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Ullrich P, Hummel M, Hauer K, Bauer JM, Werner C. Validity, Reliability, Responsiveness, and Feasibility of the Life-Space Assessment Administered via Telephone in Community-Dwelling Older Adults. THE GERONTOLOGIST 2024; 64:gnad038. [PMID: 37014063 DOI: 10.1093/geront/gnad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The life-space assessment (LSA) is the most commonly used questionnaire to assess life-space mobility (LSM) in older adults, with well-established psychometric properties for face-to-face (FF) administration. However, these properties have not yet been explicitly studied when the LSA is administered by telephone. The aim of this study was to evaluate the concurrent and construct validity, test-retest reliability, responsiveness, and feasibility of a telephone-based LSA version (TE-LSA) in older adults. RESEARCH DESIGN AND METHODS Fifty community-dwelling older adults (age = 79.3 ± 5.3 years) participated in the study. Concurrent validity was assessed against the FF-LSA construct validity by testing 15 a priori hypotheses on expected associations with LSM determinants, test-retest reliability via 2 telephone surveys 1 week apart, responsiveness after 8.5 ± 1.8 months in participants with improved, stable, and worsened mobility defined by 2 external criteria, and feasibility by the completion rate/time and ceiling/floor effects. RESULTS Good to excellent agreement between the 2 different administration methods was found (intraclass correlation coefficient [ICC2,1] = 0.73-0.98). Twelve of 15 (80%) hypotheses on construct validity were confirmed. ICCs for test-retest reliability were good to excellent (ICC2,1 = 0.62-0.94). Minimal detectable change for the TE-LSA total score was 20 points. Standardized response means were large for worsened (0.88), moderate for improved (0.68), and trivial for stable participants (0.04). Completion rate was 100% and mean completion time was 5.5 ± 3.3 min. No ceiling or floor effects were observed for the TE-LSA total score. DISCUSSION AND IMPLICATIONS Telephone administration of the LSA is valid, reliable, responsive, and feasible for assessing LSM in community-dwelling older adults.
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Affiliation(s)
- Phoebe Ullrich
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Merit Hummel
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Klaus Hauer
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen M Bauer
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Christian Werner
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
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Strauss C, Bibby-Jones AM, Jones F, Byford S, Heslin M, Parry G, Barkham M, Lea L, Crane R, de Visser R, Arbon A, Rosten C, Cavanagh K. Clinical Effectiveness and Cost-Effectiveness of Supported Mindfulness-Based Cognitive Therapy Self-help Compared With Supported Cognitive Behavioral Therapy Self-help for Adults Experiencing Depression: The Low-Intensity Guided Help Through Mindfulness (LIGHTMind) Randomized Clinical Trial. JAMA Psychiatry 2023; 80:415-424. [PMID: 36947058 PMCID: PMC10034662 DOI: 10.1001/jamapsychiatry.2023.0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/26/2023] [Indexed: 03/23/2023]
Abstract
Importance Depression is prevalent. Treatment guidelines recommend practitioner-supported cognitive behavioral therapy self-help (CBT-SH) for mild to moderate depression in adults; however, dropout rates are high. Alternative approaches are required. Objective To determine if practitioner-supported mindfulness-based cognitive therapy self-help (MBCT-SH) is superior to practitioner-supported CBT-SH at reducing depressive symptom severity at 16 weeks postrandomization among patients with mild to moderate depression and secondarily to examine if practitioner-supported MBCT-SH is cost-effective compared with practitioner-supported CBT-SH. Design, Setting, and Participants This was an assessor- and participant-blinded superiority randomized clinical trial with 1:1 automated online allocation stratified by center and depression severity comparing practitioner-supported MBCT-SH with practitioner-supported CBT-SH for adults experiencing mild to moderate depression. Recruitment took place between November 24, 2017, and January 31, 2020. The study took place in 10 publicly funded psychological therapy services in England (Improving Access to Psychological Therapies [IAPT]). A total of 600 clients attending IAPT services were assessed for eligibility, and 410 were enrolled. Participants met diagnostic criteria for mild to moderate depression. Data were analyzed from January to October 2021. Interventions Participants received a copy of either an MBCT-SH or CBT-SH workbook and were offered 6 support sessions with a trained practitioner. Main Outcomes and Measures The preregistered primary outcome was Patient Health Questionnaire (PHQ-9) score at 16 weeks postrandomization. The primary analysis was intention-to-treat with treatment arms masked. Results Of 410 randomized participants, 255 (62.2%) were female, and the median (IQR) age was 32 (25-45) years. At 16 weeks postrandomization, practitioner-supported MBCT-SH (n = 204; mean [SD] PHQ-9 score, 7.2 [4.8]) led to significantly greater reductions in depression symptom severity compared with practitioner-supported CBT-SH (n = 206; mean [SD] PHQ-9 score, 8.6 [5.5]), with a between-group difference of -1.5 PHQ-9 points (95% CI, -2.6 to -0.4; P = .009; d = -0.36). The probability of MBCT-SH being cost-effective compared with CBT-SH exceeded 95%. However, although between-group effects on secondary outcomes were in the hypothesized direction, they were mostly nonsignificant. Three serious adverse events were reported, all deemed not study related. Conclusions and Relevance In this randomized clinical trial, practitioner-supported MBCT-SH was superior to standard recommended treatment (ie, practitioner-supported CBT-SH) for mild to moderate depression in terms of both clinical effectiveness and cost-effectiveness. Findings suggest that MBCT-SH for mild to moderate depression should be routinely offered to adults in primary care services. Trial Registration isrctn.org Identifier: ISRCTN13495752.
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Affiliation(s)
- Clara Strauss
- School of Psychology, University of Sussex, Falmer, United Kingdom
- R&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
| | - Anna-Marie Bibby-Jones
- R&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
- School of Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Fergal Jones
- Salmons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, United Kingdom
- Sussex Partnership Foundation NHS Trust, Worthing, United Kingdom
| | - Sarah Byford
- King’s Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Margaret Heslin
- King’s Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Glenys Parry
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Laura Lea
- Sussex Partnership Foundation NHS Trust, Worthing, United Kingdom
| | - Rebecca Crane
- Centre for Mindfulness Research and Practice, School of Psychology, Bangor University, Bangor, United Kingdom
| | | | - Amy Arbon
- University Hospitals Sussex NHS Trust, Royal Sussex County Hospital, Brighton, United Kingdom
- Brighton & Sussex Clinical Trials Unit, Watson Building, University of Brighton, Brighton, United Kingdom
| | - Claire Rosten
- School of Sport and Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Falmer, United Kingdom
- R&D Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
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3
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Pranckeviciene A, Saudargiene A, Gecaite-Stonciene J, Liaugaudaite V, Griskova-Bulanova I, Simkute D, Naginiene R, Dainauskas LL, Ceidaite G, Burkauskas J. Validation of the patient health questionnaire-9 and the generalized anxiety disorder-7 in Lithuanian student sample. PLoS One 2022; 17:e0263027. [PMID: 35085349 PMCID: PMC8794093 DOI: 10.1371/journal.pone.0263027] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/10/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire- 7 (GAD-7) are short screening instruments used for detection of depression and anxiety symptoms in various settings, including general and mental health care as well as the general population. The aim of this study is to evaluate psychometric properties and factorial structure of the PHQ-9 and the GAD-7 in a sample of Lithuanian university students. METHODS 1368 students (mean age 22.5±4.8) completed the PHQ-9 and the GAD-7 questionnaires online; after the completion of the survey, students were asked to provide phone contact for an additional interview. Eligible students were approached later by trained interviewers and completed The Clinical Interview Schedule-Revised for assessment of depressive and anxiety disorders. RESULTS Results showed that the PHQ-9 and the GAD-7 are reliable screening tools for depression and anxiety (Cronbach alpha 0.86 and 0.91, respectively). The one-factor structure of the PHQ-9 and the GAD-7 was confirmed by the Confirmatory Factor Analysis. A cut-off of ≥10 for the PHQ-9 resulted in 71% sensitivity and 66% specificity recognizing students with increased risk for mood or anxiety disorder. For the GAD-7, a cut-off ≥9 resulted in 73% sensitivity and 70% specificity recognizing students at risk. The PHQ-9 was sensitive but not specific in recognizing students with depressive disorders. The sensitivity and specificity of the GAD-7 in differentiating students with generalized anxiety disorders were low. CONCLUSIONS The PHQ-9 and the GAD-7 have sufficient formal psychometric properties, but their clinical utility as diagnostic tools for recognition of depressive and anxiety disorders in students is limited. Due to low specificity and high false positive rates, both scales are recommended only as an initial screening tool for recognition of subjects with increased risk of mental disorders, however positive cases should be later assessed using more comprehensive instruments.
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Affiliation(s)
- Aiste Pranckeviciene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga - Kaunas, Lithuania
| | - Ausra Saudargiene
- Laboratory of Biophysics and Bioinformatics, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Informatics, Vytautas Magnus University, Kaunas, Lithuania
| | - Julija Gecaite-Stonciene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga - Kaunas, Lithuania
| | - Vilma Liaugaudaite
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga - Kaunas, Lithuania
| | - Inga Griskova-Bulanova
- Department of Neurobiology and Biophysics, Institute of Biosciences, Vilnius University, Vilnius, Lithuania
| | - Dovile Simkute
- Department of Neurobiology and Biophysics, Institute of Biosciences, Vilnius University, Vilnius, Lithuania
| | - Rima Naginiene
- Laboratory of Toxicology, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laurynas Linas Dainauskas
- Laboratory of Biophysics and Bioinformatics, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintare Ceidaite
- Department of Informatics, Vytautas Magnus University, Kaunas, Lithuania
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga - Kaunas, Lithuania
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Barnett P, Goulding L, Casetta C, Jordan H, Sheridan-Rains L, Steare T, Williams J, Wood L, Gaughran F, Johnson S. Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews. J Med Internet Res 2021; 23:e26492. [PMID: 34061758 PMCID: PMC8335619 DOI: 10.2196/26492] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/30/2021] [Accepted: 04/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Telemental health care has been rapidly adopted for maintaining services during the COVID-19 pandemic, and a substantial interest is now being devoted in its future role. Service planning and policy making for recovery from the pandemic and beyond should draw on both COVID-19 experiences and the substantial research evidence accumulated before this pandemic. OBJECTIVE We aim to conduct an umbrella review of systematic reviews available on the literature and evidence-based guidance on telemental health, including both qualitative and quantitative literature. METHODS Three databases were searched between January 2010 and August 2020 for systematic reviews meeting the predefined criteria. The retrieved reviews were independently screened, and those meeting the inclusion criteria were synthesized and assessed for risk of bias. Narrative synthesis was used to report these findings. RESULTS In total, 19 systematic reviews met the inclusion criteria. A total of 15 reviews examined clinical effectiveness, 8 reported on the aspects of telemental health implementation, 10 reported on acceptability to service users and clinicians, 2 reported on cost-effectiveness, and 1 reported on guidance. Most reviews were assessed to be of low quality. The findings suggested that video-based communication could be as effective and acceptable as face-to-face formats, at least in the short term. Evidence on the extent of digital exclusion and how it can be overcome and that on some significant contexts, such as children and young people's services and inpatient settings, was found to be lacking. CONCLUSIONS This umbrella review suggests that telemental health has the potential to be an effective and acceptable form of service delivery. However, we found limited evidence on the impact of its large-scale implementation across catchment areas. Combining previous evidence and COVID-19 experiences may allow realistic planning for the future implementation of telemental health.
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Affiliation(s)
- Phoebe Barnett
- Centre for Outcomes Research and Effectiveness, Division of Psychology and Language Sciences, University College London, London, United Kingdom.,NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Lucy Goulding
- King's Improvement Science, Centre for Implementation Science, King's College London, London, United Kingdom
| | - Cecilia Casetta
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom
| | - Harriet Jordan
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Trust, London, United Kingdom
| | - Luke Sheridan-Rains
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Thomas Steare
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Julie Williams
- Centre for Implementation Science, Health Service and Population Research Department, King's College London, London, United Kingdom
| | - Lisa Wood
- Division of Psychiatry, University College London, London, United Kingdom
| | - Fiona Gaughran
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Trust, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom.,Camden and Islington NHS Foundation Trust, London, United Kingdom
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Boede M, Gensichen JS, Jackson JC, Eißler F, Lehmann T, Schulz S, Petersen JJ, Wolf FP, Dreischulte T, Schmidt KFR. Trajectories of depression in sepsis survivors: an observational cohort study. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2021; 25:161. [PMID: 33926493 PMCID: PMC8082919 DOI: 10.1186/s13054-021-03577-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Advances in critical care medicine have led to a growing number of critical illness survivors. A considerable part of them suffers from long-term sequelae, also known as post-intensive care syndrome. Among these, depressive symptoms are frequently observed. Depressive symptom trajectories and associated factors of critical illness survivors have rarely been investigated. Study objective was to explore and compare different trajectories of depressive symptoms in sepsis survivors over 1 year after discharge from ICU. METHODS Data of a randomized controlled trial on long-term post-sepsis care were analyzed post hoc. Depressive symptoms were collected at 1, 6 and 12 months post-ICU discharge using the Major Depression Inventory (MDI), among others. Statistical analyses comprised descriptive analysis, univariate and multivariate, linear and logistic regression models and Growth Mixture Modeling. RESULTS A total of 224 patients were included into this analysis. We identified three latent classes of depressive symptom trajectories: Over the course of 1 year, 152 patients recovered from mild symptoms, 27 patients showed severe persistent symptoms, and 45 patients recovered from severe symptoms. MDI sum scores significantly differed between the three classes of depressive symptom trajectories at 1 and 6 months after ICU discharge (p < 0.024 and p < 0.001, respectively). Compared with other classes, patients with the mild recovered trajectory showed lower levels of chronic pain (median sum score of 43.3 vs. 60.0/53.3 on the Graded Chronic Pain Scale, p < 0.010) and posttraumatic stress (4.6% with a sum score of ≥ 35 on the Posttraumatic Stress Scale 10 vs. 48.1%/33.3%, p < 0.003); and higher levels of health-related quality of life (HRQOL) using the Short Form-36 scale within 1 month after ICU discharge (p < 0.035). CONCLUSIONS In the first year after discharge from ICU, sepsis survivors showed three different trajectories of depressive symptoms. Course and severity of depressive symptoms were associated with chronic pain, posttraumatic stress and reduced HRQOL at discharge from ICU. Regular screening of sepsis survivors on symptoms of depression, chronic pain and posttraumatic stress within 1 year after ICU may be considered. Trial registration ISRCTN, ISRCTN 61744782. Registered April 19, 2011-Retrospectively registered, http://www.isrctn.com/ISRCTN61744782 .
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Affiliation(s)
- Monique Boede
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.
| | - Jochen S Gensichen
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.,Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 10, 80336, Munich, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - James C Jackson
- Department of Medicine, Pulmonary and Critical Care, Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University, Suite 450, 4th Floor 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Fiene Eißler
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.,Paediatrics and Adolescent Medicine, Sanaklinikum Lichtenberg, Fanningerstraße 32, 10365, Berlin, Germany
| | - Thomas Lehmann
- Center for Clinical Studies, Jena University Hospital, Salvador-Allende-Platz 27, 07747, Jena, Germany
| | - Sven Schulz
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany
| | - Juliana J Petersen
- Institute of General Practice, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt a. Main, Germany
| | - Florian P Wolf
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany
| | - Tobias Dreischulte
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 10, 80336, Munich, Germany
| | - Konrad F R Schmidt
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.,Institute of General Practice, Charité University Medicine, Charitéplatz 1, 10117, Berlin, Germany
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Donker T, van Klaveren C, Cornelisz I, Kok RN, van Gelder JL. Analysis of Usage Data from a Self-Guided App-Based Virtual Reality Cognitive Behavior Therapy for Acrophobia: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9061614. [PMID: 32466528 PMCID: PMC7357041 DOI: 10.3390/jcm9061614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/14/2020] [Accepted: 05/22/2020] [Indexed: 11/21/2022] Open
Abstract
This study examined user engagement with ZeroPhobia, a self-guided app-based virtual reality (VR) Cognitive Behavior Therapy for acrophobia symptoms using cardboard VR viewers. Dutch acrophobic adults (n = 96) completed assessments at baseline and immediately following treatment. Primary outcome measures were the Acrophobia Questionnaire (AQ) and the Igroup Presence Questionnaire (IPQ). Usage data consisted of number of VR sessions practiced, practice time, and fear ratings directly after practicing. Results show that of the 66 participants who played at least one level, the majority continued to finish all levels, spending on average 24.4 min in VR. Self-reported fear consistently decreased between the start and finish of levels. Post-test AQ scores depended quadratically on time spent in VR. Higher pre-test AQ scores were significantly associated with subjective anxiety after the first level and a reduction of post-test AQ scores, but not with number of sessions, suggesting it might be more beneficial to play one level for a longer time period instead of practicing many VR levels. Results also show an optimum exposure level at which increasing practice time does not result in increased benefit. Self-guided VR acrophobia treatment is effective and leads to consistent reductions in self-reported anxiety both between levels and after treatment. Most participants progressed effectively to the highest self-exposure level, despite the absence of a therapist.
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Affiliation(s)
- Tara Donker
- Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Psychology, Laboratory of Biological and Personality Psychology, Albert Ludwigs-University of Freiburg, Peter-Kaplan Meierstrasse 8, 79104 Freiburg im Breisgau, Germany
- Correspondence: ; Tel.: +31-20-5988959; Fax: +31-20-5988758
| | - Chris van Klaveren
- Department of Education Sciences, Section Methods and Statistics and Amsterdam Center for Learning Analytics, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; (C.v.K.); (I.C.)
| | - Ilja Cornelisz
- Department of Education Sciences, Section Methods and Statistics and Amsterdam Center for Learning Analytics, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; (C.v.K.); (I.C.)
| | - Robin N. Kok
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
- Centre for Innovative Medical Technology, Odense University Hospital, Indgang 101, 5000 Odense, Denmark
| | - Jean-Louis van Gelder
- Institute of Education and Child Studies, Leiden University, Pieter de la Court building, 4th floor, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands;
- Max Planck Institute for the Study of Crime, Security and Law, Department of Criminology, Günterstalstraße 73, 79100 Freiburg, Germany
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Deacon RM, Mammen K, Holmes J, Dunlop A, Bruno R, Mills L, Graham R, Lintzeris N. Assessing the validity of the Australian Treatment Outcomes Profile for telephone administration in drug health treatment populations. Drug Alcohol Rev 2020; 39:441-446. [DOI: 10.1111/dar.13088] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Rachel M. Deacon
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and HealthThe University of Sydney Sydney Australia
- Drug and Alcohol ServicesSouth Eastern Sydney Local Health District Sydney Australia
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
| | - Kristie Mammen
- Drug and Alcohol ServicesSouth Eastern Sydney Local Health District Sydney Australia
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
| | - Jennifer Holmes
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
- Alcohol and other Drugs, Centre for Population HealthMinistry of Health Sydney Australia
| | - Adrian Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
- Drug and Alcohol ServicesHunter New England Local Health District Newcastle Australia
- Hunter Medical Research InstituteThe University of Newcastle Newcastle Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research CentreUNSW Sydney Sydney Australia
- School of Psychological SciencesUniversity of Tasmania Hobart Australia
| | - Llewellyn Mills
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and HealthThe University of Sydney Sydney Australia
- Drug and Alcohol ServicesSouth Eastern Sydney Local Health District Sydney Australia
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
| | - Robert Graham
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
- Drug HealthWestern Sydney Local Health District Sydney Australia
- School of MedicineWestern Sydney University Sydney Australia
| | - Nicholas Lintzeris
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and HealthThe University of Sydney Sydney Australia
- Drug and Alcohol ServicesSouth Eastern Sydney Local Health District Sydney Australia
- NSW Drug and Alcohol Clinical Research and Improvement Network Sydney Australia
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8
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Strauss C, Arbon A, Barkham M, Byford S, Crane R, de Visser R, Heslin M, Jones AM, Jones F, Lea L, Parry G, Rosten C, Cavanagh K. Low-Intensity Guided Help Through Mindfulness (LIGHTMIND): study protocol for a randomised controlled trial comparing supported mindfulness-based cognitive therapy self-help to supported cognitive behavioural therapy self-help for adults experiencing depression. Trials 2020; 21:374. [PMID: 32366320 PMCID: PMC7199325 DOI: 10.1186/s13063-020-04322-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/10/2020] [Indexed: 12/18/2022] Open
Abstract
Background Depression has serious personal, family and economic consequences. It is estimated that it will cost £12.15 billion to the economy each year in England by 2026. Improving access to psychological therapies (IAPT) is the National Health Service talking therapies service in England for adults experiencing anxiety or depression. Over 1 million people are referred to IAPT every year, over half experiencing depression. Where symptoms of depression are mild to moderate, people are typically offered cognitive behavioural therapy (CBT) self-help (CBT-SH) supported by a psychological well-being practitioner. The problem is that over half of people who complete treatment for depression in IAPT remain depressed despite receiving National Institute of Health and Care Excellent recommended treatment. Furthermore, less than half of IAPT service users complete treatment. This study seeks to investigate the effectiveness of an alternative to CBT-SH. Mindfulness-based cognitive therapy (MBCT) differs from CBT in focus, approach and practice, and may be more effective with a higher number of treatment completions. Methods/design This is a definitive randomised controlled trial comparing supported MBCT self-help (MBCT-SH) with CBT-SH for adults experiencing mild to moderate depression being treated in IAPT services. We will recruit 410 participants experiencing mild to moderate depression from IAPT services and randomise these to receive either an MBCT-based self-help workbook or a CBT-based self-help workbook. Participants will be asked to complete their workbook within 16 weeks, with six support sessions with a psychological well-being practitioner. The primary outcome is depression symptom severity on treatment completion. Secondary outcomes are treatment completion rates and measures of generalized anxiety, well-being, functioning and mindfulness. An exploratory non-inferiority analysis will be conducted in the event the primary hypothesis is not supported. A semi-structured interview with participants will guide understanding of change processes. Discussion If the findings from this randomised controlled trial demonstrate that MBCT-SH is more effective than CBT-SH for adults experiencing depression, this will provide evidence for policy makers and lead to changes to clinical practice in IAPT services, leading to greater choice of self-help treatment options and better outcomes for service users. If the exploratory non-inferiority analysis is conducted and this indicates non-inferiority of MBCT-SH in comparison to CBT-SH this will also be of interest to policy makers when seeking to increase service user choice of self-help treatment options for depression. Trial registration Current Controlled Trial registration number: ISRCTN 13495752. Registered on 31 August 2017 (www.isrctn.com/ISRCTN13495752).
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Affiliation(s)
- Clara Strauss
- School of Psychology, University of Sussex, Pevensey Building, Falmer, BN1 9QH, UK. .,Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.
| | - Amy Arbon
- Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK.,Brighton & Sussex Clinical Trials Unit, Bevendean House, University of Brighton, Falmer, BN1 9PH, UK
| | - Michael Barkham
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, S10 2TP, Sheffield, UK
| | - Sarah Byford
- King's Health Economics Research Group and Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Rebecca Crane
- Centre for Mindfulness Research and Practice, School of Psychology, Bangor University, Bangor, Gwynedd, LL57 2AS, UK
| | - Richard de Visser
- School of Psychology, University of Sussex, Pevensey Building, Falmer, BN1 9QH, UK
| | - Margaret Heslin
- King's Health Economics Research Group and Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Anna-Marie Jones
- Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.,School of Health Sciences, University of Brighton, Village Way, Brighton, BN1 9PH, UK
| | - Fergal Jones
- Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.,Canterbury Christ Church University, Salmons Institute for Applied Psychology, Lucy Fildes Building, 1 Meadow Road, Tunbridge Wells, TN1 2YG, UK
| | - Laura Lea
- Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Glenys Parry
- School of Health and Related Research, University of Sheffield, S10 2TP, Sheffield, UK
| | - Claire Rosten
- School of Health Sciences, University of Brighton, Village Way, Brighton, BN1 9PH, UK
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Pevensey Building, Falmer, BN1 9QH, UK
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Poole DN, Liao S, Larson E, Hedt-Gauthier B, Raymond NA, Bärnighausen T, Smith Fawzi MC. Sequential screening for depression in humanitarian emergencies: a validation study of the Patient Health Questionnaire among Syrian refugees. Ann Gen Psychiatry 2020; 19:5. [PMID: 32042301 PMCID: PMC6998825 DOI: 10.1186/s12991-020-0259-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 01/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the need for mental health surveillance in humanitarian emergencies, there is a lack of validated instruments. This study evaluated a sequential screening process for major depressive disorder (MDD) using the two- and eight-item Patient Health Questionnaires (PHQ-2 and PHQ-8, respectively). METHODS This study analyzed data collected during a cross-sectional survey in a Syrian refugee camp in Greece (n = 135). The response rate for each instrument was assessed, and response burden was calculated as the number of items completed. The sequential screening process was simulated to replicate the MDD classifications captured if the PHQ-2 was used to narrow the population receiving the full PHQ-8 assessment. All respondents were screened using the PHQ-2. Only respondents scoring ≥ 2 are considered at risk for symptoms of MDD and complete the remaining six items. The positive and negative percent agreement of this sequential screening process were evaluated. RESULTS The PHQ-2, PHQ-2/8 sequential screening process, and PHQ-8 were completed by 91%, 87%, and 84% of respondents, respectively. The sequential screening process had a positive percent agreement of 89% and a negative percent agreement of 100%, and eliminated the need to complete the full PHQ-8 scale for 34 (25%) respondents. CONCLUSIONS The benefits of the sequential screening approach for the classification of MDD presented here are twofold: preserving classification accuracy relative to the PHQ-2 alone while reducing the response burden of the PHQ-8. This sequential screening approach is a pragmatic strategy for streamlining MDD surveillance in humanitarian emergencies.
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Affiliation(s)
- Danielle N. Poole
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA
- Harvard Humanitarian Initiative, Harvard T.H. Chan School of Public Health, 14 Story Street, Cambridge, MA 02138 USA
- Neukom Institute for Computational Science, Dartmouth College, Hanover, NH 03755 USA
| | - Shirley Liao
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA
| | - Elysia Larson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA
| | - Bethany Hedt-Gauthier
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115 USA
| | - Nathaniel A. Raymond
- Jackson Institute of Global Affairs, Yale University, 55 Hillhouse Avenue, New Haven, CT 06520 USA
| | - Till Bärnighausen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA
- Institute for Public Health, Faculty of Medicine, Heidelberg University, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Africa Health Research Institute, Mtubatuba, 3935 KwaZulu-Natal South Africa
| | - Mary C. Smith Fawzi
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115 USA
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Hung YW, Musci R, Tol W, Aketch S, Bachani AM. Longitudinal depressive and anxiety symptoms of adult injury patients in Kenya and their risk factors. Disabil Rehabil 2019; 42:3816-3824. [PMID: 31081392 DOI: 10.1080/09638288.2019.1610804] [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: 10/26/2022]
Abstract
Background: Injuries account for a significant proportion of the health and economic burden for populations in low- and middle-income countries. However, little is known about psychological distress trajectories amongst injury survivors in low- and middle-income countries.Methods: Adult injury patients (n = 644) admitted to Kenyatta National Hospital in Nairobi, Kenya, were enrolled and interviewed in the hospital, and at 1, 2-3, and 4-7 months after hospital discharge through phone to assess depressive and anxiety symptoms and level of disability. Growth mixture modeling was applied to identify latent trajectories of depressive and anxiety symptoms.Results: Elevated depressive and moderate-level anxiety symptoms (13%) and low depressive and anxiety symptoms (87%) trajectories were found between hospitalization and up to seven months after hospital discharge. Being female, prior trauma experience, longer hospitalization, worse self-rated health status while in the hospital, and lack of monetary assistance during hospitalization were associated with the elevated symptoms trajectory. The higher symptoms trajectory associated with higher disability levels after hospital discharge and significantly lower proportion of resuming daily activities and work.Conclusion: The persistence of elevated depressive symptoms and associated reduced functioning several months after physical injury underscores the importance of identifying populations at risk for preventive and early interventions.Implications for RehabilitationHealth providers following up with injury survivors should screen for depressive and anxiety symptomsSpecial attention to women and people with a potential traumatic exposure historyIncorporation of evidence-based culturally adapted psychosocial interventions in rehabilitation and outpatient clinics.
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Affiliation(s)
- Yuen W Hung
- Department of Health Sciences, Wilfred Laurier University, Waterloo, Canada
| | - Rashelle Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wietse Tol
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Abdulgafoor M Bachani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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11
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Hung YW, Tol W, Musci R, Aketch S, Bachani AM. Trauma Exposure, Posttraumatic Stress Disorder Symptoms Trajectory, and Disability Level Among Hospitalized Injury Survivors in Kenya. J Trauma Stress 2019; 32:108-118. [PMID: 30720891 PMCID: PMC6386584 DOI: 10.1002/jts.22373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 10/04/2018] [Accepted: 10/28/2018] [Indexed: 11/10/2022]
Abstract
Potentially traumatic events (PTEs) have been consistently associated with posttraumatic stress disorder (PTSD). However, the extent of association and attribution to subsequent disability has varied, with limited studies conducted in urban low-income contexts. This longitudinal study estimated the trajectory of PTSD symptoms up to 7 months after hospitalization and the associated disability level among adult patients who had been hospitalized due to injury. Adult injury patients (N = 476) admitted to Kenyatta National Hospital in Nairobi, Kenya, were interviewed in person in the hospital, and via phone at 1, 2-3, and 4-7 months after hospital discharge. Using latent growth curve modeling, two trajectories of PTSD symptoms emerged: (a) persistently elevated PTSD symptoms (9.2%), and (b) low PTSD symptoms (90.8%). Number of PTEs experienced remained moderately associated with the elevated trajectory after controlling for in-hospital depressive symptoms. Having previously witnessed killings or serious injuries, AOR = 2.32, 95% CI [1.07, 5.05]; being female, AOR = 4.74, 95% CI [4.53, 4.96]; elevated depressive symptoms during hospitalization, AOR = 2.96, 95% CI [1.28, 6.83]; and having no household savings/assets, AOR = 1.28, 95% CI [1.13, 1.44], were associated with the elevated PTSD symptoms trajectory class after controlling for other risk factors. Latent membership in the elevated PTSD trajectory was associated with a significantly higher level of disability several months after hospital discharge, p < .001, after controlling for injury and demographic characteristics. These results underline the associations among in-hospital depressive symptoms, witnessing atrocities, and poverty, and an elevated PTSD symptoms trajectory.
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Affiliation(s)
- Yuen W. Hung
- Department of International Health, Johns Hopkins International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wietse Tol
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rashelle Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Abdulgafoor M. Bachani
- Department of International Health, Johns Hopkins International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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12
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Littlewood E, Ali S, Dyson L, Keding A, Ansell P, Bailey D, Bates D, Baxter C, Beresford-Dent J, Clarke A, Gascoyne S, Gray C, Hackney L, Hewitt C, Hutchinson D, Jefferson L, Mann R, Marshall D, McMillan D, North A, Nutbrown S, Peckham E, Pervin J, Richardson Z, Swan K, Taylor H, Waterhouse B, Wills L, Woodhouse R, Gilbody S. Identifying perinatal depression with case-finding instruments: a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy). HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background
Perinatal depression is well recognised as a mental health condition but < 50% of cases are identified in routine practice. A case-finding strategy using the Whooley questions is currently recommended by the National Institute for Health and Care Excellence.
Objectives
To determine the diagnostic accuracy, acceptability and cost-effectiveness of the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to identify perinatal depression.
Design
A prospective diagnostic accuracy cohort study, with concurrent qualitative and economic evaluations.
Setting
Maternity services in England.
Participants
A total of 391 pregnant women.
Main outcome measures
Women completed the Whooley questions, EPDS and a diagnostic reference standard (Clinical Interview Schedule – Revised) during pregnancy (20 weeks) and postnatally (3–4 months). Qualitative interviews were conducted with health professionals (HPs) and a subsample of women.
Results
Diagnostic accuracy results: depression prevalence rates were 10.3% during pregnancy and 10.5% postnatally. The Whooley questions and EPDS (cut-off point of ≥ 10) performed reasonably well, with comparable sensitivity [pregnancy: Whooley questions 85.0%, 95% confidence interval (CI) 70.2% to 94.3%; EPDS 82.5%, 95% CI 67.2% to 92.7%; postnatally: Whooley questions 85.7%, 95% CI 69.7% to 95.2%; EPDS 82.9%, 95% CI 66.4% to 93.4%] and specificity (pregnancy: Whooley questions 83.7%, 95% CI 79.4% to 87.4%; EPDS 86.6%, 95% CI 82.5% to 90.0%; postnatally: Whooley questions 80.6%, 95% CI 75.7% to 84.9%; EPDS 87.6%, 95% CI 83.3% to 91.1%). Diagnostic accuracy of the EPDS (cut-off point of ≥ 13) was poor at both time points (pregnancy: sensitivity 45%, 95% CI 29.3% to 61.5%, and specificity 95.7%, 95% CI 93.0% to 97.6%; postnatally: sensitivity 62.9%, 95% CI 44.9% to 78.5%, and specificity 95.7%, 95% CI 92.7% to 97.7%). Qualitative evaluation: women and HPs were supportive of screening/case-finding for perinatal depression. The EPDS was preferred to the Whooley questions by women and HPs, mainly because of its ‘softer’ wording. Whooley question 1 was thought to be less acceptable, largely because of the terms ‘depressed’ and ‘hopeless’, leading to women not revealing their depressive symptoms. HPs identified a ‘patient-centred’ environment that focused on the mother and baby to promote discussion about mental health. Cost-effectiveness results: screening/case-finding using the Whooley questions or the EPDS alone was not the most cost-effective strategy. A two-stage strategy, ‘Whooley questions followed by the Patient Health Questionnaire’ (a measure assessing depression symptomatology), was the most cost-effective strategy in the range between £20,000 and £30,000 per quality-adjusted life-year in both the prenatal and postnatal decision models.
Limitations
Perinatal depression diagnosis was not cross-referenced with women’s medical records so the proportion of new cases identified is unknown. The clinical effectiveness and cost-effectiveness of screening/case-finding strategies was not assessed as part of a randomised controlled trial.
Conclusions
The Whooley questions and EPDS had acceptable sensitivity and specificity, but their use in practice might be limited by low predictive value and variation in their acceptability. A two-stage strategy was more cost-effective than single-stage strategies. Neither case-finding instrument met National Screening Committee criteria.
Future work
The yield of screening/case-finding should be established with reference to health-care records. The clinical effectiveness and cost-effectiveness of screening/case-finding for perinatal depression needs to be tested in a randomised controlled trial.
Funding
The National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Elizabeth Littlewood
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Shehzad Ali
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Lisa Dyson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Ada Keding
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Pat Ansell
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Della Bailey
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Debrah Bates
- Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe General Hospital, Scunthorpe, UK
| | - Catherine Baxter
- Leeds and York Partnership NHS Foundation Trust, Bootham Park Hospital, York, UK
| | - Jules Beresford-Dent
- Leeds and York Partnership NHS Foundation Trust, Bootham Park Hospital, York, UK
| | - Arabella Clarke
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Samantha Gascoyne
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Carol Gray
- Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe General Hospital, Scunthorpe, UK
| | - Lisa Hackney
- Leeds and York Partnership NHS Foundation Trust, Bootham Park Hospital, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Dorothy Hutchinson
- Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe General Hospital, Scunthorpe, UK
| | - Laura Jefferson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Rachel Mann
- Department of Health Sciences, University of York, York, UK
| | - David Marshall
- Leeds and York Partnership NHS Foundation Trust, Bootham Park Hospital, York, UK
| | - Dean McMillan
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
| | - Alice North
- Patient and public involvement representative, York, UK
| | - Sarah Nutbrown
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Emily Peckham
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Jodi Pervin
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Zoe Richardson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Kelly Swan
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Holly Taylor
- Leeds and York Partnership NHS Foundation Trust, Bootham Park Hospital, York, UK
| | - Bev Waterhouse
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Louise Wills
- Harrogate and District NHS Foundation Trust, Harrogate District Hospital, Harrogate, UK
| | - Rebecca Woodhouse
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Simon Gilbody
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
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Costello H, Hayes GM, Highton-Williamson E, Nurock S, Hanbury D, Francis PT. A pilot study of potential brain donor satisfaction and attitudes towards telephone assessment. Int J Geriatr Psychiatry 2017; 32:1247-1256. [PMID: 27714914 DOI: 10.1002/gps.4605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 09/06/2016] [Accepted: 09/15/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Test the feasibility of assessing cognition, psychiatric symptoms and daily living skills of potential brain donors by telephone and compare satisfaction and attitudes across telephone and face-to-face assessment. METHOD Data were collected from 108 healthy participants from the Brains for Dementia Research cohort. Purposive sampling was used to assess feasibility and a randomised control trial design compared satisfaction and attitudes towards telephone and face-to-face assessment. Non-parametric tests were conducted to compare groups, and logistic regression was performed to assess the relationship between satisfaction and participant characteristics. RESULTS Of the 80 participants offered telephone assessment, 67 (83.8%) agreed, 2 (2.5%) had a significant hearing impairment, 4 (5.0%) had potential memory problems and 7 (8.7%) declined. On average, telephone assessments lasted 38 min and duration was negatively associated with Telephone Interview of Cognitive Status-Modified scores (p = 0.001) and positively associated with age (p = 0.040), Neuropsychiatric Inventory scores (p = 0.019), Geriatric Depression Scale (p = 0.035) and Global Deterioration Scale (p = 0.022). Satisfaction was high in respect to organisational and personal aspects; ratings did not differ significantly across telephone and face-to-face assessment groups and were not related to socio-demographic characteristics. Participants undergoing telephone assessment were significantly more likely to hold positive attitudes towards this mode of assessment. CONCLUSIONS Telephone assessment is feasible, time-efficient and acceptable to healthy, potential brain donors. When used with other assessment modes and within the context of established contact, telephone assessment offers greater flexibility to researchers and participants and represents an effective mechanism for overcoming the challenges of growing, ageing cohorts and uncertain resources. Copyright © 2016 John Wiley & Sons, Ltd.
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14
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Identifying depression among adolescents using three key questions: a validation study in primary care. Br J Gen Pract 2017; 66:e65-70. [PMID: 26823267 DOI: 10.3399/bjgp16x683461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Depression in adolescents is a serious psychiatric illness. GPs play an important role in identifying adolescents with depression and those at risk of developing depression. Few validated tools are suitable for identifying adolescent depression in general practice. AIM To determine if three verbally asked key questions are valid for identifying depression in adolescents. DESIGN AND SETTING A cross-sectional, general practice multicentre, validation study was conducted in Oslo, Norway, and Aarhus, Denmark. METHOD A total of 294 adolescents answered three verbally asked key questions followed by a Composite International Diagnostic Interview (CIDI) for psychiatric diagnosis. Inclusion criteria were age (14-16 years) and fluency in the Norwegian or Danish language. The primary outcome was ROC curve statistics in terms of sensitivity and specificity, predictive values, and likelihood ratios of the three key questions. Secondary outcomes were Loevinger's H, Cronbach's α, and prevalence of depression. RESULTS The three key questions met the criteria for construct and criterion validity for detecting depression among the adolescents. ROC curve statistics for the three key questions demonstrated an AUC of 0.79 for the answer 'yes' to either screening question and of 0.73 for the answer 'yes' to the help question. The positive predictive value was 31% and the negative predictive value was 97%. CONCLUSION The three key questions are useful for identifying depression in adolescents in primary health care.
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15
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Salisbury C, O’Cathain A, Thomas C, Edwards L, Montgomery AA, Hollinghurst S, Large S, Nicholl J, Pope C, Rogers A, Lewis G, Fahey T, Yardley L, Brownsell S, Dixon P, Drabble S, Esmonde L, Foster A, Garner K, Gaunt D, Horspool K, Man MS, Rowsell A, Segar J. An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BackgroundHealth services internationally are exploring the potential of telehealth to support the management of the growing number of people with long-term conditions (LTCs).AimTo develop, implement and evaluate new care programmes for patients with LTCs, focusing on two common LTCs as exemplars: depression or high cardiovascular disease (CVD) risk.MethodsDevelopmentWe synthesised quantitative and qualitative evidence on the effectiveness of telehealth for LTCs, conducted a qualitative study based on interviews with patients and staff and undertook a postal survey to explore which patients are interested in different forms of telehealth. Based on these studies we developed a conceptual model [TElehealth in CHronic disease (TECH) model] as a framework for the development and evaluation of the Healthlines Service for patients with LTCs.ImplementationThe Healthlines Service consisted of regular telephone calls to participants from health information advisors, supporting them to make behaviour change and to use tailored online resources. Advisors sought to optimise participants’ medication and to improve adherence.EvaluationThe Healthlines Service was evaluated with linked pragmatic randomised controlled trials comparing the Healthlines Service plus usual care with usual care alone, with nested process and economic evaluations. Participants were adults with depression or raised CVD risk recruited from 43 general practices in three areas of England. The primary outcome was response to treatment and the secondary outcomes included anxiety (depression trial), individual risk factors (CVD risk trial), self-management skills, medication adherence, perceptions of support, access to health care and satisfaction with treatment.Trial resultsDepression trialIn total, 609 participants were randomised and the retention rate was 86%. Response to treatment [Patient Health Questionnaire 9-items (PHQ-9) reduction of ≥ 5 points and score of < 10 after 4 months] was higher in the intervention group (27%, 68/255) than in the control group (19%, 50/270) [odds ratio 1.7, 95% confidence interval (CI) 1.1 to 2.5;p = 0.02]. Anxiety also improved. Intervention participants reported better access to health support, greater satisfaction with treatment and small improvements in self-management, but not improved medication adherence.CVD risk trialIn total, 641 participants were randomised and the retention rate was 91%. Response to treatment (maintenance of/reduction in QRISK®2 score after 12 months) was higher in the intervention group (50%, 148/295) than in the control group (43%, 124/291), which does not exclude a null effect (odds ratio 1.3, 95% CI 1.0 to 1.9;p = 0.08). The intervention was associated with small improvements in blood pressure and weight, but not smoking or cholesterol. Intervention participants were more likely to adhere to medication, reported better access to health support and greater satisfaction with treatment, but few improvements in self-management.The Healthlines Service was likely to be cost-effective for CVD risk, particularly if the benefits are sustained, but not for depression. The intervention was implemented largely as planned, although initial delays and later disruption to delivery because of the closure of NHS Direct may have adversely affected participant engagement.ConclusionThe Healthlines Service, designed using an evidence-based conceptual model, provided modest health benefits and participants valued the better access to care and extra support provided. This service was cost-effective for CVD risk but not depression. These findings of small benefits at extra cost are consistent with previous pragmatic research on the implementation of comprehensive telehealth programmes for LTCs.Trial registrationCurrent Controlled Trials ISRCTN14172341 (depression trial) and ISRCTN27508731 (CVD risk trial).FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Chris Salisbury
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Alicia O’Cathain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Clare Thomas
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Louisa Edwards
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Sandra Hollinghurst
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Jon Nicholl
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Catherine Pope
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Tom Fahey
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
| | - Simon Brownsell
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Padraig Dixon
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Sarah Drabble
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Lisa Esmonde
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Alexis Foster
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katy Garner
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Daisy Gaunt
- Bristol Randomised Trials Collaboration, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Kim Horspool
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Mei-See Man
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Alison Rowsell
- Centre for Applications of Health Psychology, School of Psychology, University of Southampton, Southampton, UK
| | - Julia Segar
- Centre for Primary Care, University of Manchester, Manchester, UK
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Ni MY, Li TK, Pang H, Chan BHY, Yuan BY, Kawachi I, Schooling CM, Leung GM. Direct Participation in and Indirect Exposure to the Occupy Central Movement and Depressive Symptoms: A Longitudinal Study of Hong Kong Adults. Am J Epidemiol 2016; 184:636-643. [PMID: 27760776 DOI: 10.1093/aje/kww103] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 09/08/2016] [Indexed: 01/22/2023] Open
Abstract
Despite the extensive history of social movements around the world, the evolution of population mental health before, during, and after a social movement remains sparsely documented. We sought to assess over time the prevalence of depressive symptoms during and after the Occupy Central movement in Hong Kong and to examine the associations of direct and indirect exposures to Occupy Central with depressive symptoms. We longitudinally administered interviews to 909 adults who were randomly sampled from the population-representative FAMILY Cohort at 6 time points from March 2009 to March 2015: twice each before, during, and after the Occupy Central protests. The Patient Health Questionnaire-9 was used to assess depressive symptoms and probable major depression (defined as Patient Health Questionnaire-9 score ≥10). The absolute prevalence of probable major depression increased by 7% after Occupy Central, regardless of personal involvement in the protests. Higher levels of depressive symptoms were associated with online and social media exposure to protest-related news (incidence rate ratio (IRR) = 1.28, 95% confidence interval (CI): 1.06, 1.55) and more frequent Facebook use (IRR = 1.38, 95% CI: 1.12, 1.71). Higher levels of intrafamilial sociopolitical conflict was associated with more depressive symptoms (IRR = 1.05, 95% CI: 1.01, 1.09). The Occupy Central protests resulted in substantial and sustained psychological distress in the community.
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Littlewood E, Ali S, Ansell P, Dyson L, Gascoyne S, Hewitt C, Keding A, Mann R, McMillan D, Morgan D, Swan K, Waterhouse B, Gilbody S. Identification of depression in women during pregnancy and the early postnatal period using the Whooley questions and the Edinburgh Postnatal Depression Scale: protocol for the Born and Bred in Yorkshire: PeriNatal Depression Diagnostic Accuracy (BaBY PaNDA) study. BMJ Open 2016; 6:e011223. [PMID: 27297012 PMCID: PMC4916566 DOI: 10.1136/bmjopen-2016-011223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Perinatal depression is well recognised as a mental health condition but <50% of cases are identified by healthcare professionals in routine clinical practice. The Edinburgh Postnatal Depression Scale (EPDS) is often used to detect symptoms of postnatal depression in maternity and child services. The National Institute for Health and Care Excellence (NICE) recommends 2 'ultra-brief' case-finding questions (the Whooley questions) to aid identification of depression during the perinatal period, but this recommendation was made in the absence of any validation studies in a perinatal population. Limited research exists on the acceptability of these depression case-finding instruments and the cost-effectiveness of routine screening for perinatal depression. METHODS AND ANALYSIS The diagnostic accuracy of the Whooley questions and the EPDS will be determined against a reference standard (the Client Interview Schedule-Revised) during pregnancy (around 20 weeks) and the early postnatal period (around 3-4 months post partum) in a sample of 379 women. Further outcome measures will assess a range of psychological comorbidities, health-related quality of life and resource utilisation. Women will be followed up 12 months postnatally. The sensitivity, specificity and predictive values of the Whooley questions and the EPDS will be calculated against the reference standard at 20 weeks pregnancy and 3-4 months post partum. Acceptability of the depression case-finding instruments to women and healthcare professionals will involve in-depth qualitative interviews. An existing decision analytic model will be adapted to determine the cost-effectiveness of routine screening for perinatal depression. ETHICS AND DISSEMINATION This study is considered low risk for participants. Robust protocols will deal with cases where risk of depression, self-harm or suicide is identified. The protocol received favourable ethical opinion from the North East-York Research Ethics Committee (reference: 11/NE/0022). The study findings will be published in peer-reviewed journals and presented at relevant conferences.
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Affiliation(s)
- Elizabeth Littlewood
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK
| | - Shehzad Ali
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK
| | - Pat Ansell
- Department of Health Sciences, Epidemiology and Cancer Statistics Research Group, University of York, York, UK
| | - Lisa Dyson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Samantha Gascoyne
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Ada Keding
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Rachel Mann
- Social Policy Research Unit, University of York, York, UK
| | - Dean McMillan
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK Hull York Medical School, University of York, York, UK
| | | | - Kelly Swan
- Department of Health Sciences, Epidemiology and Cancer Statistics Research Group, University of York, York, UK
| | - Bev Waterhouse
- Children, Women & Families Division, Calderdale and Huddersfield NHS Foundation Trust, Calderdale Royal Hospital, Halifax, UK
| | - Simon Gilbody
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK Hull York Medical School, University of York, York, UK
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Pots WTM, Fledderus M, Meulenbeek PAM, ten Klooster PM, Schreurs KMG, Bohlmeijer ET. Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial. Br J Psychiatry 2016; 208:69-77. [PMID: 26250745 DOI: 10.1192/bjp.bp.114.146068] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 12/06/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Depression is a highly prevalent disorder, causing a large burden of disease and substantial economic costs. Web-based self-help interventions seem promising in promoting mental health. AIMS To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control condition (Netherlands Trial Register NTR1296). METHOD Adults with depressive symptoms from the general population were randomised to ACT (n = 82), expressive writing (n = 67) or waiting-list control (n = 87). The main outcome was reduction in depressive symptoms assessed with the Center for Epidemiological Studies - Depression scale. RESULTS Significant reductions in depressive symptoms were found following the ACT intervention, compared with the control group (Cohen's d = 0.56) and the expressive writing intervention (d = 0.36). The effects were sustained at 6-month and 12-month follow-up. CONCLUSIONS Acceptance and commitment therapy as a web-based public mental health intervention for adults with depressive symptoms can be effective and applicable.
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Affiliation(s)
- Wendy T M Pots
- Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
| | - Martine Fledderus
- Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
| | - Peter A M Meulenbeek
- Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
| | - Peter M ten Klooster
- Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
| | - Karlein M G Schreurs
- Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
| | - Ernst T Bohlmeijer
- Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
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Rand SE, Malley JN, Netten AP, Forder JE. Factor structure and construct validity of the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer). Qual Life Res 2015; 24:2601-14. [PMID: 26038214 PMCID: PMC4592701 DOI: 10.1007/s11136-015-1011-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2015] [Indexed: 11/07/2022]
Abstract
Background The ASCOT-Carer is a self-report instrument designed to measure social care-related quality of life (SCRQoL). This article presents the psychometric testing and validation of the ASCOT-Carer four response-level interview (INT4) in a sample of unpaid carers of adults who receive publicly funded social care services in England. Methods Unpaid carers were identified through a survey of users of publicly funded social care services in England. Three hundred and eighty-seven carers completed a face-to-face or telephone interview. Data on variables hypothesised to be related to SCRQoL (e.g. characteristics of the carer, cared-for person and care situation) and measures of carer experience, strain, health-related quality of life and overall QoL were collected. Relationships between these variables and overall SCRQoL score were evaluated through correlation, ANOVA and regression analysis to test the construct validity of the scale. Internal reliability was assessed using Cronbach’s alpha and feasibility by the number of missing responses. Results The construct validity was supported by statistically significant relationships between SCRQoL and scores on instruments of related constructs, as well as with characteristics of the carer and care recipient in univariate and multivariate analyses. A Cronbach’s alpha of 0.87 (seven items) indicates that the internal reliability of the instrument is satisfactory and a low number of missing responses (<1 %) indicates a high level of acceptance. Conclusion The results provide evidence to support the construct validity, factor structure, internal reliability and feasibility of the ASCOT-Carer INT4 as an instrument for measuring social care-related quality of life of unpaid carers who care for adults with a variety of long-term conditions, disability or problems related to old age.
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Affiliation(s)
- Stacey E Rand
- Quality and Outcomes of Person-Centred Care Policy Research Unit (QORU), PSSRU Kent, Cornwallis Building, University of Kent, Canterbury, CT2 7NF, UK.
| | - Juliette N Malley
- Quality and Outcomes of Person-Centred Care Policy Research Unit (QORU), PSSRU Kent, Cornwallis Building, University of Kent, Canterbury, CT2 7NF, UK.,Quality and Outcomes of Person-Centred Care Policy Research Unit (QORU), PSSRU LSE, Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Ann P Netten
- Quality and Outcomes of Person-Centred Care Policy Research Unit (QORU), PSSRU Kent, Cornwallis Building, University of Kent, Canterbury, CT2 7NF, UK
| | - Julien E Forder
- Quality and Outcomes of Person-Centred Care Policy Research Unit (QORU), PSSRU Kent, Cornwallis Building, University of Kent, Canterbury, CT2 7NF, UK
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Pedrero-Pérez EJ, Díaz-Olalla JM. [COOP/WONCA: Reliability and validity of the test administered by telephone]. Aten Primaria 2015; 48:25-32. [PMID: 25962574 PMCID: PMC6880107 DOI: 10.1016/j.aprim.2014.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/14/2014] [Accepted: 12/05/2014] [Indexed: 11/21/2022] Open
Abstract
Objetivo La prueba COOP/WONCA se propuso inicialmente como un autoinforme en el que las respuestas eran apoyadas por dibujos que ilustraban el estado indagado. Estudios posteriores han ratificado su utilidad como mero autoinforme verbal administrado presencialmente. Carecemos de datos sobre su utilidad administrada telefónicamente. El objetivo del presente trabajo es conocer las propiedades psicométricas de la prueba COOP/WONCA para estimar la calidad de vida relacionada con la salud (CVRS), administrada telefónicamente, y compararlas con las obtenidas en otras modalidades de administración previas. Diseño Estudio epidemiológico transversal. Emplazamiento Ciudad de Madrid. Participantes Muestra aleatoria de 802 sujetos adultos, representativa de la población adulta de Madrid, obtenida por estratificación a partir del censo poblacional. Mediciones principales Cuestionario COOP/WONCA de 9 ítems, incluido en una batería más amplia, administrada mediante entrevista telefónica. Resultados El análisis factorial sin restricciones apunta a la unifactorialidad de la escala, que mide un solo constructo latente (CVRS), mostrando una gran consistencia interna, sin diferir significativamente de los hallados mediante administración presencial, descartándose la existencia de sesgos asociados a la modalidad telefónica. Conclusiones La prueba COOP/WONCA aparece como una medida fiable y válida de la CVRS y su administración telefónica no supone alteraciones en los resultados, lo que puede reducir costes en estudios poblacionales, aumentando su eficiencia sin pérdida de calidad en la información recogida.
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Luong G, Charles ST, Rook KS, Reynolds CA, Gatz M. Age differences and longitudinal change in the effects of data collection mode on self-reports of psychosocial functioning. Psychol Aging 2014; 30:106-119. [PMID: 25528065 DOI: 10.1037/a0038502] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study investigated age differences and longitudinal change in mode effects, wherein individuals report less negative and more positive psychosocial functioning with data collection modes that have greater (vs. less) direct contact with interviewers (e.g., in-person interviews vs. telephone interviews). Using 2 longitudinal datasets, the Later Life Study of Social Exchanges (LLSSE) and Swedish Adoption/Twin Study of Aging (SATSA), we tested how mode effects may vary with cohort (baseline age differences) and maturational development (longitudinal change). In Study 1, LLSSE participants (65-90 years old) completed in-person and telephone interviews assessing negative and positive aspects of psychosocial functioning across 2 years. The data collection mode with greater direct contact with interviewers (in-person interviews) was associated with reporting less negative and more positive psychosocial functioning compared to the mode with less direct contact (telephone interviews). These mode effects were more pronounced with older baseline age, but only for the negative psychosocial measures. Mode effects also became stronger over time for reports of negative affect. In Study 2, SATSA participants (38-86 years old) completed mailed questionnaires and questionnaires collected in-person that assessed depressive symptoms and positive affect across 18 years. Consistent with Study 1, participants reported fewer depressive symptoms and more positive affect with greater (vs. less) direct contact with interviewers (questionnaires collected in-person vs. mailed questionnaires). For reports of depressive symptoms, but not positive affect, mode effects were more pronounced with age and time. Together, the results underscore how mode effects may contribute to inconsistent findings in the socioemotional aging literature.
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Affiliation(s)
- Gloria Luong
- Max Planck Research Group "Affect Across the Life span," Max Planck Institute for Human Development
| | - Susan T Charles
- Department of Psychology and Social Behavior, University of California, Irvine
| | - Karen S Rook
- Department of Psychology and Social Behavior, University of California, Irvine
| | | | - Margaret Gatz
- Department of Psychology, University of Southern California, Riverside
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Psychiatric diagnosis by telephone: is it an opportunity? Soc Psychiatry Psychiatr Epidemiol 2014; 49:1677-89. [PMID: 24632782 DOI: 10.1007/s00127-014-0861-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 02/27/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND For reasons of feasibility, diagnostic telephone interviews are frequently used in research of psychiatric morbidity. However, it is unknown whether diagnostic telephone interviews are as valid as diagnostic face-to-face interviews. RESEARCH QUESTION Are diagnostic telephone interviews for psychiatric disorders as valid as diagnostic face-to-face interviews? METHOD A systematic review of original studies in PubMed, PsychINFO and Embase was carried out. We included studies considering (1) the sensitivity and specificity of diagnostic telephone interviews using face-to-face interviews as a golden standard and (2) the agreement between diagnostic telephone and diagnostic face-to-face interviews. Eligible were studies in the general population, in patients at risk for psychiatric disorders and in psychiatric outpatients. We assessed risk of bias with the quality assessment of diagnostic accuracy studies (QUADAS) instrument. RESULTS We included sixteen studies. The included studies were generally small with thirteen studies reporting about <100 participants. Specificity was generally high in populations with low or intermediate prevalence of psychiatric morbidity. Sensitivity was low in these populations, but slightly higher in samples with more psychiatric disorders. Studies with a higher risk of psychiatric disorders generally reported higher percentages of agreement and higher kappa values. Considering the QUADAS-2 criteria, most studies had a medium or high risk of bias, especially concerning patient selection and unbiased judgement of the test. Of the six studies with a medium or low risk of bias, the three studies assessing current anxiety and depressive disorders yielded kappa values between 0.69 and 0.84, indicating good agreement. DISCUSSION There is insufficient evidence that diagnostic telephone interviews for the diagnosis of psychiatric disorders are valid, although results for depression and anxiety disorders seem promising.
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Thomas CL, Man MS, O'Cathain A, Hollinghurst S, Large S, Edwards L, Nicholl J, Montgomery AA, Salisbury C. Effectiveness and cost-effectiveness of a telehealth intervention to support the management of long-term conditions: study protocol for two linked randomized controlled trials. Trials 2014; 15:36. [PMID: 24460845 PMCID: PMC3906859 DOI: 10.1186/1745-6215-15-36] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 01/07/2014] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND As the population ages, more people are suffering from long-term health conditions (LTCs). Health services around the world are exploring new ways of supporting people with LTCs and there is great interest in the use of telehealth: technologies such as the Internet, telephone and home self-monitoring. METHODS/DESIGN This study aims to evaluate the effectiveness and cost-effectiveness of a telehealth intervention delivered by NHS Direct to support patients with LTCs. Two randomized controlled trials will be conducted in parallel, recruiting patients with two exemplar LTCs: depression or raised cardiovascular disease (CVD) risk. A total of 1,200 patients will be recruited from approximately 42 general practices near Bristol, Sheffield and Southampton, UK. Participants will be randomly allocated to either usual care (control group) or usual care plus the NHS Direct Healthlines Service (intervention group). The intervention is based on a conceptual model incorporating promotion of self-management, optimisation of treatment, coordination of care and engagement of patients and general practitioners. Participants will be provided with tailored help, combining telephone advice from health information advisors with support to use a range of online resources. Participants will access the service for 12 months. Outcomes will be collected at baseline, four, eight and 12 months for the depression trial and baseline, six and 12 months for the CVD risk trial. The primary outcome will be the proportion of patients responding to treatment, defined in the depression trial as a PHQ-9 score <10 and an absolute reduction in PHQ-9 ≥5 after 4 months, and in the CVD risk trial as maintenance or reduction of 10-year CVD risk after 12 months. The study will also assess whether the intervention is cost-effective from the perspective of the NHS and personal social services. An embedded qualitative interview study will explore healthcare professionals' and patients' views of the intervention. DISCUSSION This study evaluates a complex telehealth intervention which combines evidence-based components and is delivered by an established healthcare organisation. The study will also analyse health economic information. In doing so, the study hopes to address some of the limitations of previous research by demonstrating the effectiveness and cost-effectiveness of a real world telehealth intervention. TRIAL REGISTRATION Current Controlled Trials: Depression trial ISRCTN14172341 and cardiovascular disease risk trial ISRCTN27508731.
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Affiliation(s)
- Clare L Thomas
- Centre for Academic Primary Care, NIHR School for Primary Care Research, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
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Adverse effects from antidepressant treatment: randomised controlled trial of 601 depressed individuals. Psychopharmacology (Berl) 2014; 231:2921-31. [PMID: 24525810 PMCID: PMC4099525 DOI: 10.1007/s00213-014-3467-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/20/2014] [Indexed: 11/05/2022]
Abstract
RATIONALE Premature discontinuation of antidepressant drugs is a frequent clinical problem. Adverse effects are common, occur early on in treatment and are reported to be one of the main reasons for discontinuation of antidepressant treatment. OBJECTIVES To investigate the association between adverse effects occurring in the first 2 weeks of antidepressant treatment and discontinuation by 6 weeks as the outcome. To investigate the time profile of adverse effects induced by the selective serotonin reuptake inhibitor citalopram and the noradrenaline reuptake inhibitor reboxetine over 12 weeks of treatment. METHODS Six hundred and one depressed individuals were randomly allocated to either citalopram (20 mg daily) or reboxetine (4 mg twice daily). A modified version of the Toronto Side Effects Scale was used to measure 14 physical symptoms at baseline (medication free) and at 2, 6 and 12 weeks after randomisation. RESULTS Individuals randomised to reboxetine reported a greater number of adverse effects and were more likely to stop treatment than individuals receiving citalopram. Dizziness (OR 1.83; 95% CI 1.09, 3.09; p = 0.02) and the total number of adverse effects (OR 1.12; 95% CI 1.00, 1.25; p = 0.06) reported at 2 weeks were associated with discontinuation from overall antidepressant treatment by 6 weeks. Reports of adverse effects tended to reduce throughout the 12 weeks for both antidepressants. CONCLUSIONS The majority of adverse effects were not individually associated with discontinuation from antidepressant treatment. Reports of physical symptoms tended to reduce over time. The physical symptoms that did not reduce over time may represent symptoms of depression rather than antidepressant-induced adverse effects.
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Saedon H. An analysis of ophthalmology trainees' perceptions of feedback for cataract surgery training. Clin Ophthalmol 2014; 8:43-7. [PMID: 24376339 PMCID: PMC3865084 DOI: 10.2147/opth.s54979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design Cross-sectional qualitative study. Participants Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods Semi-structured interviews were conducted via telephone or face to face. Interviews were transcribed and underwent thematic analysis using a qualitative software data package. Main outcome measures The importance of feedback to the trainee and methods to improve the giving of feedback. Results Feedback was thought to be a useful tool for improving performance in cataract surgery by all participants. Emergent themes were the importance of specificity of feedback and having confidence in the supervisor. Participants suggested ways that the feedback given can be improved upon. An insight was gained into how the feedback has an effect on their performance. Conclusion This study showed that trainees perceive the feedback they receive to be of high quality. Feedback enables the trainees to self-reflect and improve their surgical techniques.
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Affiliation(s)
- Habiba Saedon
- Birmingham Midland Eye Centre, Birmingham, West Midlands, UK
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26
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Hedman E, Ljótsson B, Blom K, El Alaoui S, Kraepelien M, Rück C, Andersson G, Svanborg C, Lindefors N, Kaldo V. Telephone versus internet administration of self-report measures of social anxiety, depressive symptoms, and insomnia: psychometric evaluation of a method to reduce the impact of missing data. J Med Internet Res 2013; 15:e229. [PMID: 24140566 PMCID: PMC3806436 DOI: 10.2196/jmir.2818] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 08/06/2013] [Accepted: 08/29/2013] [Indexed: 11/29/2022] Open
Abstract
Background Internet-administered self-report measures of social anxiety, depressive symptoms, and sleep difficulties are widely used in clinical trials and in clinical routine care, but data loss is a common problem that could render skewed estimates of symptom levels and treatment effects. One way of reducing the negative impact of missing data could be to use telephone administration of self-report measures as a means to complete the data missing from the online data collection. Objective The aim of the study was to compare the convergence of telephone and Internet administration of self-report measures of social anxiety, depressive symptoms, and sleep difficulties. Methods The Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR), Montgomery-Åsberg Depression Rating Scale-Self-Rated (MADRS-S), and the Insomnia Severity Index (ISI) were administered over the telephone and via the Internet to a clinical sample (N=82) of psychiatric patients at a clinic specializing in Internet-delivered treatment. Shortened versions of the LSAS-SR and the ISI were used when administered via telephone. Results As predicted, the results showed that the estimates produced by the two administration formats were highly correlated (r=.82-.91; P<.001) and internal consistencies were high in both administration formats (telephone: Cronbach alpha=.76-.86 and Internet: Cronbach alpha=.79-.93). The correlation coefficients were similar across questionnaires and the shorter versions of the questionnaires used in the telephone administration of the LSAS-SR and ISI performed in general equally well compared to when the full scale was used, as was the case with the MADRS-S. Conclusions Telephone administration of self-report questionnaires is a valid method that can be used to reduce data loss in routine psychiatric practice as well as in clinical trials, thereby contributing to more accurate symptom estimates.
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Affiliation(s)
- Erik Hedman
- Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Ryan TA, Bailey A, Fearon P, King J. Factorial invariance of the Patient Health Questionnaire and Generalized Anxiety Disorder Questionnaire. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2013; 52:438-49. [PMID: 24117915 PMCID: PMC4296344 DOI: 10.1111/bjc.12028] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 07/15/2013] [Indexed: 11/27/2022]
Abstract
Objectives The UK's Improving Access to Psychological Therapies (IAPT) programme uses the Patient Health Questionnaire Depression Scale (PHQ-9; Kroenke, Spitzer, & Williams, 2001, J. Gen. Intern. Med., 16, 606) and Generalized Anxiety Disorder Scale (GAD-7; Spitzer et al., 2006, Arch. Intern. Med., 166, 1092) to assess patients' symptoms of depression and anxiety respectively. Data are typically collected via telephone or face-to-face; however, no study has statistically investigated whether the questionnaires' items operate equivalently across these modes of data collection. This study aimed to address this omission. Methods & Results Questionnaire data from patients registered with an IAPT service in London (N = 23,672) were examined. Confirmatory factor analyses suggested that unidimensional factor structures adequately matched observed face-to-face and telephone data for the PHQ-9 and GAD-7. Invariance analyses revealed that while the PHQ-9 had equivalent factor loadings and latent means across data collection methods, the GAD-7 had equivalent factor loadings but unequal latent means. In support of the scales' convergent validity, positive associations between scores on the PHQ-9 and GAD-7 emerged. Conclusions With the exception of the GAD-7's latent means, the questionnaires' factor loadings and latent means were equivalent. This suggests that clinicians may meaningfully compare PHQ-9 data collected face-to-face and by telephone; however, such comparisons with the GAD-7 should be done with caution. Practitioner points The PHQ-9 and GAD-7's factor loadings were equivalent across data collection methods. Only the PHQ-9's latent means were equivalent across data collection methods. Clinicians may be confident collecting PHQ-9 data by telephone and face-to-face and, then, comparing such data. Caution is recommended when determining clinical effectiveness using telephone and face-to-face GAD-7 data. More psychometric research is warranted.
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Affiliation(s)
- Travis A Ryan
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
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Skapinakis P, Bellos S, Koupidis S, Grammatikopoulos I, Theodorakis PN, Mavreas V. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece. BMC Psychiatry 2013; 13:163. [PMID: 23734578 PMCID: PMC3686601 DOI: 10.1186/1471-244x-13-163] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 05/25/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No study in Greece has assessed so far the full range of common mental disorders using a representative sample of the population from both mainland and insular regions of the country. The aim of the present paper was to present the results of the first such study. METHODS The study was carried out between 2009-2010 in a nationally representative sample of 4894 individuals living in private households in Greece. Common mental disorders in the past week were assessed with the revised Clinical Interview Schedule (CIS-R). We also assessed alcohol use disorders (using AUDIT), smoking and cannabis use. RESULTS 14% of the population (Male: 11%, Female: 17%) was found to have clinically significant psychiatric morbidity according to the scores on the CIS-R. The prevalence (past seven days) of specific common mental disorders was as follows: Generalized Anxiety Disorder: 4.10% (95% CI: 3.54, 4.65); Depression: 2.90% (2.43, 3.37); Panic Disorder: 1.88% (1.50, 2.26); Obsessive-Compulsive Disorder: 1.69% (1.33, 2.05); All Phobias: 2.79% (2.33, 3.26); Mixed anxiety-depression: 2.67% (2.22, 3.12). Harmful alcohol use was reported by 12.69% of the population (11.75, 13.62). Regular smoking was reported by 39.60% of the population (38.22, 40.97) while cannabis use (at least once during the past month) by 2.06% (1.66, 2.46). Clinically significant psychiatric morbidity was positively associated with the following variables: female gender, divorced or widowed family status, low educational status and unemployment. Use of all substances was more common in men compared to women. Common mental disorders were often comorbid, undertreated, and associated with a lower quality of life. CONCLUSIONS The findings of the present study can help in the better planning and development of mental health services in Greece, especially in a time of mental health budget restrictions.
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Affiliation(s)
- Petros Skapinakis
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Stefanos Bellos
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Sotirios Koupidis
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Ilias Grammatikopoulos
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Pavlos N Theodorakis
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
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Hajebi A, Motevalian A, Amin-Esmaeili M, Hefazi M, Radgoodarzi R, Rahimi-Movaghar A, Sharifi V. Telephone versus face-to-face administration of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for diagnosis of psychotic disorders. Compr Psychiatry 2012; 53:579-83. [PMID: 21820651 DOI: 10.1016/j.comppsych.2011.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 05/31/2011] [Accepted: 06/07/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE The current study aims to compare telephone vs face-to-face administration of the version of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (SCID) for diagnosis of "any psychotic disorder" in a clinical population in Iran. METHOD The sample consisted of 72 subjects from 2 psychiatric outpatient services in Tehran, Iran. The subjects were interviewed using face-to-face SCID for the purpose of diagnosing psychotic disorders. A second independent telephone SCID was administered to the entire sample within 5 to 10 days, and the lifetime and 12-month diagnoses were compared. RESULTS The positive likelihood ratio of telephone-administered SCID for diagnosis of "any lifetime psychotic disorder" was 5.1 when compared with the face-to-face SCID. The value for the primary psychotic disorders in the past 12 months was lower (2.3). CONCLUSIONS The data indicate that telephone administration of the SCID is an acceptable method to differentiate between subjects with lifetime psychotic disorders and those who have had no psychotic disorders and provides a less resource-demanding alternative to face-to-face assessments.
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Affiliation(s)
- Ahmad Hajebi
- Mental Health Research Centre, Tehran Psychiatric Institute, Tehran University of Medical Sciences, Tehran 15745-344, Iran
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Donker T, van Straten A, Marks I, Cuijpers P. Quick and easy self-rating of Generalized Anxiety Disorder: validity of the Dutch web-based GAD-7, GAD-2 and GAD-SI. Psychiatry Res 2011; 188:58-64. [PMID: 21339006 DOI: 10.1016/j.psychres.2011.01.016] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 05/20/2010] [Accepted: 01/17/2011] [Indexed: 11/15/2022]
Abstract
Screening of Generalized Anxiety Disorder (GAD), which is often undetected and untreated, could be improved by quick and easy web-based data collection. This paper aims to validate the web-based self-rated 7-item GAD-7, its shortened 2-item GAD-2 and a single item from the GAD-7 scale (GAD-SI) to screen for GAD. Of a total of 502 subjects aged 18-80 who rated the web-based GAD-7, Center for Epidemiological Studies Depression scale (CES-D) and Hospital Anxiety and Depression Scale (HADS), 157 (31%) subjects had a WHO Composite International Diagnostic Interview for DSM-IV-disorders by telephone. The GAD-7 had good reliability. Subjects with a GAD-diagnosis had significantly higher means on GAD-2, GAD-SI and GAD-7 than subjects without a GAD-diagnosis. The AUC (Area Under the Curve) of the GAD-SI and GAD-2 was accurate and not significantly different to the GAD-7 AUC. The web-based GAD-SI, GAD-2 and GAD-7 are reliable, valid tools to quickly screen for GAD in busy mental health settings and clinical research. More research is needed to validate the GAD-SI 'Do you have trouble relaxing' to see if its screening properties approach those of the GAD-7.
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Affiliation(s)
- Tara Donker
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands.
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Walters K, Buszewicz M, Weich S, King M. Mixed anxiety and depressive disorder outcomes: prospective cohort study in primary care. Br J Psychiatry 2011; 198:472-8. [PMID: 21628709 DOI: 10.1192/bjp.bp.110.085092] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mixed anxiety and depressive disorder (MADD) is common yet ill-defined, with little known about outcomes. AIMS To determine MADD outcomes over 1 year. METHOD We recruited 250 adults attending seven London general practices with mild-moderate distress. Three groups were defined using a diagnostic interview: MADD, other ICD-10 psychiatric diagnosis, no psychiatric diagnosis. We assessed symptoms of distress (General Health Questionnaire-28), quality of life (12-item Short Form Health Survey), general practitioner (GP) diagnosis and consultation rate at baseline, 3 months and 1 year. RESULTS Two-thirds of participants with MADD had no significant psychological distress at 3 months (61%) or 1 year (69%). However, compared with those with no diagnosis, individuals had twice the risk of significant distress (incidence rate ratio 2.39, 95% CI 1.29-4.42) at 3 months but not 1 year, and persistently lower quality of life (mental health functioning). There was no significant difference in GP consultation rate/diagnosis. CONCLUSIONS The majority with MADD improved, but individuals had an increased risk of significant distress at 3 months and a lower quality of life. As we cannot currently predict those with a poorer prognosis these patients should be actively monitored in primary care.
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Affiliation(s)
- Kate Walters
- Research Department of Primary Care & Population Health, Hampstead Campus, University College London, London, UK.
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A comparison of depression prevalence estimates measured by the Patient Health Questionnaire with two administration modes: computer-assisted telephone interviewing versus computer-assisted personal interviewing. Int J Public Health 2011; 57:225-33. [PMID: 21523617 DOI: 10.1007/s00038-011-0253-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 03/29/2011] [Accepted: 04/03/2011] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To compare depression prevalence estimates measured by the 8-item Patient Health Questionnaire (PHQ-8) with two administration modes in two national surveys. METHODS Data on adults aged 18 years and older who participated in the 2006 Behavioral Risk Factor Surveillance System (BRFSS) (n = 198,678) and those who participated in the 2005-2006 National Health and Nutrition Examination Survey (NHANES) (n = 4,800) were analyzed. RESULTS The crude PHQ-8 depression prevalence estimate using the diagnostic algorithm was higher in BRFSS with computer-assisted telephone interviewing (CATI) (9.16%, SE 0.15) than in NHANES with computer-assisted personal interviewing (CAPI) (6.28%, SE 0.59) (P < 0.001). After adjustment for demographic characteristics, the difference in the prevalence estimates remained (9.68% in BRFSS vs. 6.13% in NHANES, P < 0.001). Similar differences in the depression prevalence estimates using the PHQ-8 cutoff score ≥10 were detected (9.22% in BRFSS vs. 5.15% in NHANES, P < 0.001). Significant differences in the depression prevalence persisted in subgroups stratified by demographic characteristics and major health risk factors and outcomes. CONCLUSIONS The PHQ-8 administered by CATI yielded about 3.5% higher depression prevalence estimate than that by CAPI.
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McComb E, Tuokko H, Brewster P, Chou PHB, Kolitz K, Crossley M, Simard M. Mental alternation test: administration mode, age, and practice effects. J Clin Exp Neuropsychol 2010; 33:234-41. [PMID: 20865619 DOI: 10.1080/13803395.2010.509916] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Administration mode, age, education, and practice effects were examined for the Mental Alternation Test (MAT), a brief orally administered measure of executive function. Participants (N = 135) between the ages of 65 and 85 years completed the MAT twice in person, twice over the telephone, or once in person and once over the telephone. MAT scores did not differ across administration modes. Furthermore, the MAT detected normative decreases in executive ability in later life. The correlation between MAT performance and educational attainment was small. Finally, practice effects, which were influenced by age, were found between administration times. These findings provide important implications for both research and clinical applications of the MAT in older populations.
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Affiliation(s)
- Erin McComb
- Centre on Aging, University of Victoria, Victoria, British Columbia, Canada
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Marceaux JC, Melville CL. Twelve-Step Facilitated Versus Mapping-Enhanced Cognitive-Behavioral Therapy for Pathological Gambling: A Controlled Study. J Gambl Stud 2010; 27:171-90. [DOI: 10.1007/s10899-010-9196-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Donker T, van Straten A, Marks I, Cuijpers P. Brief self-rated screening for depression on the Internet. J Affect Disord 2010; 122:253-9. [PMID: 19679358 DOI: 10.1016/j.jad.2009.07.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 07/20/2009] [Accepted: 07/21/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Internet offers promising possibilities for the quick screening of depression for treatment and research purposes. This paper aims to validate three self-rated measures to screen for depression on the Internet: SID (single-item depression scale), CES-D (Center for Epidemiological Studies Depression scale) and K10 (Kessler psychological distress scale). METHODS Of the 502 subjects aged 18-80 who rated the SID, CES-D and K10 measures on the Internet, 157 (31%) subjects were also interviewed by telephone using the WHO Composite International Diagnostic Interview (C)IDI) for DSM-IV-disorders. RESULTS Cronbach's alpha for both web self-rated measures CES-D and K10 was 0.90. The SID correlated 0.68 (P<0.001) with the CES-D and with the K10. The CES-D correlated 0.84 with the K10 (P<0.001). Subjects with a DSM-IV diagnosis for any depressive disorder had significantly higher means (P<0.001) on the three self-rated measures for depressive symptoms than subjects without a diagnosis of any depressive disorder. Using any depressive disorder as the gold standard, the area under the curve (AUC) of the SID was 0.71 (95% CI: 0.63-0.79), which was significantly lower than the AUC of the CES-D (AUC: 0.84; 95% CI: 0.77-0.90, P=0.003) and of the K10 (AUC: 0.81; 95% CI: 0.73-0.88, P=0.0024). The AUCs for the K10 and CES-D did not differ significantly from each other. LIMITATIONS The CIDI interviews were not recorded, so inter-rater reliability could not be calculated. CONCLUSIONS The CES-D and K10 are reliable, valid tools for care providers to quickly screen depressive patients on the Internet and for researchers to collect data.
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Affiliation(s)
- Tara Donker
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands.
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Cohidon C, Santin G, Geoffroy-Perez B, Imbernon E. Suicide et activité professionnelle en France. Rev Epidemiol Sante Publique 2010; 58:139-50. [DOI: 10.1016/j.respe.2010.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 11/30/2009] [Accepted: 01/05/2010] [Indexed: 10/19/2022] Open
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Meulenbeek P, Willemse G, Smit F, van Balkom A, Spinhoven P, Cuijpers P. Early intervention in panic: pragmatic randomised controlled trial. Br J Psychiatry 2010; 196:326-31. [PMID: 20357312 DOI: 10.1192/bjp.bp.109.072504] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many people suffer from subthreshold and mild panic disorder and are at risk of developing more severe panic disorder. AIMS This study (trial registration: ISRCTN33407455) was conducted to evaluate the effectiveness of an early group intervention based on cognitive-behavioural principles to reduce panic disorder symptomatology. METHOD Participants with subthreshold or mild panic disorder were recruited from the general population and randomised to the intervention (n = 109) or a waiting-list control group (n = 108). The course was offered by 17 community mental health centres. RESULTS In the early intervention group, 43/109 (39%) participants presented with a clinically significant change on the Panic Disorder Severity Scale-Self Report (PDSS-SR) v. 17/108 (16%) in the control group (odds ratio (OR) for favourable treatment response 3.49, 95% CI 1.77-6.88, P = 0.001). The course also had a positive effect on DSM-IV panic disorder status (OR = 1.96, 95% CI=1.05-3.66, P = 0.037). The PDSS-SR symptom reduction was also substantial (between-group standardised mean difference of 0.68). The effects were maintained at 6-month follow-up. CONCLUSIONS People presenting with subthreshold and mild panic disorder benefit from this brief intervention.
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Donker T, Comijs H, Cuijpers P, Terluin B, Nolen W, Zitman F, Penninx B. The validity of the Dutch K10 and extended K10 screening scales for depressive and anxiety disorders. Psychiatry Res 2010; 176:45-50. [PMID: 20071036 DOI: 10.1016/j.psychres.2009.01.012] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 11/19/2008] [Accepted: 01/05/2009] [Indexed: 11/24/2022]
Abstract
The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10, extended with five additional questions focusing on core anxiety symptoms, and were evaluated with the WHO Composite International Diagnostic Interview (CIDI lifetime version 2.1) to assess DSM-IV disorders (major depressive disorder, dysthymia, generalized anxiety disorder, social phobia, panic disorder, agoraphobia). Reliability (Cronbach's alpha) of the Dutch K10 was 0.94. Based on Receiver Operating Characteristics (ROC) analysis, the area under the curve (AUC) for the K10 for any depressive and/or anxiety disorder was found to be 0.87. The extended questions on the EK10 significantly improved the detection of anxiety disorders in particular. With a cut-off point of 20, the K10 reached a sensitivity of 0.80 and a specificity of 0.81 for any depressive and/or anxiety disorder. For the EK10, a cut-off point of 20 and/or at least one positive answer on the additional questions provided a sensitivity of 0.90 and a specificity of 0.75 for detecting any depressive and/or anxiety disorder. The Dutch version of the K10 is appropriate for screening depressive disorders in primary care, while the EK10 is preferred in screening for both depressive and anxiety disorders.
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Affiliation(s)
- Tara Donker
- Department of Clinical Psychology, EMGO Institute, VU University Amsterdam, The Netherlands.
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Candel-Parra E, Córcoles-Jiménez MP, Del Egido-Fernández MA, Villada-Munera A, Jiménez-Sánchez MD, Moreno-Moreno M, Carrión-González M, Denia-Cortés A. [Independence in activities of daily living 6 months after surgery in previously independent elderly patients with hip fracture caused by a fall]. ENFERMERIA CLINICA 2009; 18:309-16. [PMID: 19080883 DOI: 10.1016/s1130-8621(08)75853-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To measure recovery of independence in activities of daily living (ADL) 6 months after surgery in elderly patients (previously independent and without cognitive impairment) with hip fracture caused by a fall. METHOD We performed a longitudinal, prospective cohort study of patients who were previously independent for ADL, or had mild dependence, and who showed no cognitive impairment. Consecutive sampling was performed. The variables studied were age, sex, habitual residence, type of hip fracture, mental status (SPMSQ Pfeiffer), and independence in ADL (according to Barthel Index [BI]) prior to the fall and 6 months after the fall. RESULTS The study included 207 patients. There was a predominance of female sex (74.4%) and pertrochanteric fractures (45.9%). The mean age was 80.17 years old (SD = 6.95), and 7.7% were institutionalized. Six months after surgery, the mean BI score was 73.37 (SD = 26.76) (versus 90.05 before the fall), 16.8% showed urinary incontinence (versus 5.9%), 59.2% walked without assistance (versus 82.4%) and 24.6% climbed stairs unaided (versus 50.7%). The ability to walk down the street was regained in 64.6% (versus 82.1% before the fall). Recovery of autonomy for ADL was statistically significantly lower in patients unable to walk outdoors, who were institutionalized or who had mild cognitive impairment before the fall. CONCLUSIONS Only 33.6% of patients regained prior levels of autonomy 6 months after surgery.
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King KM, Colella TJF, Faris P, Thompson DR. Using the cardiac depression scale in men recovering from coronary artery bypass surgery. J Clin Nurs 2009; 18:1617-24. [DOI: 10.1111/j.1365-2702.2009.02800.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pinto-Meza A, Suárez D, Caseras X, Haro JM, Serrano-Blanco A, Torrubia R. Telephone assessment of behavioral inhibition and activation systems. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2009; 2:66-71. [PMID: 23034240 DOI: 10.1016/s1888-9891(09)72247-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Accepted: 02/20/2009] [Indexed: 06/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES The activity of behavioral inhibition and activation systems (BIS and BAS) has been related to several mental disorders. The availability of a validated questionnaire to assess BIS and BAS over the telephone could aid research. The objective of the present study was to evaluate the procedural validity of telephone administration of the sensitivity to punishment/sensitivity to reward questionnaire (SPSRQ) as a measure of BIS and BAS activity (by means of its two scales: the sensitivity to punishment [SP] scale and the sensitivity to reward [SR] scale). METHODS A total of 231 participants were assessed with the SPSRQ twice (over the telephone and in a self-administered format). Intraclass correlation coefficients and kappa indices were calculated. Additionally, possible differences between the mean scores obtained with the two assessment procedures and internal consistency were explored. RESULTS Telephone and self-assessment of BIS and BAS, by means of the SPSRQ, provided similar results, supporting the procedural validity of telephone administration. A slight but statistically significant tendency (estimated betha = 0.62; 95% CI, 0.33-0.92; p<0.001) toward lower scores was observed for the telephone-administered SP scale and for the interaction "first or second assessment/telephone or self-administered SPSRQ" for the SR scale (p=0.023). CONCLUSIONS The results of the present study support the reliability of telephone assessment of BIS and BAS by means of the SPSRQ.
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Affiliation(s)
- Alejandra Pinto-Meza
- Fundación Sant Joan de Déu, Unidad de Investigación y Desarrollo, Sant Joan de Déu-SSM, Barcelona, España; Unidad de Psicología Médica e Instituto de Neurociencias, Universidad Autónoma de Barcelona, Barcelona, España.
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Claassen C, Kurian B, Trivedi MH, Grannemann BD, Tuli E, Pipes R, Preston AM, Flood A. Telephone-based assessments to minimize missing data in longitudinal depression trials: a project IMPACTS study report. Contemp Clin Trials 2009; 30:13-9. [PMID: 18761427 PMCID: PMC3268227 DOI: 10.1016/j.cct.2008.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Revised: 08/05/2008] [Accepted: 08/07/2008] [Indexed: 11/26/2022]
Abstract
PURPOSE Missing data in clinical efficacy and effectiveness trials continue to be a major threat to the validity of study findings. The purpose of this report is to describe methods developed to ensure completion of outcome assessments with public mental health sector subjects participating in a longitudinal, repeated measures study for the treatment of major depressive disorder. We developed longitudinal assessment procedures that included telephone-based clinician interviews in order to minimize missing data commonly encountered with face-to-face assessment procedures. METHODS A pre-planned, multi-step strategy was developed to ensure completeness of data collection. The procedure included obtaining multiple pieces of patient contact information at baseline, careful education of both staff and patients concerning the purpose of assessments, establishing good patient rapport, and finally being flexible and persistent with phone appointments to ensure the completion of telephone-based follow-up assessments. A well-developed administrative and organizational structure was also put in place prior to study implementation. RESULTS The assessment completion rate for the primary outcome for 310 of 504 subjects who enrolled and completed 52 weeks (at the time of manuscript) of telephone-based follow-up assessments was 96.8%. CONCLUSION By utilizing telephone-based follow-up procedures and adapting our easy-to-use pre-defined multi-step approach, researchers can maximize patient data retention in longitudinal studies.
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Affiliation(s)
- Cindy Claassen
- University of Texas Southwestern Medical Center, Dallas, Texas 75390-9119, USA
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Lee S, Tsang A, Lau L, Mak A, Ng KL, Chan DML. Concordance between telephone survey classification and face-to-face structured clinical interview in the diagnosis of generalized anxiety disorder in Hong Kong. J Anxiety Disord 2008; 22:1403-11. [PMID: 18406569 DOI: 10.1016/j.janxdis.2008.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Revised: 02/04/2008] [Accepted: 02/22/2008] [Indexed: 12/15/2022]
Abstract
Telephone surveys of estimating mental disorders have been found to generate comparable findings to large-scale community surveys but the concordance between telephone instruments and clinical interviews is rarely examined. In this study, 100 Chinese respondents who had taken part in a telephone-based population survey of generalized anxiety disorder (GAD) in Hong Kong were administered the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) by clinical interviewers. The discriminability and predictive indicators of the telephone survey instrument were assessed using receiver operating characteristic analysis. Results showed that the telephone survey instrument identified individuals with a positive SCID diagnosis of GAD better than those without. Although its individual questions performed well in identifying the endorsement of the corresponding core SCID criterion of GAD, further studies are needed to find out the optimal combination of questions in the telephone instrument for identifying GAD in community surveys.
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Affiliation(s)
- Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong.
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Meulenbeek P, Willemse G, Smit F, van Balkom A, Spinhoven P, Cuijpers P. Early intervention in panic: randomized controlled trial and cost-effectiveness analysis. Trials 2008; 9:67. [PMID: 19038038 PMCID: PMC2630960 DOI: 10.1186/1745-6215-9-67] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 11/27/2008] [Indexed: 11/10/2022] Open
Abstract
Background Panic disorder (PD) is a common, severe and persistent mental disorder, associated with a high degree of distress and occupational and social disability. A substantial proportion of the population experiences subthreshold and mild PD and is at risk of developing a chronic PD. A promising intervention, aimed at preventing panic disorder onset and reducing panic symptoms, is the 'Don't Panic' course. It consists of eight sessions of two hours each. The purpose of this study is to evaluate the effectiveness of this early intervention – based on cognitive behavioural principles – on the reduction of panic disorder symptomatology. We predict that the experimental condition show superior clinical and economic outcomes relative to a waitlisted control group. Methods/design A pragmatic, pre-post, two-group, multi-site, randomized controlled trial of the intervention will be conducted with a naturalistic follow-up at six months in the intervention group. The participants are recruited from the general population and are randomized to the intervention or a waitlist control group. The intervention is offered by community mental health centres. Included are people over 18 years of age with subthreshold or mild panic disorder, defined as having symptoms of PD falling below the cut-off of 13 on the Panic Disorder Severity Scale-Self Report (PDSS-SR). Primary outcomes are panic disorder and panic symptoms. Secondary outcomes are symptoms of agoraphobia, anxiety, cognitive aspects of panic disorder, depressive symptoms, mastery, health-related quality of life, and cost-effectiveness. We will examine the following variables as potential mediators: cognitive aspects of panic disorder, symptoms of agoraphobia, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics, panic disorder, agoraphobia, treatment credibility and mastery. Discussion This study was designed to evaluate the (cost) effectiveness of an early intervention based on cognitive behavioural principles. The strong external validity is one of the strengths of the study design. Trial registration Current Controlled Trials ISRCTN33407455.
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Affiliation(s)
- Peter Meulenbeek
- Department of Clinical Psychology and EMGO Institute, VU-University, Amsterdam, The Netherlands, GGNet, Community Mental Health Center, Warnsveld, The Netherlands.
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Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundström Poromaa I. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod 2008; 23:2056-63. [PMID: 18583334 PMCID: PMC2517152 DOI: 10.1093/humrep/den154] [Citation(s) in RCA: 167] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND This study was undertaken to determine the prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization (IVF) treatment. METHODS Participants were 1090 consecutive women and men, 545 couples, attending a fertility clinic in Sweden during a two-year period. The Primary Care Evaluation of Mental Disorders (PRIME-MD), based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV), was used as the diagnostic tool for evaluating mood and anxiety disorders. RESULTS Overall, 862 (79.1%) subjects filled in the PRIME-MD patient questionnaire. Any psychiatric diagnosis was present in 30.8% of females and in 10.2% of males in the study sample. Any mood disorder was present in 26.2% of females and 9.2% of males. Major depression was the most common mood disorder, prevalent in 10.9% of females and 5.1% of males. Any anxiety disorder was encountered in 14.8% of females and 4.9% males. Only 21% of the subjects with a psychiatric disorder according to DSM-IV received some form of treatment. CONCLUSIONS Mood disorders are common in both women and men undergoing IVF treatment. The majority of subjects with a psychiatric disorder were undiagnosed and untreated.
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Affiliation(s)
- H Volgsten
- Department of Women's and Children's Health, Uppsala University Hospital, 751 85 Uppsala, Sweden.
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Garre-Olmo J, Lax-Pericall C, Turro-Garriga O, Soler-Cors O, Monserrat-Vila S, Vilalta-Franch J, Taylor JL, López-Pousa S. Adaptación y validez convergente de una versión telefónica del Mini-Mental State Examination. Med Clin (Barc) 2008; 131:89-95. [DOI: 10.1157/13124011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Musselwhite K, Cuff L, McGregor L, King KM. The telephone interview is an effective method of data collection in clinical nursing research: A discussion paper. Int J Nurs Stud 2007; 44:1064-70. [PMID: 16844128 DOI: 10.1016/j.ijnurstu.2006.05.014] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2006] [Revised: 03/24/2006] [Accepted: 05/20/2006] [Indexed: 11/20/2022]
Abstract
There are varying points of view regarding the advisability and utility of using the telephone to conduct research interviews. When undertaking the Women's Recovery from Sternotomy Study, we found the telephone was an effective mechanism for data collection. Our aim is to identify the advantages and challenges of using the telephone as a mechanism for data collection in clinical nursing research. The potential benefits associated with using telephone interviews as a mechanism of data collection include (a) using economic and human resources efficiently, (b) minimizing disadvantages associated with in-person interviewing, (c) developing positive relationships between researchers and participants, and (d) improving quality of data collection. The potential challenges to telephone interviewing include (a) maintaining participant involvement, (b) maintaining clear communication, (c) communicating with participants who offer extraneous information, (d) encountering participants with health concerns, and (e) communicating with a third party. Telephone interviewing can be an effective method of data collection when interviewers understand the potential benefits as well as challenges. We offer solutions to the identified challenges and make pragmatic recommendations to enhance researcher success based on the current literature and our research practice. Supportive training for interviewers, effective communication between interviewers and with research participants, and standardized telephone follow-up procedures are needed to ensure successful telephone data collection. We have found our 'Manual of Operations' to be an effective tool that assists research assistants to meet the requirements for successful telephone interviewing.
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Affiliation(s)
- Kimberly Musselwhite
- Faculty of Nursing and Department of Community Health Sciences, University of Calgary, 2500 University Drive, NW, Calgary, AB, Canada T2N 1N4
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Coelho HF, Cooper PJ, Murray L. A family study of co-morbidity between generalized social phobia and generalized anxiety disorder in a non-clinic sample. J Affect Disord 2007; 100:103-13. [PMID: 17113155 DOI: 10.1016/j.jad.2006.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Revised: 09/28/2006] [Accepted: 10/02/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND High rates of co-morbidity between Generalized Social Phobia (GSP) and Generalized Anxiety Disorder (GAD) have been documented. The reason for this is unclear. Family studies are one means of clarifying the nature of co-morbidity between two disorders. METHODS Six models of co-morbidity between GSP and GAD were investigated in a family aggregation study of 403 first-degree relatives of non-clinical probands: 37 with GSP, 22 with GAD, 15 with co-morbid GSP/GAD, and 41 controls with no history of GSP or GAD. Psychiatric data were collected for probands and relatives. Mixed methods (direct and family history interviews) were utilised. RESULTS Primary contrasts (against controls) found an increased rate of pure GSP in the relatives of both GSP probands and co-morbid GSP/GAD probands, and found relatives of co-morbid GSP/GAD probands to have an increased rate of both pure GAD and co-morbid GSP/GAD. Secondary contrasts found (i) increased GSP in the relatives of GSP only probands compared to the relatives of GAD only probands; and (ii) increased GAD in the relatives of co-morbid GSP/GAD probands compared to the relatives of GSP only probands. LIMITATIONS The study did not directly interview all relatives, although the reliability of family history data was assessed. The study was based on an all-female proband sample. The implications of both these limitations are discussed. CONCLUSIONS The results were most consistent with a co-morbidity model indicating independent familial transmission of GSP and GAD. This has clinical implications for the treatment of patients with both disorders.
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Affiliation(s)
- Helen F Coelho
- Winnicott Research Unit, School of Psychology, University of Reading, 3 Earley Gate, Whiteknights, Reading, UK RG6 6AL
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Smit F, Willemse G, Koopmanschap M, Onrust S, Cuijpers P, Beekman A. Cost-effectiveness of preventing depression in primary care patients: randomised trial. Br J Psychiatry 2006; 188:330-6. [PMID: 16582059 DOI: 10.1192/bjp.188.4.330] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little is known about the cost-effectiveness of preventing mental disorders. AIMS To study the cost-effectiveness of care as usual plus minimal contact psychotherapy relative to usual care alone in preventing depressive disorder. METHOD An economic evaluation was conducted alongside a randomised clinical trial. Primary care patients with sub-threshold depression were assigned to minimal contact psychotherapy plus usual care (n=107) or to usual care alone (n=109). RESULTS Primary care patients with sub-threshold depression benefited from minimal contact psychotherapy as it reduced the risk of developing a full-blown depressive disorder from 18% to 12%. In addition, this intervention had a 70% probability of being more cost-effective than usual care alone. A sensitivity analysis indicated the robustness of these results. CONCLUSIONS Over 1 year adjunctive minimal contact psychotherapy improved outcomes and generated lower costs. This intervention is therefore superior to usual care alone in terms of cost-effectiveness.
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Affiliation(s)
- Filip Smit
- Department of Prevention and Early Intervention, Trimbos Institute, PO Box 725, 2500 AS Utrecht, The Netherlands.
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Cameron C, Statham J. Variations in duty arrangements to respond to concerns about children's welfare. HEALTH & SOCIAL CARE IN THE COMMUNITY 2006; 14:167-76. [PMID: 16460366 DOI: 10.1111/j.1365-2524.2006.00608.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Reception and initial contact arrangements and practices in social services play a key role in safeguarding children and providing an avenue for the public and professionals to report concerns about a child's welfare. This paper reports on findings from a small-scale study, commissioned in the wake of the Laming Inquiry into the circumstances surrounding the death of Victoria Climbié. The aim of the study was an exploration of the arrangements local authorities had in place in early 2004 to receive referrals from the public and professional sources, and to report on duty team managers' levels of satisfaction with these arrangements. It drew on interviews with 70 social work managers responsible for daytime and out-of-hours duty services in 28 English local authorities. The authors argue that, while the Inquiry recommendations to improve the organisation of initial contact with social services in the event of concerns about a child's welfare remain important, wide variations exist in practice. The paper concludes with a discussion of possible contributory factors for such variation, and policy and practice measures that could address the variation.
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Affiliation(s)
- Claire Cameron
- Thomas Coram Research Unit, 27/28 Woburn Square, London WC1H OAA, UK.
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