS-CoV-2 antibody titer levels. RESULTS Participants experienced increased stress due to the SARS-CoV-2 pandemic with a positive correlation between GAD-7 scores and peak antibody titers overall; however, there was a negative association with scores commensurate with severe anxiety. Health care workers and younger participants were more significantly affected by anxiety. CONCLUSIONS Mild anxiety levels may have immune-enhancing effects, whereas severe anxiety may cause antibody generation reduction. Mental health-focused interventions are imperative for younger adults and health care workers. Young adults may be more resilient to increased stress levels.
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Affiliation(s)
- Valerie S. Stark
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
- University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Public Health, University of Miami, Miami, Florida, USA
| | - Erin C. Williams
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Biomedical Engineering, University of Miami, Miami, Florida, USA
| | | | - Jennifer Coto
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Adam Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dominika Bielak
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Parnavi Desai
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael E. Hoffer
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurological Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Suresh Pallikkuth
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Savita Pahwa
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Wilkins VM, Kiosses DN. Developing Psychosocial Interventions for Late-Life Depression and Comorbid Hoarding Disorder. Am J Geriatr Psychiatry 2024; 32:148-150. [PMID: 37980198 DOI: 10.1016/j.jagp.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 11/20/2023]
Affiliation(s)
- Victoria M Wilkins
- Weill Cornell Medicine (VMW, DNK), Weill-Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - Dimitris N Kiosses
- Weill Cornell Medicine (VMW, DNK), Weill-Cornell Institute of Geriatric Psychiatry, White Plains, NY.
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21
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Poole R, Huxley P. Social prescribing: an inadequate response to the degradation of social care in mental health. BJPsych Bull 2024; 48:30-33. [PMID: 37526058 PMCID: PMC10801358 DOI: 10.1192/bjb.2023.61] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 08/02/2023] Open
Abstract
Social prescribing is poorly defined and there is little evidence for its effectiveness. It cannot address the social determinants of mental health and it is unlikely to produce enduring change for that part of the population that suffers the worst physical and mental health, namely the most deprived and marginalised. It has emerged at a time of growing health inequity. This has occurred alongside the neglect of social care and of the social aspects of mental health intervention. Social prescribing gives a false impression of addressing social factors, and as such is counterproductive. We can do better than this.
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22
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Swenson CC, Schaeffer CM. Development of a family-based treatment for co-occurring intimate partner violence and child maltreatment: the MST-IPV model. BJPsych Bull 2024:1-12. [PMID: 38275077 DOI: 10.1192/bjb.2023.103] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Intimate partner violence (IPV) is a significant global problem that affects the health of children, parents/caregivers and extended family. The effects can be lifelong and span generations. Treatments for IPV are focused largely on individual work with men as the primary aggressor. Even when the situation includes child maltreatment, generally all family members are referred to a host of providers for varied treatments. Traditionally, couples and family work does not occur. In this article, we detail the development and practice of a comprehensive treatment model for complex cases of co-occurring IPV and child maltreatment that is inclusive of the family and couple. Of particular note, the development of this model, Multisystemic Therapy for Intimate Partner Violence (MST-IPV), involved input from the IPV stakeholder community.
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Abstract
Doctors' typical reaction to patients' suffering is to alleviate it when clinically appropriate. This has been described as a negative model of suffering, in contrast to the positive model of suffering. In the positive model, suffering can contain an important message of needed change, indicate a response to a psychosocial predicament or be a route to spiritual enlightenment. This approach is briefly critiqued, and circumstances where patients might prefer this approach are described. Doctors can work alongside professionals using this approach while also trying to alleviate suffering if indicated (such as if a patient wishes less suffering or if risk is involved).
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Witt K, McGill K, Leckning B, Hill NTM, Davies BM, Robinson J, Carter G. Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis. BJPsych Open 2024; 10:e29. [PMID: 38205598 PMCID: PMC10790226 DOI: 10.1192/bjo.2023.625] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/04/2023] [Accepted: 11/17/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Hospital-treated self-harm is common, costly and associated with repeated self-harm and suicide. Providing a comprehensive psychosocial assessment following self-harm is recommended by professional bodies and may improve outcomes. AIMS To review the provision of psychosocial assessments after hospital-presenting self-harm and the extent to which macro-level factors indicative of service provision explain variability in these estimates. METHOD We searched five electronic databases to 3 January 2023 for studies reporting data on the proportion of patients and/or events that were provided a psychosocial assessment. Pooled weighted prevalence estimates were calculated with the random-effects model. Random-effects meta-regression was used to investigate between-study variability. RESULTS 119 publications (69 unique samples) were included. Across ages, two-thirds of patients had a psychosocial assessment (0.67, 95% CI 0.58-0.76). The proportion was higher for young people and older adults (0.75, 95% CI 0.36-0.99 and 0.83, 95% CI 0.48-1.00, respectively) compared with adults (0.64, 95% CI 0.54-0.73). For events, around half of all presentations had these assessments across the age range. No macro-level factor explained between-study heterogeneity. CONCLUSIONS There is room for improvement in the universal provision of psychosocial assessments for self-harm. This represents a missed opportunity to review and tailor aftercare supports for those at risk. Given the marked unexplained heterogeneity between studies, the person- and system-level factors that influence provision of psychosocial assessments after self-harm should be studied further.
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Affiliation(s)
- Katrina Witt
- Centre for Youth Mental Health, The University of Melbourne, Australia; and Orygen, Parkville, Australia
| | - Katie McGill
- School of Medicine and Public Health, The University of Newcastle, Australia; and Hunter New England Local Health District, Waratah, Australia
| | - Bernard Leckning
- Menzies School of Health Research, Charles Darwin University, Australia
| | - Nicole T. M. Hill
- School of Population and Global Health, The University of Western Australia, Australia; and Telethon Kids Institute, Nedlands, Australia
| | | | - Jo Robinson
- Centre for Youth Mental Health, The University of Melbourne, Australia; and Orygen, Parkville, Australia
| | - Gregory Carter
- School of Medicine and Public Health, The University of Newcastle, Australia
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Roy R, Raman KJ, Raj EA, Varambally S. Outcomes of psychosocial interventions for homeless individuals with mental illness: A systematic review. Int J Soc Psychiatry 2024:207640231217173. [PMID: 38174711 DOI: 10.1177/00207640231217173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND Homelessness creates a significant social and economic burden in the society. Homelessness and mental illness are two interconnected social issues that poses challenges to individuals and communities across the globe. This systematic review aims to synthesize the existing literature on interventions for the homeless persons with mental illness. OBJECTIVES To systematically review the existing literature on psychosocial interventions for homeless persons with mental illness. SEARCH METHODS Five databases including PubMed, ProQuest, Cochrane Library, OVID, and Google Scholar were searched using homelessness, psychosocial interventions, mental ill, residential mental health facility, and case management for experimental studies published from January 2000 to December 2022. STUDY SELECTION Abstract review was conducted for the screened studies, and full-text review was done for studies which met inclusion exclusion criteria. DATA EXTRACTION AND ANALYSIS Among the 6,387 studies screened 20 studies were selected which fulfilled inclusion criteria. The full text review yielded data of 12,174 homeless persons with mental illness who undergone intervention. RESULTS The major psychosocial interventions found including critical time intervention, case management, housing support intervention, assertive community treatment, and life skills training. These interventions were helpful in sustaining housing stability, preventing relapse, reducing hospitalizations, and improving quality of life of the homeless persons with mental illness. CONCLUSION Targeted and integrated interventions addressing homelessness and mental illness are required to tackle the social problems of homelessness and mental illness. Further research is required to explore the most effective strategies that address homelessness and mental illness.
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Affiliation(s)
- Roniyamol Roy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - K Janaki Raman
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - E Aravind Raj
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Shivarama Varambally
- Depatment of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Yeoh SA, Webb S, Phillips A, Li LSK, Kumar S. Psychosocial interventions for ovarian cancer survivors: A systematic review. Psychooncology 2024; 33:e6280. [PMID: 38282217 DOI: 10.1002/pon.6280] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES Ovarian cancer survivorship is complex and is associated with greater symptom burden, fear of reoccurrence, sexual dysfunction, lower quality of life and heightened existential distress in contrast to other cancers. This systematic review aimed to investigate the effectiveness for, and perspective of, psychosocial interventions encompassing psychological, social, and emotional support, tailored to, or involving ovarian cancer survivors at all stages of disease. METHODS Adhering to the PRISMA-SR statement guidelines, a systematic search was conducted across PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, Cochrane Library databases, Google, and Google Scholar. Two reviewers independently undertook a two-stage screening process. The Mixed Methods Appraisal Tool was utilised to assess the methodological quality of included studies. Data were extracted using customised data extraction tools and narratively synthesised. RESULTS Thirteen studies were included in this review. Generally positive effects of psychosocial interventions were observed across a range of outcome domains (meaning enhancing, cognitive, social, emotional, and cancer-specific). However, the characteristics of interventions and outcome measures varied across studies. Psychoeducational interventions were identified as the most common psychosocial approach, while Acceptance and Commitment Therapy showed promise in addressing the disease's high symptom burden. Women's perspectives of psychosocial interventions were described as "useful" and promoted positive self-regard. CONCLUSION While the evidence base largely support positive effects of psychosocial interventions for ovarian cancer survivors, this finding is constrained by heterogeneity of interventions and modest gains. Future research may explore the standardisation of psychosocial interventions for this demographic, investigating its effects on less explored but prevalent concerns among ovarian cancer survivors such as fear of cancer recurrence and sexual dysfunction.
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Affiliation(s)
- Su Ann Yeoh
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Stephanie Webb
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Anna Phillips
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Lok Sze Katrina Li
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Saravana Kumar
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Vrontaras N, Koulierakis G, Ntourou I, Karakatsoulis G, Sergentanis TΝ, Kyrou D, Kapetanakis A, Karademas E, Karamanidou C. Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta-analysis of clinical trials. Psychooncology 2023; 32:1798-1826. [PMID: 37964424 DOI: 10.1002/pon.6241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND It has been increasingly recognized that some people experience post-traumatic growth (PTG) as a result of struggling with cancer. OBJECTIVE This systematic review aims to identify psychosocial interventions that might facilitate PTG in adults with cancer. METHODS A search was conducted in PsycINFO, PubMed, Scopus, the Cochrane Library, and ProQuest up to 16 September 2022. The PRISMA guidelines were followed; all included interventional studies had to comprise 30 or more adults with cancer, using the Posttraumatic Growth Inventory, from 1994 forward. RESULTS A total of 2731 articles were retrieved, 1028 of those were screened and 37 unique trials were included (46 articles). A large number of studies were published since 2018 (52.4%), were randomized controlled trials (43.2%), and had group interventions (34.8%), including mainly female participants (83.8%) with a single cancer type (54.1%). Most interventions (75.7%) were moderately to highly effective in increasing PTG (d = 0.65, 95% CI 0.39-0.91) with the most effective interventions using Cognitive Behavioral Therapy (d = 1.24, 95% CI: 0.05-2.44), Mindfulness-based (d = 0.54, 95% CI = 0.14-0.94) and Education, Peer Support and Health Coaching interventions (d = 0.28, 95% CI: 0.1-0.46). Expression-based and Positive Psychology-based approaches also showed promising results. Notably, the majority of studies had a high risk of bias. CONCLUSIONS PTG facilitation is a promising field that should be pursued as it not only allows people with cancer to overcome their trauma but also results in them going over and above their pre-cancer state, enhancing resilience, health, and well-being.
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Affiliation(s)
- Nikolaos Vrontaras
- Department of Public Health Policy, University of West Attica, Athens, Greece
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | | | - Iliana Ntourou
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | - Georgios Karakatsoulis
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | | | - Dimitrios Kyrou
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | - Anargyros Kapetanakis
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
| | | | - Christina Karamanidou
- Institute of Applied Biosciences, Center for Research & Technology - Hellas, Thessaloniki, Greece
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Billings J, Zhan Yuen Wong N, Nicholls H, Burton P, Zosmer M, Albert I, Grey N, El-Leithy S, Murphy D, Tehrani N, Wheatley J, Bloomfield MAP, Greene T. Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance. Eur J Psychotraumatol 2023; 14:2281751. [PMID: 38032045 PMCID: PMC10990448 DOI: 10.1080/20008066.2023.2281751] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, UK
| | | | - Helen Nicholls
- Division of Psychiatry, University College London, London, UK
| | - Peter Burton
- Division of Psychiatry, University College London, London, UK
| | - Maya Zosmer
- Division of Psychiatry, University College London, London, UK
| | - Idit Albert
- King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Nick Grey
- University of Sussex, Falmer, UK
- Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK
| | | | - Dominic Murphy
- King’s College London, London, UK
- Combat Stress, London, UK
| | | | - Jon Wheatley
- Homerton Healthcare NHS Foundation Trust, London, UK
| | - Michael A. P. Bloomfield
- Division of Psychiatry, University College London, London, UK
- Camden & Islington NHS Foundation Trust, London, UK
| | - Talya Greene
- Clinical, Educational and Health Psychology, University College London, London, UK
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Brola W, Szcześniak M, Wilski M, Żak M, Sobolewski P, Wnuk M, Szałachowski RR, Kapica-Topczewska K, Czarnowska A, Tarasiuk J, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Bartosik-Psujek H, Lech B, Perenc A, Popiel M, Ratajczak A, Ratajczak M, Kroplewski Z, Potemkowski A. Sense of happiness in Polish patients with multiple sclerosis. Neurol Neurochir Pol 2023; 57:484-491. [PMID: 38009502 DOI: 10.5603/pjnns.97534] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Happiness is crucial to patient well-being and their acceptance of their disease. The aim of this study was to assess the sense of happiness in persons with multiple sclerosis (PwMS), compare it to the level of happiness in patients with other neurological conditions, and determine which factors affect the sense of happiness in PwMS. MATERIAL AND METHODS Five hundred and eighty-nine PwMS and 145 control subjects (post-stroke patients with chronic pain syndromes and neuropathies) were included in the study. Due to the differences between the groups in terms of demographic variables, an adjusted group of PwMS (n = 145) was selected from the entire group of PwMS. All patients were assessed using the Oxford Happiness Questionnaire (OHQ), the Satisfaction with Life Scale (SLS), and the Family APGAR Questionnaire. Based on regression analysis, the study examined which variables affected the level of happiness in the groups. RESULTS Analysis of the OHQ scores showed that PwMS had a lower sense of happiness compared to the control group in the overall score [113.21 (25-42) vs. 119.88 (25-49), respectively; p = 0.031] and the subscales (OHQ subscale 1 - 54.52 vs. 57.84, respectively; p = 0.027; subscale 2 - 35.61 vs. 37.67; respectively; p = 0.044). Based on linear regression analysis, life satisfaction (β = 0.40; p < 0.001), positive orientation (β = 0.32; p < 0.001), and primary education (β = 0.08; p = 0.009) were the most significant predictors of a higher level of happiness in PwMS. Similar results were found in the control group. CONCLUSIONS The sense of happiness in PwMS was lower than in patients with other conditions. The most important factors influencing happiness included life satisfaction and positive orientation. Influencing these predictors should be the aim of psychological interventions, especially in patients with a reduced sense of happiness.
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Affiliation(s)
- Waldemar Brola
- Department of Neurology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
| | | | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznan, Poland
| | - Marek Żak
- Department of Neurology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Piotr Sobolewski
- Department of Neurology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Marcin Wnuk
- Department of Psychology, Adam Mickiewicz University in Poznan, 60-568 Poznan, Poland
| | | | | | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Natalia Morawiec
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurological Rehabilitation and Stroke Sub-Division, Specialist Hospital in Mięedzylesie, Warsaw, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Beata Lech
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2, Rzeszow, Poland
| | - Adam Perenc
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2, Rzeszow, Poland
| | - Małgorzata Popiel
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2, Rzeszow, Poland
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Sampogna G, Brohan E, Luciano M, Chowdhary N, Fiorillo A. Psychosocial interventions for carers of people with severe mental and substance use disorders: a systematic review and meta-analysis. Eur Psychiatry 2023; 66:e98. [PMID: 37997647 PMCID: PMC10755580 DOI: 10.1192/j.eurpsy.2023.2472] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Severe mental disorders - such as schizophrenia, bipolar disorder, and substance use disorders - exert a negative impact not only on affected people but also on their carers. To support carers of people with severe mental disorders, several psychosocial interventions have been developed. METHODS This systematic review and meta-analysis aimed to assess whether psychosocial interventions for carers of persons with schizophrenia, bipolar disorder, or substance use disorders produce benefit/harm with respect to a series of outcomes - including subjective and objective burden, depressive symptoms, well-being/quality of life, sleep, skills/knowledge, self-efficacy, physical health - as compared to standard support/support as usual or other control conditions. RESULTS In carers of persons with schizophrenia, psychoeducational interventions were associated with significant improvement in personal burden, well-being, and knowledge about the illness; and a supportive-educational intervention with an improvement in personal burden. In carers of persons with bipolar disorder, psychoeducational interventions were associated with significant improvement in personal burden and depressive symptoms; family-led supportive interventions with an improvement in family burden; family-focused intervention and online "mi.spot" intervention with a significant reduction in depressive symptoms. Psychosocial interventions used for carers of persons with substance use disorders were found to be overall effective on the level of well-being, but the low number of trials did not allow detection of differences between the various psychosocial interventions. CONCLUSIONS The quality of the evidence ranged from very low to moderate, suggesting the need for further better-quality research.
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Affiliation(s)
- Gaia Sampogna
- Department of Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy
- WHO Collaborating Centre for Research and Training, Naples, Italy
| | - Elaine Brohan
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Mario Luciano
- Department of Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy
- WHO Collaborating Centre for Research and Training, Naples, Italy
| | - Neerja Chowdhary
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Andrea Fiorillo
- Department of Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy
- WHO Collaborating Centre for Research and Training, Naples, Italy
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Prina E, Ceccarelli C, Abdulmalik JO, Amaddeo F, Cadorin C, Papola D, Tol WA, Lund C, Barbui C, Purgato M. Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis. Int J Soc Psychiatry 2023; 69:1578-1591. [PMID: 37183793 DOI: 10.1177/00207640231174451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM to assess the efficacy of psychosocial interventions delivered through task-sharing approaches for preventing perinatal common mental disorders among women in low- and middle-income countries. METHODS We conducted a systematic review of randomized controlled trials following a prespecified protocol registered in the Open Science Framework (osf.io/qt4y3). We searched MEDLINE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) through June 2022. Two reviewers independently extracted the data and evaluated the risk of bias of included studies using the Cochrane risk of bias tool. We performed random-effects meta-analyses and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS We included 23 studies with 24,442 participants. At post-intervention, task-shared psychosocial interventions, were effective in preventing the development of mental disorders in general (RR 0.57, 95% CI [0.35, 0.91]), and specifically depression (RR 0.51, 95% CI [0.35, 0.75]), but not anxiety disorders (RR 0.46, 95% CI [0.06, 3.33]). Similarly, psychosocial interventions reduced psychological distress (SMD -1.32, 95% CI [-2.28, -0.35]), and depressive symptoms (SMD -0.50, 95% CI [-0.80, -0.16]), and increased parenting self-efficacy (SMD -0.76, 95% CI [-1.13, -0.38]) and social support (SMD -0.72, 95% CI [-1.22, -0.22]). No effect was detected for anxiety symptoms at post-intervention. At follow-up the beneficial effects of interventions progressively decreased. CONCLUSIONS Psychosocial interventions delivered through the task-sharing modality are effective in preventing perinatal common mental disorders and fostering positive mental health among women in low- and middle-income countries. However, our findings are tentative, due to the low number of preventative intervention strategies considering outcomes as the incidence of mental disorders, especially in the long-term. This evidence supports calls to implement and scale up psychosocial prevention interventions for perinatal common mental disorders in low- and middle-income countries.
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Affiliation(s)
- Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Caterina Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Wietse A Tol
- Department of Public Health, University of Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
- Cochrane Global Mental Health, University of Verona, Italy
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Kuipers E. Catching the threads: caregiving in Alzheimer's disease. Br J Psychiatry 2023; 223:507-508. [PMID: 37910152 PMCID: PMC10895493 DOI: 10.1192/bjp.2023.114] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/12/2023] [Accepted: 08/05/2023] [Indexed: 11/03/2023]
Abstract
As someone who has researched the effects on carers living with people with severe psychiatric disorders, the author describes her own recent experience of being a carer. The article serves as a companion piece to her psychiatrist husband's account of his cognitive decline in Alzheimer's disease.
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Affiliation(s)
- Elizabeth Kuipers
- Department of Psychology, School of Mental Health & Psychological Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
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Ojagbemi A, Daley S, Feeney Y, Elugbadebo O, Kola L, Gureje O. Participatory development of a home-based depression care model with lived experience older Nigerians and their caregivers: A theory of change. Int J Geriatr Psychiatry 2023; 38:e6019. [PMID: 37909145 PMCID: PMC7615294 DOI: 10.1002/gps.6019] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES There is a huge treatment gap for late-life depression in sub-Saharan Africa. Building on prior work to scale-up mental healthcare with the aid of the WHO Mental Health Gap Action Programme Intervention Guide electronic version (emhGAP-IG), this study aims to involve older people in the iterative development of innovations to overcome challenges in the detection and clinical management of late-life depression by frontline non-specialist primary healthcare workers (PHCW) in Nigeria. METHODS There were 43 participants in the study. We conducted formative qualitative research using 15 in-depth key informant interviews with persons who were 60 years or older and had a recent experience of depression. We also conducted two focus group discussions comprising 13 of their caregivers. Through a full day stakeholders workshop comprising 15 participants, we drew on the results of our qualitative explorations to identify the pathway to impact of an intervention package (emhGAP-Age) appropriate for the specific needs of persons with late-life depression in Nigeria. RESULTS A Theory of Change (ToC) map was produced. It highlights the expected long-term outcomes of emhGAP-Age to include the potential for improvement of the mental health and wellbeing of older people living in Nigeria and the generation of interest among governmental agencies concerned with policy and planning for mental healthcare. Key resources that serve as preconditions were identified to consist of the availability of PHCW who are skilled in the identification and treatment of depression and have interest in and commitment to providing care to older people. Required community resources include support from immediate family, neighbours, and informal groups. Interventions that are appropriate for depression in old age need to incorporate these community resources and address not only the symptoms of the condition but also comorbid physical health problems. CONCLUSIONS A participatory ToC process led to the identification of the key components of an age-appropriate version of the emhGAP-IG for delivering care to older persons with depression by PHCW in Nigeria.
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Affiliation(s)
- Akin Ojagbemi
- World Health Organization collaborating centre for research and training in mental health, neuroscience, and substance abuse, Department of psychiatry, College of Medicine, University of Ibadan, Nigeria
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Stephanie Daley
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Yvonne Feeney
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Olufisayo Elugbadebo
- World Health Organization collaborating centre for research and training in mental health, neuroscience, and substance abuse, Department of psychiatry, College of Medicine, University of Ibadan, Nigeria
| | - Lola Kola
- World Health Organization collaborating centre for research and training in mental health, neuroscience, and substance abuse, Department of psychiatry, College of Medicine, University of Ibadan, Nigeria
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London
| | - Oye Gureje
- World Health Organization collaborating centre for research and training in mental health, neuroscience, and substance abuse, Department of psychiatry, College of Medicine, University of Ibadan, Nigeria
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Mughal F, Burton FM, Fletcher H, Lascelles K, O'Connor RC, Rae S, Thomson AB, Kapur N. New guidance for self-harm: an opportunity not to be missed. Br J Psychiatry 2023; 223:501-503. [PMID: 37642173 PMCID: PMC7615272 DOI: 10.1192/bjp.2023.113] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
In this editorial we, as members of the 2022 NICE Guideline Committee, highlight and discuss what, in our view, are the key guideline recommendations (generated through evidence synthesis and consensus) for mental health professionals when caring for people after self-harm, and we consider some of the implementation challenges.
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Affiliation(s)
| | - Fiona M Burton
- Department of Emergency Medicine, Queen Elizabeth University Hospital, Glasgow, UK
| | - Harriet Fletcher
- Medical Psychotherapy Service, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | | | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sarah Rae
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Alex B Thomson
- Department of Liaison Psychiatrist, Northwick Park Hospital, Central and North West London NHS Foundation Trust, London, UK
| | - Nav Kapur
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Mersey Care NHS Foundation Trust, Manchester, UK; and NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, UK
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Asher L, Birhane R, Weiss HA, Medhin G, Selamu M, Patel V, De Silva M, Hanlon C, Fekadu A. Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE) cluster-randomised controlled trial: An exploratory analysis of impact on food insecurity, underweight, alcohol use disorder and depressive symptoms. Glob Ment Health (Camb) 2023; 10:e70. [PMID: 38024800 PMCID: PMC10643237 DOI: 10.1017/gmh.2023.67] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
We evaluated the effectiveness of community-based rehabilitation (CBR) in reducing depressive symptoms, alcohol use disorder, food insecurity and underweight in people with schizophrenia. This cluster-randomised controlled trial was conducted in a rural district of Ethiopia. Fifty-four sub-districts were allocated in a 1:1 ratio to the facility-based care [FBC] plus CBR arm and the FBC alone arm. Lay workers delivered CBR over 12 months. We assessed food insecurity (self-reported hunger), underweight (BMI< 18.5 kg/m2), depressive symptoms (PHQ-9) and alcohol use disorder (AUDIT ≥ 8) at 6 and 12 months. Seventy-nine participants with schizophrenia in 24 sub-districts were assigned to CBR plus FBC and 87 participants in 24 sub-districts were assigned to FBC only. There was no evidence of an intervention effect on food insecurity (aOR 0.52, 95% CI 0.16-1.67; p = 0.27), underweight (aOR 0.44, 95% CI 0.17-1.12; p = 0.08), alcohol use disorder (aOR 0.82, 95% CI 0.24-2.74; p = 0.74) or depressive symptoms (adjusted mean difference - 0.06, 95% CI -1.35, 1.22; p = 0.92). Psychosocial interventions in low-resource settings should support access to treatment amongst people with schizophrenia, and further research should explore how impacts on economic, physical and mental health outcomes can be achieved.
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Affiliation(s)
- Laura Asher
- Academic Unit of Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rahel Birhane
- WHO Collaborating Centre for Mental Health Research and Capacity-Building, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Helen A. Weiss
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medhin Selamu
- WHO Collaborating Centre for Mental Health Research and Capacity-Building, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Charlotte Hanlon
- WHO Collaborating Centre for Mental Health Research and Capacity-Building, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Abebaw Fekadu
- WHO Collaborating Centre for Mental Health Research and Capacity-Building, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Department of Global Health & Infection, Brighton and Sussex Medical School, Brighton, UK
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Buchanan M, Walker G, Boden JM, Mansoor Z, Newton-Howes G. Protective factors for psychosocial outcomes following cumulative childhood adversity: systematic review. BJPsych Open 2023; 9:e197. [PMID: 37855106 PMCID: PMC10594245 DOI: 10.1192/bjo.2023.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/26/2023] [Accepted: 08/13/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The long-term cumulative impact of exposure to childhood adversity is well documented. There is an increasing body of literature examining protective factors following childhood adversity. However, no known reviews have summarised studies examining protective factors for broad psychosocial outcomes following childhood adversity. AIMS To summarise the current evidence from longitudinal studies of protective factors for adult psychosocial outcomes following cumulative exposure to childhood adversity. METHOD We conducted a formal systematic review of studies that were longitudinal; were published in a peer-reviewed journal; examined social, environmental or psychological factors that were measured following a cumulative measure of childhood adversity; and resulted in more positive adult psychosocial outcomes. RESULTS A total of 28 studies from 23 cohorts were included. Because of significant heterogeneity and conceptual differences in the final sample of articles, a meta-analysis was not conducted. The narrative review identified that social support is a protective factor specifically for mental health outcomes following childhood adversity. Findings also suggest that aspects of education are protective factors to adult socioeconomic, mental health and social outcomes following childhood adversity. Personality factors were protective for a variety of outcomes, particularly mental health. The personality factors were too various to summarise into meaningful combined effects. Overall GRADE quality assessments were low and very low, although these scores mostly reflect that all observational studies are low quality by default. CONCLUSIONS These findings support strategies that improve connection and access to education following childhood adversity exposure. Further research is needed for the roles of personality and dispositional factors, romantic relationship factors and the combined influences of multiple protective factors.
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Affiliation(s)
- Mary Buchanan
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Grace Walker
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M. Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Zara Mansoor
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Paphitis S, Akilu F, Chilambo N, Iruayenama A, Samaroo X, Mustapha A, Goldsmith K, Ismail O, Slovak P, Ikpe E, Smith P, Patel P, Sullivan R, Abas M, Olonisakin F. Toward an integrated approach for mental health and psychosocial support and peacebuilding in North-East Nigeria: programme description and preliminary outcomes from 'Counselling on Wheels'. BJPsych Open 2023; 9:e190. [PMID: 37822220 PMCID: PMC10594183 DOI: 10.1192/bjo.2023.575] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Despite theoretical support for including mental health and psychosocial support (MHPSS) with peacebuilding, few programmes in conflict-affected regions fully integrate these approaches. AIMS To describe and assess preliminary outcomes of the Counselling on Wheels programme delivered by the NEEM Foundation in the Borno State of North-East Nigeria. METHOD We first describe the components of the Counselling on Wheels programme, including education and advocacy for peace and social cohesion through community peacebuilding partnerships and activities, and an MHPSS intervention open to all adults, delivered in groups of eight to ten people. We then conducted secondary analysis of data from 1550 adults who took part in the MHPSS intervention, who provided data at baseline and 1-2 weeks after the final group session. Vulnerability to violent extremism was assessed with a locally developed 80-item scale. Symptoms of common mental disorders were assessed with the Depression, Anxiety and Stress Scale (DASS-21) and Post-Traumatic Stress Disorder Scale (PTSD-8). Data were analysed through a mixed-effect linear regression model, accounting for clustering by community and adjusted for age and gender. RESULTS After taking part in group MHPSS, scores fell for depression (-5.8, 95% CI -6.7 to -5.0), stress (-5.5, 95% CI -6.3 to -4.6), post-traumatic stress disorder (-2.9, 95% CI -3.4 to -2.4) and vulnerability to violent extremism (-44.6, 95% CI -50.6 to -38.6). CONCLUSIONS The Counselling on Wheels programme shows promise as a model for integrating MHPSS with community peacebuilding activities in this conflict-affected region of Africa.
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Affiliation(s)
- Sharli Paphitis
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Philosophy, Rhodes University, South Africa
| | - Fatima Akilu
- Department of Psychology, Research and Policy, The NEEM Foundation, Abuja, Nigeria; and African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Natasha Chilambo
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Abiye Iruayenama
- Department of Psychology, Research and Policy, The NEEM Foundation, Abuja, Nigeria
| | - Xena Samaroo
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Asma'u Mustapha
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kimberley Goldsmith
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Olawale Ismail
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Petr Slovak
- Department of Informatics, King's College London, UK
| | - Eka Ikpe
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
| | - Patrick Smith
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Preeti Patel
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Centre for Conflict and Health Research, King's College London, UK
| | - Richard Sullivan
- Faculty of Life Sciences and Medicine, King's College London, UK
| | - Melanie Abas
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Funmi Olonisakin
- African Leadership Centre, School of Global Affairs, Faculty of Social Sciences and Public Policy, King's College London, UK
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Renouf P, Budgett J, Wyman D, Banks S, Poppe M, Cooper C. Non-clinically trained facilitators' experiences of remote psychosocial interventions for older adults with memory loss and their family carers. BJPsych Open 2023; 9:e174. [PMID: 37791537 PMCID: PMC10594201 DOI: 10.1192/bjo.2023.558] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Dementia is the seventh leading cause of global mortality, with cases increasing. Psychosocial interventions might help prevent dementia and improve quality of life. Although it is cost-effective for non-clinically trained staff to deliver these, concerns are raised and little is known about the resulting impact on staff, especially for remote interventions. AIMS To explore how non-clinically trained facilitators experienced delivering remote, one-to-one and group-based psychosocial interventions with older adults with memory loss and their family carers, under training and supervision. METHOD We conducted a secondary thematic analysis of interviews with non-clinically trained facilitators, employed by universities, the National Health Service and third-sector organisations, who facilitated either of two manualised interventions: the APPLE-Tree group dementia prevention for people with mild memory loss or the NIDUS-Family one-to-one dyadic intervention for people living with dementia and their family carers. RESULTS The overarching theme of building confidence in developing therapeutic relationships was explained with subthemes that described the roles of positioning expertise (subtheme 1), developing clinical skills (subtheme 2), peer support (subtheme 3) in enabling this process and remote delivery as a potential barrier to it (subtheme 4). CONCLUSIONS Non-clinically trained facilitators can have positive experiences delivering remote psychosocial interventions with older adults. Differences in life experience could compound initial fears of being 'in at the deep end' and 'exposed' as lacking expertise. Fears were allayed by experiencing positive therapeutic relationships and outcomes, and by growing confidence. For this to happen, appropriate training and supervision is needed, alongside accounting for the challenges of remote delivery.
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Affiliation(s)
- Philippa Renouf
- Division of Psychiatry, University College London, UK; and Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK
| | - Jessica Budgett
- Division of Psychiatry, University College London, UK; and Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK
| | - Danielle Wyman
- School of Psychology and Sport Science, Anglia Ruskin University, UK
| | - Sara Banks
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK
| | - Michaela Poppe
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK; and Memory Services, East London NHS Foundation Trust, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK; and Memory Services, East London NHS Foundation Trust, UK
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Lin Y, Zhang X, Zhou T, Xu F, Zhu X, Zhou H, Wang X, Ding Y. Identifying the common elements of psychological and psychosocial interventions for preventing postpartum depression: Application of the distillation and matching model to 37 winning protocols from 36 intervention studies. Early Interv Psychiatry 2023; 17:947-962. [PMID: 37680169 DOI: 10.1111/eip.13462] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/16/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
AIM Postpartum depression is prevalent worldwide and seriously endangers maternal and child health. Previous studies have demonstrated the effectiveness of psychological and psychosocial intervention programmes in preventing postpartum depression. However, the literature offers limited practice guidance. Therefore, this study aimed to deeply analyse prior findings to gather rich evidence-based information on this topic. METHODS Using the distillation and matching model, we conducted a systematic review of psychological and psychosocial interventions used to effectively prevent postpartum depression. Four researchers trained in coding system independently read eligible studies and identified reliable (Cohen's kappa >0.40) and frequently occurring (frequency ≥3 winning study groups) practice elements. RESULTS Our review included 36 studies containing 37 winning study groups. Fourteen practice elements were identified and subsequently divided into six categories: postpartum practical problems-related, social support-related, interpersonal psychotherapy-related, cognitive behavioural therapy-related, labour trauma-related and non-specific techniques. The most common practice elements were baby care skills and mother-infant bonding/interaction enhancement. Inter-rater reliability averaged 0.86, ranging from 0.48 to 1. CONCLUSION The practice elements identified in this study provide rich evidence-based information that can guide clinical practitioners in selecting or developing effective, realistically available intervention programmes.
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Affiliation(s)
- Yuping Lin
- School of Nursing, Fudan University, Shanghai, China
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | | | - Tianchun Zhou
- School of Nursing, Fudan University, Shanghai, China
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Feng Xu
- Nursing Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xinli Zhu
- Department of Obstetrics, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Huixin Zhou
- Department of Obstetrics, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Xiao Wang
- Department of Obstetrics, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
| | - Yan Ding
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China
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Brown CK, DiBiase J, Nathanson A, Cadet TJ. Trauma-Informed Care for Inpatient Palliative Care Social Work: Applying Existing Models at the Bedside. J Soc Work End Life Palliat Care 2023; 19:309-325. [PMID: 37698906 PMCID: PMC10840610 DOI: 10.1080/15524256.2023.2256479] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Coexisting serious illness and posttraumatic stress place hospitalized individuals at risk for complex pain, anxiety, and retraumatization. Hospital palliative care social workers increasingly recognize the value of trauma-informed care (TIC) for reducing harm in the inpatient setting. Despite this recognition, there is limited operationalization of TIC principles for inpatient interventions. This paper integrates each TIC principle with inpatient psychosocial interventions to advance trauma-informed competencies among inpatient palliative care social workers and to provide a foundation for future TIC implementation research.
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Affiliation(s)
| | - Jennifer DiBiase
- Department of Geriatrics and Palliative Medicine, Mount Sinai Beth Israel
| | | | - Tamara J. Cadet
- School of Social Policy & Practice, University of Pennsylvania
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Rafferty G, Brar G, Petrut M, Meagher D, O'Connell H, St John-Smith P. Banging the drum: evolutionary and cultural origins of music and its implications for psychiatry. BJPsych Bull 2023; 47:251-254. [PMID: 37313980 PMCID: PMC10764840 DOI: 10.1192/bjb.2023.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/23/2023] [Indexed: 06/15/2023] Open
Abstract
SUMMARY There is growing interest in music-based therapies for mental/behavioural disorders. We begin by reviewing the evolutionary and cultural origins of music, proceeding then to discuss the principles of evolutionary psychiatry, itself a growing a field, and how it may apply to music. Finally we offer some implications for the role of music and music-based therapies in clinical practice.
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DiBiase J. Social Workers as Leaders for Facilitating Trauma-Informed Palliative Care in the Outpatient Palliative Care Clinic. J Soc Work End Life Palliat Care 2023; 19:296-308. [PMID: 37768197 DOI: 10.1080/15524256.2023.2262157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Palliative care social workers are trained to identify how trauma manifests over the course of serious and chronic illness. This expertise can guide patients and team members to ensure a trauma-informed experience of care. This paper identifies the growth of outpatient palliative care clinics as an opportunity for palliative care social workers to emphasize this clinical skill set and assume a leadership role in the implementation of trauma-informed practices early in the trajectory of serious illness.
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Affiliation(s)
- Jennifer DiBiase
- Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai Beth Israel Hospital, New York, New York, USA
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43
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Miao M, Morrow R, Salomon A, Mcculloch B, Evain JC, Wright MR, Murphy MT, Welsh M, Williams L, Power E, Rietdijk R, Debono D, Brunner M, Togher L. Digital Health Implementation Strategies Coproduced With Adults With Acquired Brain Injury, Their Close Others, and Clinicians: Mixed Methods Study With Collaborative Autoethnography and Network Analysis. J Med Internet Res 2023; 25:e46396. [PMID: 37725413 PMCID: PMC10548320 DOI: 10.2196/46396] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/10/2023] [Accepted: 08/03/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Acquired brain injuries (ABIs), such as stroke and traumatic brain injury, commonly cause cognitive-communication disorders, in which underlying cognitive difficulties also impair communication. As communication is an exchange with others, close others such as family and friends also experience the impact of cognitive-communication impairment. It is therefore an internationally recommended best practice for speech-language pathologists to provide communication support to both people with ABI and the people who communicate with them. Current research also identifies a need for neurorehabilitation professionals to support digital communication, such as social media use, after ABI. However, with >135 million people worldwide affected by ABI, alternate and supplementary service delivery models are needed to meet these communication needs. The "Social Brain Toolkit" is a novel suite of 3 interventions to deliver communication rehabilitation via the internet. However, digital health implementation is complex, and minimal guidance exists for ABI. OBJECTIVE This study aimed to support the implementation of the Social Brain Toolkit by coproducing implementation knowledge with people with ABI, people who communicate with people with ABI, clinicians, and leaders in digital health implementation. METHODS A maximum variation sample (N=35) of individuals with living experience of ABI, close others, clinicians, and digital health implementation leaders participated in an explanatory sequential mixed methods design. Stakeholders quantitatively prioritized 4 of the 7 theoretical domains of the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework as being the most important for Social Brain Toolkit implementation. Qualitative interview and focus group data collection focused on these 4 domains. Data were deductively analyzed against the NASSS framework with stakeholder coauthors to determine implementation considerations and strategies. A collaborative autoethnography of the research was conducted. Interrelationships between considerations and strategies were identified through a post hoc network analysis. RESULTS Across the 4 prioritized domains of "condition," "technology," "value proposition," and "adopters," 48 digital health implementation considerations and 52 tailored developer and clinician implementation strategies were generated. Benefits and challenges of coproduction were identified. The post hoc network analysis revealed 172 unique relationships between the identified implementation considerations and strategies, with user and persona testing and responsive design identified as the potentially most impactful strategies. CONCLUSIONS People with ABI, close others, clinicians, and digital health leaders coproduced new knowledge of digital health implementation considerations for adults with ABI and the people who communicate with them, as well as tailored implementation strategies. Complexity-informed network analyses offered a data-driven method to identify the 2 most potentially impactful strategies. Although the study was limited by a focus on 4 NASSS domains and the underrepresentation of certain demographics, the wealth of actionable implementation knowledge produced supports future coproduction of implementation research with mutually beneficial outcomes for stakeholders and researchers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/35080.
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Affiliation(s)
- Melissa Miao
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rosemary Morrow
- Stakeholder with living experience of acquired brain injury, Sydney, Australia
| | - Alexander Salomon
- Stakeholder with living experience of acquired brain injury, Sydney, Australia
| | - Ben Mcculloch
- Stakeholder with living experience of acquired brain injury, Sydney, Australia
| | - Jean-Christophe Evain
- Acquired Brain Injury Rehabilitation Ward, Caulfield Hospital, Alfred Health Network, Melbourne, Australia
- Stakeholder with living experience of acquired brain injury, Melbourne, Australia
| | - Meg Rebecca Wright
- Stakeholder with living experience of acquired brain injury, Blenheim, Australia
| | - Marie Therese Murphy
- Stakeholder with living experience as a communication partner of a person with acquired brain injury, Sydney, Australia
- Faculty of Education, Western Sydney University, Sydney, Australia
- Faculty of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Monica Welsh
- Brain Injury Rehabilitation Unit, South Australian Brain Injury Rehabilitation Service, Adelaide, Australia
| | - Liz Williams
- Brain Injury Rehabilitation Community and Home (BIRCH), South Australian Brain Injury Rehabilitation Service, Adelaide, Australia
| | - Emma Power
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Deborah Debono
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Nunes DP, dos Santos-Orlandi AA, Brito TRP. Editorial: Caregivers of older individuals: reflections about living, health, work and social conditions. Front Med (Lausanne) 2023; 10:1269361. [PMID: 37771982 PMCID: PMC10523311 DOI: 10.3389/fmed.2023.1269361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/08/2023] [Indexed: 09/30/2023] Open
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Breuer E, Morris A, Blanke L, Pearsall M, Rodriguez R, Miller BF, Naslund JA, Saxena S, Balsari S, Patel V. A theory of change for community-initiated mental health care in the United States. Glob Ment Health (Camb) 2023; 10:e56. [PMID: 37854428 PMCID: PMC10579655 DOI: 10.1017/gmh.2023.49] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 10/20/2023] Open
Abstract
Mental health service delivery needs radical reimagination in the United States where unmet needs for care remain large and most metrics on the burden of mental health problems have worsened, despite significant numbers of mental health professionals, spending on service provision and research. The COVID-19 pandemic has exacerbated the need for mental health care. One path to a radical reimagination is "Community Initiated Care (CIC)" which equips and empowers communities to address by providing brief psychosocial interventions by people in community settings. We co-developed a theory of change (ToC) for CIC with 24 stakeholders including representatives from community-based, advocacy, philanthropic and faith-based organizations to understand how CIC could be developed and adapted for specific contexts. We present a ToC which describes ways in which the CIC initiative can promote and strengthen mental health in communities in the United States with respect to community organization and leadership; community care and inclusion and normalizing mental health. We propose 10 strategies as part of CIC and propose a way forward for implementation and evaluation. This CIC model is a local, tailored approach which can expand the role of community members to strengthen our response to mental health needs in the United States.
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Affiliation(s)
- Erica Breuer
- College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
| | - Angelika Morris
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Miriam Pearsall
- National Academy for State Health Policy (NASHP), Portland, ME, USA
| | | | - Benjamin F. Miller
- Department of Psychiatry and Behavioural Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Shekhar Saxena
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Satchit Balsari
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Hemrage S, Brobbin E, Deluca P, Drummond C. Efficacy of psychosocial interventions to reduce alcohol use in comorbid alcohol use disorder and alcohol-related liver disease: a systematic review of randomized controlled trials. Alcohol Alcohol 2023; 58:478-484. [PMID: 37530582 PMCID: PMC10493519 DOI: 10.1093/alcalc/agad051] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/10/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
This systematic review (PROSPERO CRD42021234598) fills a gap in the literature by assessing the efficacy of psychosocial interventions in patients with alcohol use disorder and alcohol-related liver disease (ARLD), focusing on drinking reduction and abstinence as intervention goals. A systematic search for randomized controlled trials (RCTs) was conducted across various databases. Study screening and data extraction were conducted independently by two reviewers. The data were presented through narrative synthesis. Primary outcomes were alcohol reduction and abstinence at the longest follow-up. Ten RCTs were included, evaluating interventions such as cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), motivational interviewing, or peer support. The total population included 1519 participants. Four studies included a combination of more than one intervention, and two trialed an integrated approach, including medical and psychosocial management. A significant reduction was observed with MET, while abstinence was observed with peer support, MET, and CBT/MET within integrated treatment. The overall certainty of the evidence was moderate. Six studies presented a low risk of bias, one had some concerns, and three were high risk. The findings highlight the potential of psychosocial interventions, with MET being repeatedly associated with improved outcomes. Integrated treatment also demonstrated a promising role in ARLD. Future research should head toward improving the robustness and quality of the evidence. It should also aim to further tailor and trial new psychosocial interventions on this specific clinical population. This will enhance the translation of the evidence into real-world settings.
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Affiliation(s)
- Sofia Hemrage
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Eileen Brobbin
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Paolo Deluca
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Colin Drummond
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
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Gregory SW, Aul AJ, Lodermeier TM, Rodemeyer JL, Weaver AL, Lynch BA. The certified child life specialist: A novel resource in the pediatric primary care clinic for managing children's pain during routine immunizations. Paediatr Neonatal Pain 2023; 5:66-75. [PMID: 37744282 PMCID: PMC10514778 DOI: 10.1002/pne2.12101] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 01/12/2023] [Accepted: 02/13/2023] [Indexed: 09/26/2023]
Abstract
This study evaluated the effect of the Certified Child Life Specialist (CCLS) on pediatric pain and pain management during routine immunization administration in the pediatric primary care clinic. Children 4-12 years of age (n = 125) presenting for a well child physical examination at a rural primary care clinic were selected to receive standard nursing care or standard nursing care plus CCLS support during routine immunization administration. Patient reported pain was measured using the Faces Pain Scale-Revised (FPS-R), and patient behavioral responses were measured during immunization administration using the Children's Emotional Manifestation Scale (CEMS). The performance of psychosocial interventions and administration of topical pain-relieving interventions were measured between both groups. CCLS support was associated with fewer negative emotional behaviors during immunization administration among 7- to 12-year-old children and a significantly higher provision of psychosocial interventions and topical pain-relieving interventions among all ages. This study demonstrates that the presence of a CCLS can increase the provision of psychosocial and pain-relieving interventions and reduce distress during immunization administration in a busy pediatric primary care clinic.
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Affiliation(s)
- Seth W. Gregory
- Department of Pediatric and Adolescent MedicineMayo Clinic Health SystemRed WingMinnesotaUSA
- Department of Pediatric and Adolescent MedicineMayo ClinicRochesterMinnesotaUSA
| | - Andrea J. Aul
- Department of Pediatric and Adolescent MedicineMayo ClinicRochesterMinnesotaUSA
| | - Tara M. Lodermeier
- Department of Nursing, Child Life ProgramMayo ClinicRochesterMinnesotaUSA
| | | | - Amy L. Weaver
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Brian A. Lynch
- Department of Pediatric and Adolescent MedicineMayo ClinicRochesterMinnesotaUSA
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Chase L. The double-edged sword of 'community' in community-based psychosocial care: reflections on task-shifting in rural Nepal. Anthropol Med 2023; 30:294-309. [PMID: 36724214 DOI: 10.1080/13648470.2022.2161765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 11/01/2022] [Indexed: 02/03/2023]
Abstract
Research in the field of Global Mental Health has stoked hopes that 'task-shifting' to community workers can help fill treatment gaps in low-resource settings. The fact that community workers inhabit the same local moral worlds as their clients is widely framed as a boon, with little consideration of the social and ethical dilemmas this might create in the care of chronic, stigmatized conditions. Drawing on 14 months of ethnographic research focused on psychosocial interventions in Nepal, this paper traces how the multiple roles community workers occupied with respect to their clients - clinician, neighbour, and at times kin - came to bear on the care they provided. In-depth case studies are used to explore two divergent logics of care informing Nepali community workers' practice. While formal psychosocial care guidelines emphasized clients' autonomy, calling for non-judgmental and non-directive forms of emotional support, everyday efforts to 'convince' neighbours and relatives in distress often involved directive guidance oriented toward the restoration of moral personhood and social relations. These approaches could be mutually supportive, but tensions arose when community workers invoked moral standards linked with mental health stigma. This analysis highlights the challenge of mobilizing communities' strengths and resources without inadvertently reproducing their exclusions. It suggests the deployment of community workers to address psychosocial care gaps may entail not only leveraging existing relationships within communities, but also reconfiguring the very terms of relatedness.
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Affiliation(s)
- Liana Chase
- Department of Anthropology, Durham University, Durham, UK
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Tan JYA, Ong GYQ, Cheng LJ, Pikkarainen M, He HG. Effectiveness of mHealth-based psychosocial interventions for breast cancer patients and their caregivers: A systematic review and meta-analysis. J Telemed Telecare 2023:1357633X231187432. [PMID: 37650270 DOI: 10.1177/1357633x231187432] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Breast cancer causes significant distress in patient-caregiver dyads. While psychosocial and/or mHealth-based interventions have shown efficacy in improving their psychosocial well-being, no reviews have synthesised the effectiveness of such interventions delivered specifically to the breast cancer patient-caregiver dyad. OBJECTIVE To synthesise available evidence examining the effectiveness of mHealth-based psychosocial interventions among breast cancer patient-caregiver dyads in improving their psychosocial well-being (primary outcomes: dyadic adjustment, depression and anxiety; secondary outcomes: stress, symptom distress, social well-being and relationship quality), compared to active or non-active controls. DESIGN A systematic review and meta-analysis. METHODS Randomised controlled trials and quasi-experimental studies were comprehensively searched from seven electronic databases (PubMed, CENTRAL, CINAHL, Embase, PsycINFO, Scopus, Web of Science), ongoing trial registries (ClinicalTrials.gov, WHO ICTRP) and grey literature (ProQuest Dissertations and Theses Global) from inception of databases till 23 December 2022. Studies involving breast cancer patient-caregiver dyads participating in mHealth-based psychosocial interventions, compared to active or non-active controls, were included. Exclusion criteria were terminally ill patients and/or participants with psychiatric disorders or cognitive impairment and interventions collecting symptomatic data, promoting breast cancer screening or involving only physical activities. Screening, data extraction and quality appraisal of studies were conducted independently by two reviewers. Cochrane Risk of Bias Tool version 1 and JBI Critical Appraisal Checklist were used to appraise the randomised controlled trials and quasi-experimental studies, respectively. Meta-analyses using Review Manager 5.4.1 synthesised the effects of outcomes of interest. Sensitivity and subgroup analyses were conducted. The GRADE approach appraised the overall evidence quality. RESULTS Twelve trials involving 1204 breast cancer patient-caregiver dyads were included. Meta-analyses found statistically significant increase in caregiver anxiety (standardised mean difference (SMD) = 0.43, 95% confidence interval (CI) [0.09, 0.77], Z = 2.47, p = 0.01), involving 479 caregivers in 5 studies, and stress (SMD = 0.25, 95% CI [0.05, 0.45], Z = 2.44, p = 0.01), involving 387 caregivers in 4 studies post-intervention, favouring control groups. The intervention effects on the remaining outcomes were statistically insignificant. Beneficial effects of such interventions remain uncertain. The overall quality of evidence was very low for all primary outcomes. CONCLUSIONS Results of the effectiveness of mHealth-based psychosocial interventions on the psychosocial well-being of breast cancer patient-caregiver dyads are inconclusive. The high heterogeneity shown in the meta-analyses and very-low overall quality of evidence imply the need for cautious interpretation of findings. Higher-quality studies are needed to assess the effects of psychosocial interventions on dyadic outcomes and determine optimal intervention regimes.
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Affiliation(s)
- Jia Yu Amelia Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Germaine Yi Qing Ong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Department of Occupational Therapy, Prosthetics and Orthoptics, Faculty of Health Sciences & Department of Product Design, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
- Martti Ahtisaari Institute, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- National University Health System, Singapore, Singapore
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Lloyd A, Broadbent A, Brooks E, Bulsara K, Donoghue K, Saijaf R, Sampson KN, Thomson A, Fearon P, Lawrence PJ. The impact of family interventions on communication in the context of anxiety and depression in those aged 14-24 years: systematic review of randomised control trials. BJPsych Open 2023; 9:e161. [PMID: 37641851 PMCID: PMC10594091 DOI: 10.1192/bjo.2023.545] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 07/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The ability to communicate is integral to all human relationships. Previous research has specifically highlighted communication within families as both a risk and protective factor for anxiety disorders and/or depression. Yet, there is limited understanding about whether communication is amenable to intervention in the context of adolescent psychopathology, and whether doing so improves outcomes. AIMS The aim of this systematic review was to determine in which contexts and for whom does addressing communication in families appear to work, not work and why? METHOD We pre-registered our systematic review with PROSPERO (identifier CRD42022298719), followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and assessed study quality with the Risk of Bias 2 tool. RESULTS Seven randomised controlled trials were identified from a systematic search of the literature. There was significant heterogeneity in the features of communication that were measured across these studies. There were mixed findings regarding whether family-focused interventions led to improvements in communication. Although there was limited evidence that family-focused interventions led to improvements in communication relative to interventions without a family-focused component, we discuss these findings in the context of the significant limitations in the studies reviewed. CONCLUSIONS We conclude that further research is required to assess the efficacy of family-focused interventions for improving communication in the context of anxiety and depression in those aged 14-24 years.
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Affiliation(s)
- Alex Lloyd
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | | | | | | | - Kim Donoghue
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | | | - Katie N. Sampson
- National Collaborating Centre for Mental Health, The Royal College of Psychiatrists, London, UK
| | - Abigail Thomson
- Department of Experimental Psychology, University of Oxford, UK
| | - Pasco Fearon
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK; Department of Psychology, University of Cambridge, UK; and Developmental Neuroscience Unit, Anna Freud Centre, London, UK
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