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Soares Ferreira Junior A, Pinheiro Maux Lessa M, Kaplan S, Coles TM, Terrell DR, Onwuemene OA. Patient-Reported Outcome Measures in Patients with Thrombotic Thrombocytopenic Purpura: A Systematic Review of the Literature. J Clin Med 2023; 12:5155. [PMID: 37568558 PMCID: PMC10420299 DOI: 10.3390/jcm12155155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Health-related quality of life (HRQoL) impacts of thrombotic thrombocytopenic purpura (TTP) have been captured in clinical studies using patient-reported outcome (PRO) measures (PROMs) that are validated for other diseases. However, the validity evidence to support the use of existing PROMs in patients with TTP is unknown. In a systematic review of the literature, including studies of adults and children with TTP, we assessed the validity evidence for use of PROMs in clinical research and clinical practice, characterized HRQoL, described the integration of PROMs in clinical practice and evaluated PRO scores for patients with TTP compared with reference populations. From an initial 4518 studies, we identified 14 studies using 16 PROMs to assess general HRQoL domains in patients in remission. No identified studies assessed the validity of PROMs for the context of use of TTP and no studies described PROM integration into TTP clinical practice or evaluated PROMs that were specific for patients with TTP. Moreover, PRO scores were worse in patients with TTP compared with reference populations and other chronic conditions. We conclude that, in patients with TTP, PROMs pick up on important patient experiences not captured by clinical outcomes at present. There is, therefore, a need for studies that assess the validity of existing PROMs in patients with TTP to determine if TTP-specific PROMs specific to patients with TTP should be developed.
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Affiliation(s)
| | - Morgana Pinheiro Maux Lessa
- Department of Medicine, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto 15090-000, São Paulo, Brazil
| | - Samantha Kaplan
- Medical Center Library & Archives, Duke University Medical Center, Durham, NC 27710, USA;
| | - Theresa M. Coles
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA;
| | - Deirdra R. Terrell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Oluwatoyosi A. Onwuemene
- Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
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Vaccarino AL, Black SE, Gilbert Evans S, Frey BN, Javadi M, Kennedy SH, Lam B, Lam RW, Lasalandra B, Martens E, Masellis M, Milev R, Mitchell S, Munoz DP, Sparks A, Swartz RH, Tan B, Uher R, Evans KR. Rasch analyses of the Quick Inventory of Depressive Symptomatology Self-Report in neurodegenerative and major depressive disorders. Front Psychiatry 2023; 14:1154519. [PMID: 37333922 PMCID: PMC10273843 DOI: 10.3389/fpsyt.2023.1154519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/27/2023] [Indexed: 06/20/2023] Open
Abstract
Background Symptoms of depression are present in neurodegenerative disorders (ND). It is important that depression-related symptoms be adequately screened and monitored in persons living with ND. The Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) is a widely-used self-report measure to assess and monitor depressive severity across different patient populations. However, the measurement properties of the QIDS-SR have not been assessed in ND. Aim To use Rasch Measurement Theory to assess the measurement properties of the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) in ND and in comparison to major depressive disorder (MDD). Methods De-identified data from the Ontario Neurodegenerative Disease Research Initiative (NCT04104373) and Canadian Biomarker Integration Network in Depression (NCT01655706) were used in the analyses. Five hundred and twenty participants with ND (Alzheimer's disease or mild cognitive impairment, amyotrophic lateral sclerosis, cerebrovascular disease, frontotemporal dementia and Parkinson's disease) and 117 participants with major depressive disorder (MDD) were administered the QIDS-SR. Rasch Measurement Theory was used to assess measurement properties of the QIDS-SR, including unidimensionality and item-level fit, category ordering, item targeting, person separation index and reliability and differential item functioning. Results The QIDS-SR fit well to the Rasch model in ND and MDD, including unidimensionality, satisfactory category ordering and goodness-of-fit. Item-person measures (Wright maps) showed gaps in item difficulties, suggesting poor precision for persons falling between those severity levels. Differences between mean person and item measures in the ND cohort logits suggest that QIDS-SR items target more severe depression than experienced by the ND cohort. Some items showed differential item functioning between cohorts. Conclusion The present study supports the use of the QIDS-SR in MDD and suggest that the QIDS-SR can be also used to screen for depressive symptoms in persons with ND. However, gaps in item targeting were noted that suggests that the QIDS-SR cannot differentiate participants falling within certain severity levels. Future studies would benefit from examination in a more severely depressed ND cohort, including those with diagnosed clinical depression.
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Affiliation(s)
| | - Sandra E. Black
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | | | - Benicio N. Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | | | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Benjamin Lam
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Raymond W. Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Mario Masellis
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, Providence Care, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Sara Mitchell
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Douglas P. Munoz
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | | | - Richard H. Swartz
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Agrawal M, Emanuel E, Richards B, Richards W, Roddy K, Thambi P. Assessment of Psilocybin Therapy for Patients With Cancer and Major Depression Disorder. JAMA Oncol 2023; 9:864-866. [PMID: 37052904 PMCID: PMC10102915 DOI: 10.1001/jamaoncol.2023.0351] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/26/2023] [Indexed: 04/14/2023]
Abstract
This nonrandomized controlled trial used a 1-to-1 therapist-to-patient ratio to administer psilocybin to groups of patients with cancer who were diagnosed with major depression disorder to create a scalable, rapidly effective depression treatment.
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Affiliation(s)
| | - Ezekiel Emanuel
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Healthcare Management, The Wharton School, University of Pennsylvania, Philadelphia
| | - Brian Richards
- Sunstone Therapies, Rockville, Maryland
- Aquilino Cancer Center, Maryland Oncology Hematology, Rockville
| | - William Richards
- Sunstone Therapies, Rockville, Maryland
- Aquilino Cancer Center, Maryland Oncology Hematology, Rockville
| | - Kim Roddy
- Sunstone Therapies, Rockville, Maryland
| | - Paul Thambi
- Sunstone Therapies, Rockville, Maryland
- Aquilino Cancer Center, Maryland Oncology Hematology, Rockville
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Van der Watt ASJ, Dalvie N, Seedat S. Weekly telephone mood monitoring is associated with decreased suicidality and improved sleep quality in a clinical sample. Psychiatry Res 2022; 317:114821. [PMID: 36088835 DOI: 10.1016/j.psychres.2022.114821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 01/04/2023]
Abstract
Sleep disturbances and suicidality are common presentations of mood and anxiety disorders. If not closely monitored post-discharge, patients may be at an increased risk of symptom worsening and completed suicide. We explored the associations between telephone mood monitoring, suicidality, and sleep quality in a clinical sample. Fifty inpatients (mean age = 39.49, SD = 11.17; female = 74%) with a mood and/or anxiety disorder were telephonically monitored weekly post-discharge for16 weeks for depression and mania. Suicidality and sleep quality were assessed at intake (pre-discharge), and at weeks 4, 8, 12, and 16 post-discharge. ANOVA indicated that suicidality significantly decreased, and sleep quality improved over 16 weeks. Linear regression analysis indicated that depression severity at week 1 post-discharge significantly predicted suicidality and sleep quality at week 16. Mania severity at week 1 post-discharge predicted sleep quality, but not suicidality, at week 16. Participants generally had positive experiences of the monitoring and perceived it as helpful. Monitoring of mood state, suicidality, and sleep quality post-discharge may allow for early detection of relapse when initiated at 1-week post-discharge. This is a potentially cost-effective intervention and may relieve the burden on the mental healthcare system, especially when face-to-face consultations are not possible.
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Affiliation(s)
- A S J Van der Watt
- Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape, South Africa.
| | - N Dalvie
- Department of Psychiatry, Lentegeur Hospital, Cape Town, Western Cape, South Africa
| | - S Seedat
- Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape, South Africa
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Padmakar S, Murti K, Pandey K, Kumari S, Kumar R, Siddiqui NA, Pal B. Suicidal ideation associated with vitiligo - A systematic review of prevalence and assessment. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Transgender and Gender Diverse Patients in Intensive Mood Disorder Treatment: A Comparative Examination of Clinical Presentation and Treatment Outcomes. Behav Ther 2022; 53:1062-1076. [PMID: 35987536 DOI: 10.1016/j.beth.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022]
Abstract
Individuals who are transgender and gender diverse (TGD) are more likely to suffer from and to seek mental health services for mood disorders. Some literature suggests that TGD individuals, because of pervasive and systemic minority stress, may have more complex clinical presentations (i.e., psychiatric conditions and severity of symptoms) and may benefit from empirically based treatments to a lesser degree than their cisgender peers. However, research has yet to examine individuals who are TGD receiving treatment in specialized, intensive mood disorder treatment despite the propensity for them to be diagnosed with and treated for mood disorders. Using a sample of 1,326 adult patients in intensive mood disorder treatment (3.8% TGD), the clinical presentation and treatment outcomes were compared between patients who are TGD and cisgender. Contrary to previous research, TGD patients were largely similar if not healthier than their cisgender counterparts, including similar depression severity, quality of life, emotion dysregulation, and behavioral activation, and less severe rumination at admission. Despite similar to better reported mental health symptoms, TGD patients were diagnosed with more psychiatric conditions overall, including greater prevalence of social anxiety and neurodevelopmental diagnoses. Those who are TGD did not experience attenuated treatment response as predicted. Findings suggest that patients in intensive mood disorder treatment who are TGD may be more resilient than previously assumed, or supports may have increased to buffer effects of stigma on mental health, and emphasize the need to exercise discretion and sensitivity in diagnostic practices to prevent over-diagnosis and pathologizing of TGD individuals.
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Murkar A, Kendzerska T, Shlik J, Quilty L, Saad M, Robillard R. Increased cannabis intake during the COVID-19 pandemic is associated with worsening of depression symptoms in people with PTSD. BMC Psychiatry 2022; 22:554. [PMID: 35978287 PMCID: PMC9382626 DOI: 10.1186/s12888-022-04185-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Some evidence suggests substance use affects clinical outcomes in people with posttraumatic stress disorder (PTSD). However, more work is required to examine links between mental health and cannabis use in PTSD during exposure to external stressors such as the COVID-19 pandemic. This study assessed mental health factors in individuals with self-reported PTSD to: (a) determine whether stress, anxiety, and depression symptoms were associated with changes in cannabis consumption across the pandemic, and (b) to contrast the degree to which clinically significant perceived symptom worsening was associated with changes in cannabis intake. METHOD Data were obtained as part of a larger web-based population survey from April 3rd to June 24th 2020 (i.e., first wave of the pandemic in Canada). Participants (N = 462) with self-reported PTSD completed questionnaires to assess mental health symptoms and answered questions pertaining to their cannabis intake. Participants were categorized according to whether they were using cannabis or not, and if using, whether their use frequency increased, decreased, or remained unchanged during the pandemic. RESULTS Findings indicated an overall perceived worsening of stress, anxiety, and depression symptoms across all groups. A higher-than-expected proportion of individuals who increased their cannabis consumption reached threshold for minimal clinically important worsening of depression, X2(3) = 10.795, p = 0.013 (Cramer's V = 0.166). CONCLUSION Overall, those who increased cannabis use during the pandemic were more prone to undergo meaningful perceived worsening of depression symptoms. Prospective investigations will be critical next steps to determine the directionality of the relationship between cannabis and depressive symptoms.
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Affiliation(s)
- A. Murkar
- grid.28046.380000 0001 2182 2255University of Ottawa Institute of Mental Health Research at The Royal, Sleep Research Unit, 1145 Carling Ave, ON K1Z 7K4 Ottawa, Canada
| | - T. Kendzerska
- grid.412687.e0000 0000 9606 5108The Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - J. Shlik
- grid.414622.70000 0001 1503 7525The Royal Ottawa Mental Health Centre, Ottawa, ON Canada
| | - L. Quilty
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - M. Saad
- grid.28046.380000 0001 2182 2255University of Ottawa Institute of Mental Health Research at The Royal, Sleep Research Unit, 1145 Carling Ave, ON K1Z 7K4 Ottawa, Canada
| | - R. Robillard
- grid.28046.380000 0001 2182 2255University of Ottawa Institute of Mental Health Research at The Royal, Sleep Research Unit, 1145 Carling Ave, ON K1Z 7K4 Ottawa, Canada ,grid.28046.380000 0001 2182 2255University of Ottawa School of Psychology, ON Ottawa, Canada
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Figueroa-Hall LK, Xu B, Kuplicki R, Ford BN, Burrows K, Teague TK, Sen S, Yeh HW, Irwin MR, Savitz J, Paulus MP. Psychiatric symptoms are not associated with circulating CRP concentrations after controlling for medical, social, and demographic factors. Transl Psychiatry 2022; 12:279. [PMID: 35821205 PMCID: PMC9276683 DOI: 10.1038/s41398-022-02049-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 01/08/2023] Open
Abstract
Elevated serum concentrations (>3 mg/L) of the acute-phase protein, C-reactive protein (CRP), is used as a clinical marker of inflammation and is reported to be a strong risk factor for cardiovascular disease. In psychiatric populations, CRP concentration is reported to be higher in depressed versus healthy individuals. Positive associations between CRP and depression have been established in both clinical and community samples, but effect sizes are attenuated after controlling for confounding variables. Similarly, emerging research has begun to draw a link between inflammation, symptoms of anxiety, and substance abuse. Given the high level of comorbid anxiety and substance use disorders in many depressed populations, this study examined whether depression (Patient Health Questionnaire 9 [PHQ-9]) and substance use-related (Drug Abuse Screening Test [DAST]) symptoms were associated with CRP concentrations in the blood after adjusting for relevant medical, social, and demographic covariates in a large sample undergoing screening for several transdiagnostic psychiatric research studies. A total of 1,724 participants were analyzed for association of CRP with variables using multivariate linear regression. An unadjusted model with no covariates showed that PHQ-9 was significantly associated with CRP in All (β = 0.125), Female (β = 0.091), and Male (β = 0.154) participants, but DAST was significantly associated with CRP in males only (β = 0.120). For the adjusted model, in both males and females, mood-stabilizer treatment (β = 0.630), opioid medication (β = 0.360), body mass index (β = 0.244), percent body fat (β = 0.289), nicotine use (β = 0.063), and self-reported sleep disturbance (β = 0.061) were significantly associated with increased CRP concentrations. In females, oral contraceptive use (β = 0.576), and waist-to-hip ratio (β = 0.086), and in males, non-steroidal anti-inflammatory drug use (β = 0.367) were also associated with increased CRP concentrations. There was no significant association between CRP and individual depressive, anxiety, or substance use-related symptoms when covariates were included in the regression models. These results suggest that associations between circulating CRP and the severity of psychiatric symptoms are dependent on the type of covariates controlled for in statistical analyses.
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Affiliation(s)
| | - Bohan Xu
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
- Department of Computer Science, Tandy School of Computer Science, The University of Tulsa, Tulsa, OK, 74104, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
| | - Bart N Ford
- Department of Pharmacology & Physiology, Oklahoma State University, Center for Health Sciences, Tulsa, OK, 74107, USA
| | - Kaiping Burrows
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
| | - T Kent Teague
- Department of Surgery and Department of Psychiatry, University of Oklahoma-School of Community Medicine, Tulsa, OK, 74135, USA
| | - Sandip Sen
- Department of Computer Science, Tandy School of Computer Science, The University of Tulsa, Tulsa, OK, 74104, USA
| | - Hung-Wen Yeh
- Division of Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, 74199, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, 74199, USA
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Rooney EA, Hallauer CJ, Xie H, Shih CH, Rapport D, Elhai JD, Wang X. Longitudinal PTSD symptom trajectories: Relative contributions of state anxiety, depression, and emotion dysregulation. J Affect Disord 2022; 308:281-288. [PMID: 35452754 PMCID: PMC10693746 DOI: 10.1016/j.jad.2022.04.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/09/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Prospective research on the development and trajectory of PTSD symptoms after a traumatic event is crucial for assessment and early intervention. Further, examining predictors of PTSD pathology provides a better conceptualization of the temporal course of PTSD in trauma victims. METHODS The present study examined PTSD symptom severity in individuals presenting to the emergency department (ED) following a traumatic event. Participants (N = 147) were assessed at four timepoints: 2-weeks, 3-months, between 6 and 9 months, and 12-months after ED admission. Growth curve modeling was conducted to examine changes in PTSD symptom severity over time. Age, sex, state anxiety, trait anxiety, emotion dysregulation, depression, and trauma type (motor vehicle accident [MVA] and assault), and PTSD diagnosis were included as covariates in the model. RESULTS Results demonstrated that baseline PTSD symptom severity was positively associated with severity of depression and state (but not trait) anxiety, emotion dysregulation, and PTSD diagnosis. Results also revealed significant associations with PTSD symptom changes over time; greater state anxiety and depression symptoms at baseline were associated with steeper declines in PTSD symptoms over time. LIMITATIONS Data were collected at only four timepoints over the course of 12-months. Results may be different with more measurement points over longer periods and inclusion of pre-, peri- and post-trauma risk factors. CONCLUSIONS Results illustrate the relevance of assessing state anxiety, depression, and emotion dysregulation in following trauma victims for trauma-related psychopathology over the course of time to alleviate the negative impact of the same.
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Affiliation(s)
- Emily A Rooney
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA
| | - Caleb J Hallauer
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA
| | - Hong Xie
- Department of Neurosciences, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA
| | - Chia-Hao Shih
- Department of Emergency Medicine, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA
| | - Daniel Rapport
- Department of Psychiatry, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA
| | - Jon D Elhai
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA; Department of Psychiatry, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA.
| | - Xin Wang
- Department of Psychiatry, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606, USA
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Changes in Positive Airway Pressure Use in Adults with Sleep-Related Breathing Disorder During the COVID-19 Pandemic: A Cross-Sectional National Community-Based Survey. SLEEP AND VIGILANCE 2022; 6:281-286. [PMID: 35692865 PMCID: PMC9175157 DOI: 10.1007/s41782-022-00207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/04/2022] [Accepted: 05/13/2022] [Indexed: 11/01/2022]
Abstract
Purpose Methods Results Conclusions
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11
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Tamman AJF, Anand A, Mathew SJ. A comparison of the safety, feasibility, and tolerability of ECT and ketamine for treatment-resistant depression. Expert Opin Drug Saf 2022; 21:745-759. [PMID: 35253555 DOI: 10.1080/14740338.2022.2049754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Treatment-resistant depression (TRD) is a problematic and prevalent public health and societal concern. Although electroconvulsive therapy (ECT) is the gold standard TRD intervention, the treatment evokes apprehension due to public perceptions, feasibility, and tolerability. Despite significant medical advancements, few medications have been approved by the U.S. Food and Drug Administration for TRD. In 2019, intranasal esketamine, the S-isomer of racemic ketamine, was approved for TRD, garnering significant excitement about the potential for the drug to act as an alternative treatment to ECT. AREAS COVERED The goal of this narrative review is to compare the safety, efficacy, and tolerability of ketamine and ECT; clarify whether ketamine is a reasonable alternative to ECT; and to facilitate improved treatment assignment for TRD. Empirical quantitative and qualitative studies and national and international guidelines these treatments are reviewed. EXPERT OPINION : The field awaits the results of two ongoing large comparative effectiveness trials of ECT and IV ketamine for TRD, which should help guide clinicians and patients as to the relative risk and benefit of these interventions. Over the next five years we anticipate further innovations in neuromodulation and in drug development which broadly aim to develop more tolerable versions of ECT and ketamine, respectively.
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Affiliation(s)
- Amanda J F Tamman
- Department of Psychology, St. John's University, Queens, NY, USA.,Mood and Anxiety Disorders Program, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Amit Anand
- Department of Psychiatry, Mass General Brigham, Harvard Medical School, Boston, MA, USA
| | - Sanjay J Mathew
- Michael E. Debakey VA Medical Center, Houston, TX, USA.,Mood and Anxiety Disorders Program, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Ning L, Rathi Y, Barbour T, Makris N, Camprodon JA. White matter markers and predictors for subject-specific rTMS response in major depressive disorder. J Affect Disord 2022; 299:207-214. [PMID: 34875281 PMCID: PMC8766915 DOI: 10.1016/j.jad.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has established therapeutic efficacy for major depressive disorder (MDD). While translational research has focused primarily on understanding the mechanism of action of TMS on functional activation and connectivity, the effects on structural connectivity remain largely unknown especially when rTMS is applied using subject-specific brain targets. This study aims to use novel diffusion magnetic resonance imaging (dMRI) analysis to examine microstructural changes related to rTMS treatment response using a unique cohort of 21 patients with MDD treated using rTMS with subject-specific targets. White matter dMRI microstructural measures and clinical scores were captured before and after the full course of treatment. We defined disease-relevant fiber bundles connected to different subregions of the left prefrontal cortex and analyzed changes in diffusion properties as well as correlations between the changes of dMRI measures and the changes in Hamilton Depression Rating Scale (HAMD). No significant changes were observed in tracts connected to the TMS targets. rTMS significantly increased the extra-axonal free-water volume, fractional anisotropy and decreased the radial diffusivity in anterior-medial prefrontal fiber bundles but did not lead to raw changes in lateral prefrontal tracts. That said, the microstructural changes in the lateral prefrontal white matter were significantly correlated with treatment response. Moreover, pre-rTMS dMRI measures of the dorsal anterior cingulate cortex and lateral prefrontal cortex connections are correlated with changes in HAMD scores. Microstructural changes in the anterior-medial and lateral prefrontal white matter are potentially involved in treatment response to TMS, though further investigation is needed using larger datasets.
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Affiliation(s)
- Lipeng Ning
- Brigham and Women's Hospital, Boston, MA, United States of America; Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
| | - Yogesh Rathi
- Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Tracy Barbour
- Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Nikos Makris
- Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Joan A. Camprodon
- Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
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Yahya AS, Khawaja S, Williams PS, Naguib M. Neuromodulation approaches for borderline personality disorder. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2022. [DOI: 10.1002/pnp.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ahmed Saeed Yahya
- Dr Yahya is a Consultant Psychiatrist at the Maudsley Hospital in South London and the Priory Hospital North London
| | - Shakil Khawaja
- Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead at North East London NHS Foundation Trust
| | - Paul Simon Williams
- Dr Williams is a Consultant Forensic Psychiatrist at Barnet, Enfield and Haringey Mental Health NHS Trust
| | - Meena Naguib
- Dr Naguib is a Locum Consultant Psychiatrist at North East London NHS Foundation Trust
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14
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Spilg EG, Rushton CH, Phillips JL, Kendzerska T, Saad M, Gifford W, Gautam M, Bhatla R, Edwards JD, Quilty L, Leveille C, Robillard R. The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic. BMC Psychiatry 2022; 22:19. [PMID: 34991514 PMCID: PMC8734541 DOI: 10.1186/s12888-021-03637-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/30/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Global health crises, such as the COVID-19 pandemic, confront healthcare workers (HCW) with increased exposure to potentially morally distressing events. The pandemic has provided an opportunity to explore the links between moral distress, moral resilience, and emergence of mental health symptoms in HCWs. METHODS A total of 962 Canadian healthcare workers (88.4% female, 44.6 + 12.8 years old) completed an online survey during the first COVID-19 wave in Canada (between April 3rd and September 3rd, 2020). Respondents completed a series of validated scales assessing moral distress, perceived stress, anxiety, and depression symptoms, and moral resilience. Respondents were grouped based on exposure to patients who tested positive for COVID-19. In addition to descriptive statistics and analyses of covariance, multiple linear regression was used to evaluate if moral resilience moderates the association between exposure to morally distressing events and moral distress. Factors associated with moral resilience were also assessed. FINDINGS Respondents working with patients with COVID-19 showed significantly more severe moral distress, anxiety, and depression symptoms (F > 5.5, p < .020), and a higher proportion screened positive for mental disorders (Chi-squared > 9.1, p = .002), compared to healthcare workers who were not. Moral resilience moderated the relationship between exposure to potentially morally distressing events and moral distress (p < .001); compared to those with higher moral resilience, the subgroup with the lowest moral resilience had a steeper cross-sectional worsening in moral distress as the frequency of potentially morally distressing events increased. Moral resilience also correlated with lower stress, anxiety, and depression symptoms (r > .27, p < .001). Factors independently associated with stronger moral resilience included: being male, older age, no mental disorder diagnosis, sleeping more, and higher support from employers and colleagues (B [0.02, |-0.26|]. INTERPRETATION Elevated moral distress and mental health symptoms in healthcare workers facing a global crisis such as the COVID-19 pandemic call for the development of interventions promoting moral resilience as a protective measure against moral adversities.
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Affiliation(s)
- Edward G Spilg
- Department of Medicine, University of Ottawa and Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada.
| | - Cynda Hylton Rushton
- Berman Institute of Bioethics & School of Nursing, Johns Hopkins University, 1809 Ashland Avenue, Baltimore, MD, 21205, USA
| | - Jennifer L Phillips
- The University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
- Faculty of Medicine, University of Ottawa, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
| | - Tetyana Kendzerska
- Department of Medicine, University of Ottawa and Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
| | - Mysa Saad
- The University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
- Faculty of Medicine, University of Ottawa, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
| | - Wendy Gifford
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Mamta Gautam
- Faculty of Medicine, University of Ottawa, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
| | - Rajiv Bhatla
- Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
| | - Jodi D Edwards
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario, K1G 5Z3, Canada
| | - Lena Quilty
- Centre for Addiction and Mental Health, 1025 Queen Street, Toronto, Ontario, M6J 1H1, Canada
| | - Chloe Leveille
- The University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
| | - Rebecca Robillard
- The University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, Ontario, K1N 6N5, Canada
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15
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Pinciotti CM, Bulkes NZ, Horvath G, Riemann BC. Efficacy of intensive CBT telehealth for obsessive-compulsive disorder during the COVID-19 pandemic. J Obsessive Compuls Relat Disord 2022; 32:100705. [PMID: 34956827 PMCID: PMC8692880 DOI: 10.1016/j.jocrd.2021.100705] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
Despite evidence for the effectiveness of cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD), many individuals with OCD lack access to needed behavioral health treatment. Although some literature suggests that virtual modes of treatment for OCD are effective, it remains unclear whether intensive programs like partial hospitalization and intensive outpatient programs (PHP and IOPs) can be delivered effectively over telehealth (TH) and within the context of a global pandemic. Limited extant research suggests that clinicians perceive attenuated treatment response during the pandemic. The trajectory and outcomes of two matched samples were compared using linear mixed modeling: a pre-COVID in-person (IP) sample (n = 239) and COVID TH sample (n = 239). Findings suggested that both modalities are effective at treating OCD and depressive symptoms, although the pandemic TH group required an additional 2.6 treatment days. The current study provides evidence that PHP and IOP treatment delivered via TH during the COVID-19 pandemic is approximately as effective as pre-pandemic IP treatment and provides promising findings for the future that individuals with complicated OCD who do not have access to IP treatment can still experience significant improvement in symptoms through TH PHP and IOP treatment during and potentially after the pandemic.
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Affiliation(s)
- Caitlin M Pinciotti
- Rogers Behavioral Health System, 34700 Valley Rd., Oconomowoc, WI 53066, USA
| | - Nyssa Z Bulkes
- Rogers Behavioral Health System, 34700 Valley Rd., Oconomowoc, WI 53066, USA
| | - Gregor Horvath
- Rogers Behavioral Health System, 34700 Valley Rd., Oconomowoc, WI 53066, USA
| | - Bradley C Riemann
- Rogers Behavioral Health System, 34700 Valley Rd., Oconomowoc, WI 53066, USA
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16
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Diurnal preference and depressive symptomatology: a meta-analysis. Sci Rep 2021; 11:12003. [PMID: 34099766 PMCID: PMC8184740 DOI: 10.1038/s41598-021-91205-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/24/2021] [Indexed: 02/05/2023] Open
Abstract
Eveningness, a preference for later sleep and rise times, has been associated with a number of negative outcomes in terms of both physical and mental health. A large body of evidence links eveningness to Major Depressive Disorder (MDD). However, to date, evidence quantifying this association is limited. The current meta-analysis included 43 effect sizes from a total 27,996 participants. Using a random-effects model it was demonstrated that eveningness is associated with a small effect size (Fisher's Z = - 2.4, 95% CI [- 0.27. - 0.21], p < 0.001). Substantial heterogeneity between studies was observed, with meta-regression analyses demonstrating a significant effect of mean age on the association between diurnal preference and depression. There was also evidence of potential publication bias as assessed by visual inspection of funnel plots and Egger's test. The association between diurnal preference and depression is small in magnitude and heterogenous. A better understanding of the mechanistic underpinnings linking diurnal preference to depression and suitably powered prospective studies that allow causal inference are required.
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17
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Khan A, Palka J, Joshi PH, Khera A, Brown ES. Association of depressive symptom severity with coronary artery calcium: The Dallas heart study. J Affect Disord 2020; 276:267-271. [PMID: 32697708 PMCID: PMC7484243 DOI: 10.1016/j.jad.2020.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/19/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous studies have yielded mixed results regarding the relationship between depressive symptoms and coronary artery calcium (CAC). This analysis sought to evaluate this relationship using a multiethnic, population-based cohort. METHODS Data were extracted from the second phase of the Dallas Heart Study (DHS-2). Depressive symptom severity was measured with the 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS), a validated depressive symptom severity scale. A regression analysis was performed using QIDS score as the predictor variable and CAC as the outcome variable. Covariates included age, sex, ethnicity, diabetes, hypertension, smoking, systolic blood pressure, total cholesterol, HDL cholesterol, and body mass index. RESULTS The cohort consisted of 2,293 individuals with a mean age of 50 years and included 47.1% female and 47.1% black participants. The mean QIDS score was 4.37(±3.69), and 43.3% had CAC > 0. Regression results indicated that QIDS does not statistically significantly predict whether one does or does not have CAC, when controlling for age, sex, and ethnicity (β = 0.088, p = .240, OR = 1.092, 95% CI 0.943-1.264). LIMITATIONS Cross sectional design is limited to one point in time, very depressed patients with higher CAC burden may not have participated, and depressive symptoms may be associated with subclinical atherosclerosis differently with a formal diagnosis of depression. CONCLUSION Depressive symptoms were not associated with presence or severity of CAC in a multiethnic population based sample. Future studies are needed to determine if other prognostic markers of coronary heart disease are associated with depressive symptoms.
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Affiliation(s)
- Amber Khan
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas,Dallas, TX, USA
| | - Jayme Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas,Dallas, TX, USA
| | - Parag H Joshi
- Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Amit Khera
- Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas,Dallas, TX, USA.
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18
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Cameron L, Palikhe NS, Laratta C, Vliagoftis H. Elevated Circulating Th2 Cells in Women With Asthma and Psychological Morbidity: A New Asthma Endotype? Clin Ther 2020; 42:1015-1031. [PMID: 32482491 DOI: 10.1016/j.clinthera.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Psychological stress shifts the immune system toward the production of T-helper (Th)-2-mediated cytokines and eosinophilia, increases the risks for both asthma and depression, and can precipitate asthma exacerbations. Th2-mediated inflammation is a characteristic of allergic asthma. We have shown that the levels of CD4+ Th2 cells in the peripheral blood of patients with asthma are associated with severity and/or control of the disease. To improve our understanding of the interactions between stress and asthma symptoms, we evaluated the effects of psychological comorbidity on Th2-mediated inflammation in patients with asthma. METHODS Sixty-six asthmatic patients were recruited from the University of Alberta Asthma Clinic after they gave informed consent. Stress-related effects on asthma and psychological morbidity were assessed using the Asthma Control Questionnaire, completed by the patients at recruitment. Venous blood was collected at recruitment and Th2-mediated immunity evaluated by flow cytometry, quantitative real-time reverse-transcription polymerase chain reaction and enzyme-linked immunosorbent assay. FINDINGS Patients with stress-triggered asthma (n = 12) had higher percentage of CD4+ T cells (P = 0.006) and Th2 cells (CD4+CRTh2+ T cells; P = 0.002) in peripheral blood compared to patients with asthma who did not experience stress-related worsening of disease (n = 54). The same was true when we analyzed patients with any form of psychological comorbidity (n = 19) compared to those without psychological comorbidities (n = 47). These differences were evident among women, but not among men. Women with psychological comorbidity also required higher doses of inhaled and oral corticosteroids compared to those without psychological comorbidity. IMPLICATIONS Asthma involving psychological morbidity associates with an elevated level of circulating Th2 cells and increased corticosteroid usage, and may be more prevalent in women. Larger-scale prospective studies are required for assessing whether these women constitute a new endotype of Th2-high asthma responsive to treatments aimed to improve psychological comorbidities.
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Affiliation(s)
- Lisa Cameron
- Department of Pathology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Respiratory Centre, University of Alberta, Edmonton, Alberta, Canada.
| | - Nami Shrestha Palikhe
- Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Respiratory Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Cheryl Laratta
- Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Respiratory Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Harissios Vliagoftis
- Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Respiratory Centre, University of Alberta, Edmonton, Alberta, Canada
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19
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Increased expression of plasminogen activator inhibitor-1 (PAI-1) is associated with depression and depressive phenotype in C57Bl/6J mice. Exp Brain Res 2019; 237:3419-3430. [DOI: 10.1007/s00221-019-05682-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023]
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20
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Higgins IA, Kundu S, Choi KS, Mayberg HS, Guo Y. A difference degree test for comparing brain networks. Hum Brain Mapp 2019; 40:4518-4536. [PMID: 31350786 PMCID: PMC6865740 DOI: 10.1002/hbm.24718] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
Recently, there has been a proliferation of methods investigating functional connectivity as a biomarker for mental disorders. Typical approaches include massive univariate testing at each edge or comparisons of network metrics to identify differing topological features. Limitations of these methods include low statistical power due to the large number of comparisons and difficulty attributing overall differences in networks to local variation. We propose a method to capture the difference degree, which is the number of edges incident to each region in the difference network. Our difference degree test (DDT) is a two-step procedure for identifying brain regions incident to a significant number of differentially weighted edges (DWEs). First, we select a data-adaptive threshold which identifies the DWEs followed by a statistical test for the number of DWEs incident to each brain region. We achieve this by generating an appropriate set of null networks which are matched on the first and second moments of the observed difference network using the Hirschberger-Qi-Steuer algorithm. This formulation permits separation of the network's true topology from the nuisance topology induced by the correlation measure that alters interregional connectivity in ways unrelated to brain function. In simulations, the proposed approach outperforms competing methods in detecting differentially connected regions of interest. Application of DDT to a major depressive disorder dataset leads to the identification of brain regions in the default mode network commonly implicated in this ruminative disorder.
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Affiliation(s)
- Ixavier A. Higgins
- Department of Biostatistics and BioinformaticsRollins School of Public Health, Emory UniversityAtlantaGeorgia
| | - Suprateek Kundu
- Department of Biostatistics and BioinformaticsRollins School of Public Health, Emory UniversityAtlantaGeorgia
| | - Ki Sueng Choi
- Department of Psychiatry and NeurologyEmory University School of MedicineAtlantaGeorgia
| | - Helen S. Mayberg
- Department of Psychiatry and NeurologyEmory University School of MedicineAtlantaGeorgia
| | - Ying Guo
- Department of Biostatistics and BioinformaticsRollins School of Public Health, Emory UniversityAtlantaGeorgia
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21
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Cheng P, Luik AI, Fellman-Couture C, Peterson E, Joseph CL, Tallent G, Tran KM, Ahmedani BK, Roehrs T, Roth T, Drake CL. Efficacy of digital CBT for insomnia to reduce depression across demographic groups: a randomized trial. Psychol Med 2019; 49:491-500. [PMID: 29792241 PMCID: PMC7050476 DOI: 10.1017/s0033291718001113] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Insomnia and depression are highly comorbid and mutually exacerbate clinical trajectories and outcomes. Cognitive behavioral therapy for insomnia (CBT-I) effectively reduces both insomnia and depression severity, and can be delivered digitally. This could substantially increase the accessibility to CBT-I, which could reduce the health disparities related to insomnia; however, the efficacy of digital CBT-I (dCBT-I) across a range of demographic groups has not yet been adequately examined. This randomized placebo-controlled trial examined the efficacy of dCBT-I in reducing both insomnia and depression across a wide range of demographic groups. METHODS Of 1358 individuals with insomnia randomized, a final sample of 358 were retained in the dCBT-I condition and 300 in the online sleep education condition. Severity of insomnia and depression was examined as a dependent variable. Race, socioeconomic status (SES; household income and education), gender, and age were also tested as independent moderators of treatment effects. RESULTS The dCBT-I condition yielded greater reductions in both insomnia and depression severity than sleep education, with significantly higher rates of remission following treatment. Demographic variables (i.e. income, race, sex, age, education) were not significant moderators of the treatment effects, suggesting that dCBT-I is comparably efficacious across a wide range of demographic groups. Furthermore, while differences in attrition were found based on SES, attrition did not differ between white and black participants. CONCLUSIONS Results provide evidence that the wide dissemination of dCBT-I may effectively target both insomnia and comorbid depression across a wide spectrum of the population.
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Affiliation(s)
- Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Annemarie I. Luik
- Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Edward Peterson
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Gabriel Tallent
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Brian K. Ahmedani
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Timothy Roehrs
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Thomas Roth
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
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Akula M, Kulikova A, Khan DA, Brown ES. The relationship between asthma and depression in a community-based sample. J Asthma 2018; 55:1271-1277. [PMID: 29336633 PMCID: PMC6212321 DOI: 10.1080/02770903.2017.1418885] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/07/2017] [Accepted: 12/14/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Asthma is an increasingly prevalent disease that is associated with substantial physical and financial burdens. Additionally, asthma is linked to psychiatric disorders. This study examines the relationship between asthma diagnosis, current depressive symptoms, and lifetime psychiatric disorder history in a large, community-based sample. METHODS We analyzed data from 2168 participants in the Dallas Heart Study, a large, diverse, community-based sample of people designed to be representative of the Dallas County population. Logistic regressions analyzing the relationship between asthma diagnosis and history of a psychiatric disorder, as well as between asthma diagnosis and the Quick Inventory of Depressive Symptomatology (QIDS) scores were performed, controlling for demographic data. RESULTS 13.4% of the sample had an asthma diagnosis. Asthma diagnosis was significantly associated with a history of nervous, emotional, or mental health disorder diagnosis [OR 1.810 (95% CI 1.280-2.559) p = 0.001], and with QIDS scores consistent with moderate or greater current depressive symptom severity [OR 1.586 (95%CI 1.106-2.274) p = 0.012]. The relationships were not moderated by age, gender, race, smoking status, or Body Mass Index. CONCLUSIONS A diagnosis of asthma may be associated with current clinically significant levels of depressive symptoms and a lifetime psychiatric disorder. The current report adds to the existing literature in this area by assessing both current and lifetime symptoms and by using a large and diverse population. The findings highlight the clinical importance of considering the possibility of psychiatric illness in asthma patients and suggest further research in this area is needed.
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Affiliation(s)
- Mahima Akula
- Departments of Psychiatry, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
| | - Alexandra Kulikova
- Departments of Psychiatry, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
| | - David A. Khan
- Internal Medicine, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
| | - E. Sherwood Brown
- Departments of Psychiatry, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
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A randomized controlled double-blind clinical trial comparing versus placebo the effect of an edible algal extract (Ulva Lactuca) on the component of depression in healthy volunteers with anhedonia. BMC Psychiatry 2018; 18:215. [PMID: 29954354 PMCID: PMC6027788 DOI: 10.1186/s12888-018-1784-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 06/12/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The effects of the seaweed extract were evaluated on the animal model equivalent of depression compared with a control group treated with the carrier (spring water) and a reference group treated with Imipramine and showed significative effect. This clinical trial was intended to confirm in humans the potential efficacy identified in animals. The primary objective was to compare against a placebo the effect of Ulva L.L extract in healthy volunteers whose anhedonia was characterized by a component of depression. METHODS Single-centre double-blind randomized placebo-controlled clinical trial on parallel arms of two groups of 45 subjects. The study could include men or women aged 18 to 65 years with anhedonia characterized by a Snaith Hamilton Pleasure Scale score (SHAPS) of ≥5 and feeling low morale for at least four weeks characterized by a component of depression evaluated on the Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR). Evaluation criteria: QIDS-SR; Patient Global Improvement Impression (PGII) and Clinical Global Improvement Impression (CGII). RESULTS 86 subjects were included in the trial: 42 in the placebo group and 44 Ulva group. At D84, QIDS-SR significantly decreased more in the Ulva.L.L. group than in the placebo group (p: 0.0389). This difference is essentially linked to an improvement of the sleep disorders (p: 0.0219), of the psychomotor consequences (p: 0.002) and of the nutrition behaviour (p: 0.0694). 90.1% have the feeling of being improved in the Ulva group vs 72.5% in the placebo group (p: 0.0114) and in parallel 90.9% of the practitioners have the feeling that the subject has improved vs 70.8% (p: 0.0214). CONCLUSION This double-blind randomized placebo-controlled trial shows that daily intake for three months of a water-soluble extract of Ulva L.L. continues to significantly improve the component of depression of subjects presenting anhedonia compared with a placebo. TRIAL REGISTRATION Trial retrospectively registred on ClinicalTrial.gov under ID: NCT03545399 Date: 05/22/2018.
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24
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Nugter MA, Hermens ML, Robbers S, Van Son G, Theunissen J, Engelsbel F. Use of outcome measurements in clinical practice: How specific should one be? Psychother Res 2017; 29:432-444. [DOI: 10.1080/10503307.2017.1408975] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- M. Annet Nugter
- Department of Research and Monitoring, GGZ Noord-Holland-Noord, Heiloo, Netherlands
| | - Marleen L.M. Hermens
- GGZ Ingeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Sylvana Robbers
- Yulius Academy, Yulius Mental Health, Barendrecht, Netherlands
| | - Gabrielle Van Son
- Departement of Care and Quality, GGZ Rivierduinen, Leiden, Netherlands
| | - Jan Theunissen
- GGZ Ingeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Fabiana Engelsbel
- Department of Research and Monitoring, GGZ Noord-Holland-Noord, Heiloo, Netherlands
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Mergen H, Bernstein IH, Tavli V, Ongel K, Tavli T, Tan S. Comparative Validity and Reliability Study of The QIDS-SR16in Turkish and American College Student Samples. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20110223124825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Haluk Mergen
- Uludağ University Family Health Center, Bursa-Turkey
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26
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Feng Y, Huang W, Tian TF, Wang G, Hu C, Chiu HFK, Ungvari GS, Kilbourne AM, Xiang YT. The psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and the Patient Health Questionnaire-9 (PHQ-9) in depressed inpatients in China. Psychiatry Res 2016; 243:92-6. [PMID: 27376668 DOI: 10.1016/j.psychres.2016.06.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/05/2016] [Accepted: 06/15/2016] [Indexed: 12/30/2022]
Abstract
This study examined the psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and Patient Health Questionnaire-9 (PHQ-9). The study sample comprised 297 depressed inpatients. The severity of depressive symptoms was assessed with the Hamilton Rating Scale for Depression, the QIDS-SR and the PHQ-9 in all subjects at baseline and a random sample of 50 subjects two weeks later. The internal consistency, convergent validity, factor structure and sensitivity to change of these scales were assessed. Internal consistency (Cronbach's alpha) of the PHQ-9 and QIDS-SR were 0.88 and 0.83, respectively at baseline and 0.91 and 0.87, respectively at exit. Item to total score correlations were higher for the PHQ-9 than those for the QIDS-SR at baseline and exit. Three domains at baseline and two at study exit of the QIDS-SR had a correlation less than 0.65; while only two items at baseline and no item at exit were less than 0.65 for the PHQ-9. Both the PHQ-9 and the QIDS-SR showed uni-dimensional measurement properties at baseline; the two instruments were less sensitive than the HAMD to detect changes of depressive symptoms suggesting low convergent validity. The QIDS-SR and the PHQ-9 have similar and acceptable psychometric properties in most domains as tested in depressed inpatients.
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Affiliation(s)
- Yuan Feng
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; China Clinical Research Center for Mental Disorders, China; Center of Depression, Beijing Institute for Brain Disorders, China
| | - Wei Huang
- Department of Psychiatry, Harbin First Specialist Hospital, Heilongjiang province, China
| | - Teng-Fei Tian
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; China Clinical Research Center for Mental Disorders, China; Center of Depression, Beijing Institute for Brain Disorders, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; China Clinical Research Center for Mental Disorders, China; Center of Depression, Beijing Institute for Brain Disorders, China.
| | - Chen Hu
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Amy M Kilbourne
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA; Veterans Administration Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Surís A, Holder N, Holliday R, Clem M. Psychometric validation of the 16 Item Quick Inventory of Depressive Symptomatology Self-Report Version (QIDS-SR16) in military veterans with PTSD. J Affect Disord 2016; 202:16-22. [PMID: 27253212 DOI: 10.1016/j.jad.2016.05.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/19/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) is one example of a screening tool for depression, which has been utilized extensively following validation in a number of clinical populations. Despite the strengths of the QIDS-SR16, it has not been validated in military veterans, a particularly unique population considering their exposure to trauma and high rate of psychiatric comorbidities. The current report describes a psychometric validation of the QIDS-SR16 in a sample of United States military veterans diagnosed with military-related PTSD. METHODS Participants (n=240) were administered the QIDS-SR16 and one of two gold-standard semi-structured interviews to establish diagnosis of a current Major Depressive Episode (MDE). The ability to discriminate between individuals with and without a current MDE using the QIDS-SR16 was tested with a stepwise logistic regression. Additionally, an optimal cutoff score for the QIDS-SR16 was established. RESULTS The QIDS-SR16 was able to reliabily discriminate between individuals with and without a current MDE. The optimal cutoff score of the QIDS-SR16 for a current MDE was 13, with a sensitivity of 77.55% and specificity of 56.25%. LIMITATIONS Limitations of this study included underrepresentation of some racial/ethnic groups, the inability to disentangle the potential influence of trauma type and gender on results, and the use of two diagnostic interviews to diagnose current MDE. DISCUSSION The QIDS-SR16 can be effectively utilized in military veterans with comorbid PTSD. However, the calculated cutoff score for this population was higher than the cutoff score for the general population. This could result from the overlap between PTSD and MDE symptoms.
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Affiliation(s)
- Alina Surís
- Veterans Affairs North Texas Health Care System, United States; University of Texas Southwestern Medical Center, United States.
| | - Nicholas Holder
- Veterans Affairs North Texas Health Care System, United States; University of Texas Southwestern Medical Center, United States
| | - Ryan Holliday
- Veterans Affairs North Texas Health Care System, United States; University of Texas Southwestern Medical Center, United States
| | - Matthew Clem
- University of Texas Southwestern Medical Center, United States
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Brennan FX, Gardner KR, Lombard J, Perlis RH, Fava M, Harris HW, Scott R. A Naturalistic Study of the Effectiveness of Pharmacogenetic Testing to Guide Treatment in Psychiatric Patients With Mood and Anxiety Disorders. Prim Care Companion CNS Disord 2015; 17:14m01717. [PMID: 26445691 PMCID: PMC4560190 DOI: 10.4088/pcc.14m01717] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/22/2014] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To examine the effectiveness of genetic testing in a real-world setting and to assess its impact on clinician treatment decisions. METHOD This was a naturalistic, unblinded, prospective analysis of psychiatric patients and clinicians who utilized a commercially available genetic test (between April and October of 2013), which incorporates 10 genes related to pharmacokinetics and pharmacodynamics of psychiatric medications. Each patient's genetic results were provided to participating clinicians, who completed a baseline survey including patient medications, history, and severity of illness. Clinicians were prompted to complete surveys within 1 week of receiving the genetic results and again 3 months later. Patients likewise completed assessments of depression, anxiety, medication side effects, and quality of life at baseline, 1 month, and 3 months. RESULTS Data from 685 patients were collected. Approximately 70% and 29% of patients had primary diagnoses of either a mood or anxiety disorder, respectively. Clinician-reported data, as measured by the Clinical Global Impressions-Improvement scale, indicated that 87% of patients showed clinically measurable improvement (rated as very much improved, much improved, or minimally improved), with 62% demonstrating clinically significant improvement. When analysis was restricted to the 69% of individuals with ≥ 2 prior treatment failures, 91% showed clinically measurable improvement. Patients also reported significant decreases in depression (P < .001), anxiety (P < .001), and medication side effects (P < .001) and increases in quality of life (P < .001). CONCLUSIONS These results suggest that a substantial proportion of individuals receiving pharmacogenetic testing showed clinically significant improvements on multiple measures of symptoms, adverse effects, and quality of life over 3 months. In the absence of a treatment-as-usual comparator, the proportion of improvement attributable to the test cannot be estimated. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01507155.
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Affiliation(s)
- Francis X Brennan
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
| | - Kathryn R Gardner
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
| | - Jay Lombard
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
| | - Roy H Perlis
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
| | - Maurizio Fava
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
| | - Herbert W Harris
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
| | - Rachel Scott
- Genomind, Inc, King of Prussia, Pennsylvania (Drs Brennan, Lombard, and Scott and Ms Gardner); Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Perlis and Fava); and North Carolina Elderly Psychiatric Services, Raleigh (Dr Harris)
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Psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology: a systematic review and meta-analysis. J Psychiatr Res 2015; 60:132-40. [PMID: 25300442 DOI: 10.1016/j.jpsychires.2014.09.008] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/05/2014] [Accepted: 09/11/2014] [Indexed: 02/07/2023]
Abstract
Effective management of depression is predicated upon reliable assessment. The Quick Inventory of Depressive Symptomatology (QIDS) is a depression severity scale with both self-rated (QIDS-SR16) and clinician-rated (QIDS-C16) versions. Although widely used in research, the psychometric properties of the QIDS16 have not been systematically reviewed. We performed a systematic review of studies of the psychometric properties (factor structure, internal consistency, convergent validity, discriminant validity, test-retest reliability and responsiveness to change) of the QIDS-SR16 or QIDS-C16. Six databases were searched: MEDLINE, EMBASE, PsycINFO, CinAHL, Web of Science and the Cochrane Central Register of Controlled Trials. Findings were summarised, bias assessed and correlations with reference standards were pooled. 37 studies (17,118 participants) were included in the review. Both versions of the QIDS16 were unidimensional. Cronbach's alpha ranged from 0.69 to 0.89 for the QIDS-SR16 and 0.65 to 0.87 for the QIDS-C16. The QIDS-SR16 correlated moderately to highly with several depression severity scales. Seven studies were pooled where QIDS-SR16 was correlated with the HRSD-17 (r = 0.76, CI 0.69, 0.81) in patients diagnosed with depression. Four studies examined convergent validity with the QIDS-C16. Four studies examined discriminant validity, for the QIDS-SR16 alone. Eighteen studies had at least one author who was a co-author of the original QIDS16 study. Most studies were conducted in the USA (n = 26). The QIDS-SR16 and the QIDS-C16 are unidimensional rating scales with acceptable internal consistency. To justify the use of the QIDS16 scale in clinical practice, more research is needed on convergent and discriminant validity, and in populations outside the USA.
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Trujols J, de Diego-Adeliño J, Feliu-Soler A, Iraurgi I, Puigdemont D, Alvarez E, Pérez V, Portella MJ. The Spanish version of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16): a psychometric analysis in a clinical sample. J Affect Disord 2014; 169:189-96. [PMID: 25212994 DOI: 10.1016/j.jad.2014.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/25/2014] [Accepted: 08/06/2014] [Indexed: 01/30/2023]
Abstract
BACKGROUND Psychometrically robust and easy-to-administer scales for depressive symptoms are necessary for research and clinical assessment. This is a psychometric study of the Spanish version of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) in a clinical sample. METHOD One-hundred and seventy-three patients (65% women) with a psychiatric disorder including depressive symptoms were recruited. Such symptoms were assessed by means of the QIDS-SR16 and two interviewer-rated instruments: the 17-item Hamilton Depression Rating Scale (HDRS17) and the Clinical Global Impression-Severity (CGI-S) scale. Self-rated measures of health-related quality of life, subjective happiness and perceived social support were also obtained. Dimensionality, internal consistency, construct validity, criterion validity, and responsiveness to change of the QIDS-SR16 were examined. RESULTS Exploratory and confirmatory factor analyses replicated the original one-factor structure. The Spanish version of the QIDS-SR16 showed good to excellent internal consistency (α=0.88), convergent validity [HDRS17 (r=0.77), CGI-S (r=0.78)], and divergent validity [EuroQol-5D Visual Analogue Scale (r=-0.78), Subjective Happiness Scale (r=-0.72)]. The QIDS-SR16 was excellent in discriminating clinically significant from non-significant depressive symptomatology (area under ROC curve=0.93). It also showed a high sensitivity to treatment-related changes: patients with greater clinical improvement showed a greater decrease in QIDS-SR16 scores (p<0.001). LIMITATIONS The study was conducted in a single center, which may limit the generalizability of the findings. CONCLUSIONS The Spanish version of the QIDS-SR16 retains the soundness of metric characteristics of the original version which makes the scale an invaluable instrument to assess depressive symptoms.
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Affiliation(s)
- Joan Trujols
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain.
| | - Javier de Diego-Adeliño
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
| | - Albert Feliu-Soler
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
| | - Ioseba Iraurgi
- DeustoPsych - Unidad de Investigación, Desarrollo e Innovación en Psicología y Salud, Universidad de Deusto, Bilbao, Spain
| | - Dolors Puigdemont
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
| | - Enric Alvarez
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Víctor Pérez
- Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain; Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Maria J Portella
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
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Cameron IM, Crawford JR, Cardy AH, du Toit SW, Lawton K, Hay S, Mitchell K, Sharma S, Shivaprasad S, Winning S, Reid IC. Psychometric properties of the Quick Inventory of Depressive Symptomatology (QIDS-SR) in UK primary care. J Psychiatr Res 2013; 47:592-8. [PMID: 23419617 DOI: 10.1016/j.jpsychires.2013.01.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 11/30/2012] [Accepted: 01/21/2013] [Indexed: 11/29/2022]
Abstract
It is widely believed that severity of depressive disorder should guide treatment selection and many guidelines emphasise this factor. The Quick Inventory of Depressive Symptomatology (QID-SR16) is a self-complete measure of depression severity which includes all DSM-IV criterion symptoms for major depressive disorder. The object of this study was to assess the psychometric properties of the QIDS-SR16 in a primary care sample. Adult primary care patients completed the QIDS-SR16 and were assessed by a psychiatrist (blind to QIDS-SR16) with the 17-item Hamilton Rating Scale for Depression (GRID-HAMD). Internal consistency, homogeneity and convergent and discriminant validity of the QIDS-SR16 were assessed. Severity cut-off scores for QIDS-SR16 were assessed for convergence with HRSD-17 cut-offs. Published methods for converting scores to HRSD-17 were also assessed. Two hundred and eighty-six patients participated: mean age = 49.5 (s.d. = 13.8), 68% female, mean HRSD-17 = 12.6 (s.d. = 7.6). The QIDS-SR16 exhibited acceptable internal consistency (Cronbach's alpha = 0.86), a robust factor structure indicating one underlying dimension and correlated highly with the HRSD-17 (r = 0.79) but differed significantly in how it categorised the severity of depression relative to the HRSD-17 (Wilcoxon Signed Rank Test p < 0.001). Using published methods to convert QIDS-SR16 scores to HRSD-17 scores did not result in alignment of severity categorisation. In conclusion, psychometric properties of the QIDS-SR16 were found to be strong in terms of internal consistency, factor structure and convergent and discriminant validity. Using conventional scoring and conversion methods the scale was found not to concur with the HRSD-17 in categorising the severity of depressive symptoms.
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Affiliation(s)
- Isobel M Cameron
- Applied Medical Sciences (Psychiatry), University of Aberdeen, Clinical Research Centre, Royal Cornhill Hospital, Aberdeen, UK.
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