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Karr JE, White AE. Academic self-efficacy and cognitive strategy use in college students with and without depression or anxiety. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1387-1393. [PMID: 35623049 DOI: 10.1080/07448481.2022.2076561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examined whether college students with and without depression or anxiety differed in subjective cognitive concerns, academic self-efficacy, and cognitive strategy use. PARTICIPANTS Participants included 582 college students (M = 19.0 ± 1.0 years-old, 79.4% women, 81.9% White). METHODS Participants completed online self-report questionnaires on subjective cognitive functioning, academic self-efficacy, cognitive strategy use, and depression and anxiety symptoms, which were used to categorize participants as having anxiety or depression based on established clinical cutoffs. RESULTS Participants with anxiety or depression reported greater subjective cognitive concerns and lower academic self-efficacy compared to participants without anxiety or depression, but these groups differed only modestly in cognitive strategy use. CONCLUSIONS Despite greater cognitive concerns, participants with anxiety or depression reported only modestly greater cognitive strategy use. Future research should evaluate interventions to increase strategy use among college students with anxiety or depression, tailoring these interventions for modern students by incorporating telehealth approaches and smartphone use.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Agnes E White
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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2
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McWhirter M, Bugarcic A, Steel A, Schloss J. Endocannabinoid levels in female-sexed individuals with diagnosed depression: a systematic review. BMC Womens Health 2024; 24:350. [PMID: 38886733 PMCID: PMC11181673 DOI: 10.1186/s12905-024-03168-y] [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: 07/11/2023] [Accepted: 05/28/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly prevalent mental health disorder with females experiencing higher rates of depression (11.6%), anxiety (15.7%) and physiological distress (14.5%) than males. Recently, the Endocannabinoid system (ECS) has been proposed to be a key contributing factor in the pathogenesis and symptom severity of MDD due to its role in neurotransmitter production, inflammatory response and even regulation of the female reproductive cycle. This review critically evaluates evidence regarding ECS levels in female-sexed individuals with depressive disorders to further understand ECS role. MATERIALS AND METHODS A systematic literature review of available research published prior to April 2022 was identified using PubMed (U.S. National Library of Medicine), CINAHL (EBSCO), Web of Science, AMED and Scopus (Elsevier). Studies were included if they reported ECS analysis of female-sexed individuals with depression and were excluded if they did not differentiate results between sexes, assessed mental health conditions other than depression, tested efficacy of endocannabinoid/n-acylethanolamine/cannabis or marijuana administration and that were unable to be translated. Critical appraisal of each included study was undertaken using the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. RESULTS The 894 located citations were screened for duplicates (n = 357) and eligibility by title and abstract (n = 501). The full text of 33 studies were reviewed, and 7 studies were determined eligible for inclusion. These studies indicated that depressed female-sexed individuals have altered levels of ECS however no significant pattern was identified due to variability of study outcomes and measures, limiting overall interpretation. DISCUSSION This review suggests potential involvement of ECS in underlying mechanisms of MDD in female sexed-individuals, however no pattern was able to be determined. A major contributor to the inability to attain reliable and valid understanding of the ECS levels in female-sexed individuals with depression was the inconsistency of depression screening tools, inclusion criteria's and analysis methods used to measure eCBs. Future studies need to implement more standardised methodology to gain a deeper understanding of ECS in female-sexed individuals with depressive disorders. TRIAL REGISTRATION : This review was submitted to PROSPERO for approval in April 2022 (Registration #CRD42022324212).
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Affiliation(s)
- Meagan McWhirter
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia.
| | - Andrea Bugarcic
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
| | - Amie Steel
- ACCRIM, The University of Technology Sydney, Ultimo, NSW, Australia
| | - Janet Schloss
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
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3
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Dai S, Wellens J, Yang N, Li D, Wang J, Wang L, Yuan S, He Y, Song P, Munger R, Kent MP, MacFarlane AJ, Mullie P, Duthie S, Little J, Theodoratou E, Li X. Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence. Clin Nutr 2024; 43:1386-1394. [PMID: 38688162 DOI: 10.1016/j.clnu.2024.04.016] [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: 11/27/2023] [Revised: 03/04/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND & AIMS Ultra-processed food (UPF) intake has increased sharply over the last few decades and has been consistently asserted to be implicated in the development of non-communicable diseases. We aimed to evaluate and update the existing observational evidence for associations between ultra-processed food (UPF) consumption and human health. METHODS We searched Medline and Embase from inception to March 2023 to identify and update meta-analyses of observational studies examining the associations between UPF consumption, as defined by the NOVA classification, and a wide spectrum of health outcomes. For each health outcome, we estimated the summary effect size, 95% confidence interval (CI), between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate evidence credibility of the identified associations. RESULTS This umbrella review identified 39 meta-analyses on the associations between UPF consumption and health outcomes. We updated all meta-analyses by including 122 individual articles on 49 unique health outcomes. The majority of the included studies divided UPF consumption into quartiles, with the lowest quartile being the reference group. We identified 25 health outcomes associated with UPF consumption. For observational studies, 2 health outcomes, including renal function decline (OR: 1.25; 95% CI: 1.18, 1.33) and wheezing in children and adolescents (OR: 1.42; 95% CI: 1.34, 1.49), showed convincing evidence (Class I); and five outcomes were reported with highly suggestive evidence (Class II), including diabetes mellitus, overweight, obesity, depression, and common mental disorders. CONCLUSIONS High UPF consumption is associated with an increased risk of a variety of chronic diseases and mental health disorders. At present, not a single study reported an association between UPF intake and a beneficial health outcome. These findings suggest that dietary patterns with low consumption of UPFs may render broad public health benefits.
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Affiliation(s)
- Shuhui Dai
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Judith Wellens
- Translational Gastro-Intestinal Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK; KU Leuven Department of Chronic Diseases and Metabolism, Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium
| | - Nan Yang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Doudou Li
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingjing Wang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Shuai Yuan
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yazhou He
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ron Munger
- Department of Nutrition and Food Sciences and the Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Patrick Mullie
- International Prevention Research Institute, Lyon, France; Belgian Centre for Evidence-Based Medicine, Leuven, Belgium
| | - Susan Duthie
- School of Pharmacy and Life Sciences, The Robert Gordon University, Aberdeen, UK
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
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4
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Melzer L, Forkmann T, Teismann T. Suicide Crisis Syndrome: A systematic review. Suicide Life Threat Behav 2024; 54:556-574. [PMID: 38411273 DOI: 10.1111/sltb.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND The objective of this systematic review is to describe the scientific evidence for the Suicide Crisis Syndrome (SCS), a presuicidal cognitive and affective state consisting of five symptomatic dimensions: entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The aim of this article is to summarize the emerging literature on the SCS and to assess the extent to which a uniform syndrome can be assumed. METHODS A systematic literature search was conducted in three different databases (PubMed, PsycInfo, and Google Scholar) using the search terms "Suicide Crisis Inventory," "Suicide Crisis Syndrome," "Narrative Crisis Model of Suicide," and "Suicide Trigger State." RESULTS In total, 37 articles from 2010 to 2022 were identified by search criteria. Twenty-one articles published between 2017 and 2022 were included in the systematic review. All but three studies were conducted in the United States and examined clinical samples of adult high-risk psychiatric in- and outpatients. Sample sizes ranged from N = 170 to 4846. The findings confirm the unidimensional structure of the proposed disorder and support the predictive validity for short-term suicidal behavior above and beyond suicidal ideation. CONCLUSION Despite the promising predictive validity of the SCS, a precise prediction of future suicidal behavior remains difficult.
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Affiliation(s)
- Laura Melzer
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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Lundqvist C, Schary DP, Jacobsson J, Korhonen L, Timpka T. Aligning categories of mental health conditions with intervention types in high-performance sports: A narrative cornerstone review and classification framework. J Sci Med Sport 2024:S1440-2440(24)00150-6. [PMID: 38796375 DOI: 10.1016/j.jsams.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024]
Abstract
Epidemiological studies suggest that psychiatric disorders are as prevalent amongst high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sport organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sport performance ethos with a discourse on mental health. This narrative cornerstone review examines challenges related to definitions and classifications of athlete mental health in high-performance sports and how these influence assessments and the implementation of interventions. We discuss challenges with concept creep and psychiatrisation and outline their consequences for sport healthcare professionals. Based on this, we present a framework that aligns different categories of athlete mental health conditions (from the reduction of wellbeing to psychiatric disorders) with intervention types (from the provision of supporting environments to pharmacotherapy). We conclude that researchers and sport practitioners need to carefully consider conceptual creep and the risk of pathologising normal and healthy, albeit emotionally aversive, reactions to athlete lifeworld events when assessing athlete mental health. A clear separation of terminology denoting the athlete's resources to handle the lifeworld (including salutogenic factors) and terms describing psychiatric conditions and their management is necessary to avoid misguidance in intervention planning.
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Affiliation(s)
- Carolina Lundqvist
- Department of Behavioural Sciences and Learning, Linköping University, Sweden; Athletics Research Center, Linköping University, Sweden.
| | - David P Schary
- Department of Physical Education, Sport and Human Performance, Winthrop University, USA. https://twitter.com/DrDavidSchary
| | - Jenny Jacobsson
- Athletics Research Center, Linköping University, Sweden; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Sweden
| | - Toomas Timpka
- Athletics Research Center, Linköping University, Sweden; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Sweden; Regional Executive Office, Region Östergötland, Sweden
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6
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Weisenburger RL, Mullarkey MC, Labrada J, Labrousse D, Yang MY, MacPherson AH, Hsu KJ, Ugail H, Shumake J, Beevers CG. Conversational assessment using artificial intelligence is as clinically useful as depression scales and preferred by users. J Affect Disord 2024; 351:489-498. [PMID: 38290584 DOI: 10.1016/j.jad.2024.01.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Depression is prevalent, chronic, and burdensome. Due to limited screening access, depression often remains undiagnosed. Artificial intelligence (AI) models based on spoken responses to interview questions may offer an effective, efficient alternative to other screening methods. OBJECTIVE The primary aim was to use a demographically diverse sample to validate an AI model, previously trained on human-administered interviews, on novel bot-administered interviews, and to check for algorithmic biases related to age, sex, race, and ethnicity. METHODS Using the Aiberry app, adults recruited via social media (N = 393) completed a brief bot-administered interview and a depression self-report form. An AI model was used to predict form scores based on interview responses alone. For all meaningful discrepancies between model inference and form score, clinicians performed a masked review to determine which one they preferred. RESULTS There was strong concurrent validity between the model predictions and raw self-report scores (r = 0.73, MAE = 3.3). 90 % of AI predictions either agreed with self-report or with clinical expert opinion when AI contradicted self-report. There was no differential model performance across age, sex, race, or ethnicity. LIMITATIONS Limitations include access restrictions (English-speaking ability and access to smartphone or computer with broadband internet) and potential self-selection of participants more favorably predisposed toward AI technology. CONCLUSION The Aiberry model made accurate predictions of depression severity based on remotely collected spoken responses to a bot-administered interview. This study shows promising results for the use of AI as a mental health screening tool on par with self-report measures.
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Affiliation(s)
- Rachel L Weisenburger
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, United States of America.
| | | | | | - Daniel Labrousse
- Department of Psychiatry, Georgetown University Medical Center, United States of America
| | - Michelle Y Yang
- Department of Psychiatry, Georgetown University Medical Center, United States of America
| | - Allison Huff MacPherson
- Department of Family and Community Medicine, College of Medicine, University of Arizona, United States of America
| | - Kean J Hsu
- Department of Psychiatry, Georgetown University Medical Center, United States of America; Department of Psychology, National University of Singapore, Singapore
| | - Hassan Ugail
- Centre for Visual Computing, University of Bradford, United Kingdom of Great Britain and Northern Ireland
| | | | - Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, United States of America
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7
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Lebel S, Lépine O, Brillon P. Mental Health of Homicidally Bereaved Individuals: A Systematic Review of Post-Homicide Factors. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241245751. [PMID: 38584454 DOI: 10.1177/00302228241245751] [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: 04/09/2024]
Abstract
Experiencing the homicide of a loved one has a substantial impact on the mental health of family members and friends who must survive their loved one's tragic death. This systematic review aims to synthesize the current findings on post-homicide factors and identify the factors most frequently related to the mental health of homicidally bereaved individuals (HBI). Four databases were searched (PsycINFO, SCOPUS, Sociological Abstract, PubMed). The selection of studies was based on a peer review process conducted by two independent researchers to ensure interrater reliability. The articles were screened to ensure the presence of homicidally bereaved adults, resulting in a total of 35 eligible papers to be considered in the current review. Factors were organized into categories, with the criminal justice system-related factors (n = 18), social factors (n = 17), and coping factors (n = 13) being the most prevalent. This review identifies clinical avenues for preventing distress and fostering the well-being of HBI.
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Affiliation(s)
- Sarah Lebel
- Psychology Department, Université du Québec à Montréal, Montreal, QC, Canada
| | - Olivier Lépine
- Psychology Department, Université du Québec à Montréal, Montreal, QC, Canada
| | - Pascale Brillon
- Psychology Department, Université du Québec à Montréal, Montreal, QC, Canada
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Berretta S, Garbin S, Iannario M, Paccagnella O. A Novel Indicator to Correct for Individual Reported Heterogeneity. An Application to Self-Evaluation of Later-Life Depression. EVALUATION REVIEW 2024; 48:221-250. [PMID: 37153985 DOI: 10.1177/0193841x231171965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Program evaluations often investigate complex or multi-dimensional constructs, such as individual opinions or attitudes, by means of ratings. A different interpretation of the same question may affect cross-country comparability, leading to the Differential Item Functioning problem. Anchoring vignettes were introduced in the literature as a way to adjust self-evaluations from this interpersonal incomparability. In this paper, we first introduce a new nonparametric solution to analyse anchoring vignette data, recoding a variable based on a rating scale to a new corrected-variable that guarantees comparability in any cross-country analysis. Then, we exploit the flexibility of a mixture model introduced to account for uncertainty in the response process (the CUP model) to test if the proposed solution is effectively able to remove this reported heterogeneity. This solution is easy to construct and has important advantages compared with the original nonparametric solution adopted with anchoring vignette data. The novel indicator is applied to investigate self-reported depression in an old population. Data that will be analysed come from the second wave of the Survey of Health, Ageing and Retirement in Europe, collected in 2006/2007. Results highlight the need of correcting for reported heterogeneity comparing individual self-evaluations. Once interpersonal incomparability resulting from the different uses of response scales is removed from the self-assessments, some estimates are reversed in magnitude and signs with respect to the analysis of the collected data.
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Affiliation(s)
- Serena Berretta
- Department of Mathematics, University of Genoa, Genova, Italy
| | - Sara Garbin
- Bank of Italy, branch of Bolzano, Bolzano, Italy
| | - Maria Iannario
- Department of Political Sciences, University of Naples Federico II, Napoli, Italy
| | - Omar Paccagnella
- Department of Statistical Sciences, University of Padua, Padova, Italy
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Limenih G, MacDougall A, Wedlake M, Nouvet E. Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:95-107. [PMID: 38105446 PMCID: PMC10955781 DOI: 10.1177/27551938231220230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/09/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023]
Abstract
Over the past two decades, depression has become a prominent global public health concern, especially in low- and middle-income countries (LMICs). The World Health Organization (WHO) and the Movement for Global Mental Health have developed international guidelines to improve mental health services globally, prioritizing LMICs. These efforts hold promise for advancing care and treatment for depression and other mental, neurological, and substance abuse disorders in LMICs. The intervention guides, such as the WHO's mhGAP-Intervention Guides, are evidence-based tools and guidelines to help detect, diagnose, and manage the most common mental disorders. Using the Global South as an empirical site, this article draws on Foucauldian critical discourse and document analysis methods to explore how these international intervention guides operate as part of knowledge-power processes that inscribe and materialize in the world in some forms rather than others. It is proposed that these international guidelines shape the global discourse about depression through their (re)production of biopolitical assumptions and impacts, governmentality, and "conditions of possibility." The article uses empirical data to show nuance, complexity, and multi-dimensionality where binary thinking sometimes dominates, and to make links across arguments for and against global mental health. The article concludes by identifying several resistive discourses and suggesting reconceptualizing the treatment gap for common mental disorders.
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Affiliation(s)
- Gojjam Limenih
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Arlene MacDougall
- Department of Pyschiatry, Western University Schulich School of Medicine & Dentistry, London, ON, Canada
| | - Marnie Wedlake
- School of Health Studies, Western University, London, ON, Canada
| | - Elysee Nouvet
- School of Health Studies, Western University, London, ON, Canada
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Eliza Georgiou EZ, Politis A, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N, Economou P, Alexopoulos P. Depressive symptoms in the entire spectrum of cognitive ageing in Greece: evidence from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Int J Psychiatry Clin Pract 2024; 28:27-34. [PMID: 38145312 DOI: 10.1080/13651501.2023.2296889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To study (i) the prevalence of mild and moderate-to-severe depressive symptoms in the entire spectrum of cognitive ageing in Greece and (ii) the relationship between these symptoms and demographic and clinical data. METHODS The study was based on the randomly selected cohort of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Depressive symptoms were assessed with the 15-item version of the Geriatric Depression Scale. Participants also received a comprehensive neuropsychological assessment, while the clinical diagnoses of dementia and mild cognitive impairment were established according to international diagnostic criteria. Statistical analyses relied on comparison tests and a logistic (proportional odds) ordinal regression model. RESULTS Depressive symptoms were detected in 19.5% of the 1936 study participants, while 11.3% of both people with MCI and dementia had moderate-to-severe depressive symptoms. The regression model revealed that older adults with more severe depressive symptoms were more likely female, cognitively impaired, less educated, were treated with psychotropic medication and lived in Attica versus Thessaly. CONCLUSIONS Since depressive symptoms were detected in almost one in five older adults, healthcare professionals in Greece should safeguard the timely detection and effective treatment of such symptoms and the post-diagnostic care of older adults with depression.
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Affiliation(s)
- Eleni-Zacharoula Eliza Georgiou
- Department of Medicine, School of Health Sciences, Mental Health Services, Patras University General Hospital, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, MD, USA
| | - Mary H Kosmidis
- School of Psychology, Lab of Cognitive Neuroscience, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Panagiotis Alexopoulos
- Department of Medicine, School of Health Sciences, Mental Health Services, Patras University General Hospital, University of Patras, Patras, Greece
- Medical School, Global Brain Health Institute, Trinity College Dublin, The University of Dublin, Dublin, Republic of Ireland
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Patras Dementia Day Care Centre, Patras, Greece
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11
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Zeng Z, Li Q, Caine ED, Takwoingi Y, Zhong B, Tong Y, Cheng KK, Gong W. Prevalence of and optimal screening tool for postpartum depression in a community-based population in China. J Affect Disord 2024; 348:191-199. [PMID: 38154584 DOI: 10.1016/j.jad.2023.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/28/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is an important public health problem worldwide. China is planning to launch PPD screening in community settings, but there are questions on the community prevalence of PPD and validated screening tools. METHODS We sought to recruit all eligible new mothers during postnatal home visits in two districts of Changsha, China, and after informed consent, screened them for PPD using three self-administered questionnaires-the Edinburgh Postpartum Depression Scale (EPDS), the Patient Health Questionnaire (PHQ-9), and Whooley Questions for Depression Screening. Video structured diagnostic interviews were performed online according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) by qualified specialists who were blinded to screening results. Optimal screening was determined based on the acceptability of scales and diagnostic accuracy metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS Out of 3004 eligible women, 2730 (90.9 %) completed the screening questionnaires. Among those screened, the video structured diagnostic interview was administered to 1862 (68.2 %) and 62 (3.3 %) were diagnosed with a current depressive condition. The optimal screening approach involved combining Whooley Questions (at least one "yes") with EPDS (cutoff >10) in series, with sensitivity of 0.76 (95 % CI 0.63 to 0.85), specificity of 0.93 (0.92 to 0.94), PPV of 0.28 (0.21 to 0.36) and NPV of 0.99 (0.98 to 1.00). LIMITATIONS Due to the regional sample and exclusion of mothers with telephone contact rather than home visits, our findings may not be fully generalizable to the entire population. CONCLUSIONS The prevalence of PPD among women in this sample was substantially lower than those reported in previous studies in China, the majority of which used screen positivity in measuring prevalence. Combining Whooley Questions with EPDS in series is the most optimal screening approach in this population, though this would still result in a high number of false positives at current prevalence.
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Affiliation(s)
- Zhen Zeng
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Hunan 410078, China.
| | - Qiao Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Hunan 410078, China.
| | - Eric D Caine
- Department of Psychiatry, University of Rochester, Rochester, NY, USA.
| | - Yemisi Takwoingi
- Institute of Applied Health Research, University of Birmingham, B15 2TT Birmingham, UK; National Institute for Health Research Birmingham Biomedical Research Centre, University Hospitals Birmingham National Health Service Foundation Trust and University of Birmingham, Birmingham, UK.
| | - Baoliang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, No. 89, Gongnongbing Road, Wuhan, Hubei Province 430012, China.
| | - Yongsheng Tong
- Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, 7 Nan Dian Road, Changping, Beijing 100096, China.
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, B15 2TT Birmingham, UK.
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Hunan 410078, China; Department of Psychiatry, University of Rochester, Rochester, NY, USA; Institute of Applied Health Research, University of Birmingham, B15 2TT Birmingham, UK.
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12
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Alwis I, Baminiwatta A, Chandradasa M. Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2024; 59:353-373. [PMID: 37256323 PMCID: PMC10230494 DOI: 10.1007/s00127-023-02495-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/24/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Epidemiological data on depression are required to inform policies and service planning in mental health in Sri Lanka. This review aimed to synthesise data from existing studies to calculate the pooled prevalence of depression in Sri Lanka, assess its variability across subgroups, and identify associated factors within each subgroup. METHODS PubMed, Embase, PsycINFO, Science Direct, Google Scholar and local journals were searched to identify peer-reviewed studies reporting the prevalence of depression among non-clinical adult, young, older, and maternal populations in Sri Lanka. A meta-analysis was performed using a random-effects model to calculate pooled prevalence estimates. Subgroup, sensitivity and moderator analyses were performed. A qualitative synthesis of factors associated with depression was conducted. RESULTS A total of 33 studies representing a total of 52,778 participants were included. Overall, the pooled prevalence of depression was 19.4% [14.44-25.54%]. Among subpopulations, the highest prevalence was reported among young persons (39%); the rates in adults, older persons and maternal populations were 8.7%, 18.4% and 16.9%, respectively. Prevalence estimates were higher when based on screening instruments (21.2%) compared to diagnostic interviews (4.3%). A high degree of heterogeneity (I2 = 99.2) was observed. A qualitative synthesis of factors associated with depression, including individual attributes and behaviours, socio-economic circumstances and broader environmental factors, is reported for each age group. CONCLUSION Approximately one-fifth of the population was detected to have depression. Notable variations in prevalence were observed across age groups. The heterogeneity of studies limits the inferences drawn from this review.
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Affiliation(s)
- Inosha Alwis
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
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13
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Buhagiar R, Bettenzana K, Grant KA. The prevalence of perinatal mental health disorders and psychosocial characteristics of women in Malta: A cross-sectional study. Birth 2024. [PMID: 38212936 DOI: 10.1111/birt.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/25/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Perinatal mental health disorders (PMHDs) are associated with a myriad of negative outcomes for women, infants, and the rest of the family unit. Understanding the prevalence of these conditions is important to guide prevention and treatment pathways. Indeed, the burden of PMHDs has been studied in many countries, but for Malta, an island with an annual birth rate of 4500 births, this burden is still to be determined. The main objective of this study was to address this gap, determine the prevalence of PMHDs among postpartum women in Malta, and study associated psychosocial determinants for this population. METHODS A cross-sectional epidemiological study was conducted between March and April 2022 to determine the point prevalence of postpartum PMHDs in Malta. A representative, random sample of 243 postnatal mothers were recruited and screened for mental health issues using a two stage approach incorporating symptom scales and a diagnostic interview. RESULTS The point prevalence of postnatal PMHDs in Malta, according to a diagnostic interview, was found to be 21.4%. Anxiety disorders were the most prevalent conditions (16.8%), followed by obsessive-compulsive disorder (6.1%) and borderline personality disorder (5.6%), respectively. A higher rate of 32.1% was identified with self-report measures. CONCLUSIONS PMHDs are highly prevalent, affecting approximately 20% of women in Malta across the first postnatal year. The value of this finding accentuates the need for service availability and the implementation of perinatal mental health screening programs.
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Affiliation(s)
| | | | - Kerry-Ann Grant
- Health Education and Training Institute, Sydney, New South Wales, Australia
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14
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Oh J, Lee T, Chung ES, Kim H, Cho K, Kim H, Choi J, Sim HH, Lee J, Choi IY, Kim DJ. Development of depression detection algorithm using text scripts of routine psychiatric interview. Front Psychiatry 2024; 14:1256571. [PMID: 38239906 PMCID: PMC10794729 DOI: 10.3389/fpsyt.2023.1256571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/13/2023] [Indexed: 01/22/2024] Open
Abstract
Background A psychiatric interview is one of the important procedures in diagnosing psychiatric disorders. Through this interview, psychiatrists listen to the patient's medical history and major complaints, check their emotional state, and obtain clues for clinical diagnosis. Although there have been attempts to diagnose a specific mental disorder from a short doctor-patient conversation, there has been no attempt to classify the patient's emotional state based on the text scripts from a formal interview of more than 30 min and use it to diagnose depression. This study aimed to utilize the existing machine learning algorithm in diagnosing depression using the transcripts of one-on-one interviews between psychiatrists and depressed patients. Methods Seventy-seven clinical patients [with depression (n = 60); without depression (n = 17)] with a prior psychiatric diagnosis history participated in this study. The study was conducted with 24 male and 53 female subjects with the mean age of 33.8 (± 3.0). Psychiatrists conducted a conversational interview with each patient that lasted at least 30 min. All interviews with the subjects between August 2021 and November 2022 were recorded and transcribed into text scripts, and a text emotion recognition module was used to indicate the subject's representative emotions of each sentence. A machine learning algorithm discriminates patients with depression and those without depression based on text scripts. Results A machine learning model classified text scripts from depressive patients with non-depressive ones with an acceptable accuracy rate (AUC of 0.85). The distribution of emotions (surprise, fear, anger, love, sadness, disgust, neutral, and happiness) was significantly different between patients with depression and those without depression (p < 0.001), and the most contributing emotion in classifying the two groups was disgust (p < 0.001). Conclusion This is a qualitative and retrospective study to develop a tool to detect depression against patients without depression based on the text scripts of psychiatric interview, suggesting a novel and practical approach to understand the emotional characteristics of depression patients and to use them to detect the diagnosis of depression based on machine learning methods. This model could assist psychiatrists in clinical settings who conduct routine conversations with patients using text transcripts of the interviews.
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Affiliation(s)
- Jihoon Oh
- Department of Psychiatry, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Taekgyu Lee
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Su Chung
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | | | | | - Jihye Choi
- Department of Psychiatry, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon-Hee Sim
- Department of Psychiatry, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jongseo Lee
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Young Choi
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dai-Jin Kim
- Department of Psychiatry, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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15
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Stroebe MS, Schut HAW, Eisma MC. On the Classification and Reporting of Prolonged Grief: Assessment and Research Guidelines. Harv Rev Psychiatry 2024; 32:15-32. [PMID: 38181100 DOI: 10.1097/hrp.0000000000000389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
LEARNING OBJECTIVES AFTER PARTICIPATING IN THIS CME ACTIVITY, THE PSYCHIATRIST SHOULD BE BETTER ABLE TO • Explain the steps required for diagnosis of mental disorders in diagnostic handbooks.• Identify current procedures for classifying and reporting prolonged grief disorder. ABSTRACT Prolonged grief disorder (PGD) was added to the 11th edition of the International Classification of Diseases in 2018 and to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders in its 2022 text revision. Thus, reporting and classifying PGD according to established guidelines has become fundamental for scientific research and clinical practice. Yet, PGD assessment instruments and criteria are still being developed and debated. The purpose of this article is to examine the adequacy of current procedures for classifying and reporting PGD in research and to suggest guidelines for future investigation and dissemination of knowledge. We outline the standard steps required for diagnosis and assessment of a mental disorder (notably, the administration of clinical interviews). In order to illustrate reporting about the presence/prevalence of PGD in recent scientific articles, we conducted a search of Scopus that identified 22 relevant articles published between 2019 and 2023. Our review of the literature shows that standard classification procedures are not (yet) followed. Prevalences of PGD are based on self-reported symptomatology, with rates derived from percentages of bereaved persons reaching a certain cutoff score on a questionnaire, without clinical interviewing. This likely results in systematic overestimation of prevalences. Nevertheless, the actual establishment of PGD prevalence was often stated in titles, abstracts, and results sections of articles. Further, the need for structured clinical interviews for diagnostic classification was frequently mentioned only among limitations in discussion sections-but was not highlighted. We conclude by providing guidelines for researching and reporting self-reported prolonged grief symptoms and the presence/prevalence of PGD.
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Affiliation(s)
- Margaret S Stroebe
- From the Department of Clinical Psychology, Utrecht University (Drs. Stroebe and Schut); Department of Clinical Psychology & Experimental Psychopathology, University of Groningen (Drs. Stroebe and Eisma)
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16
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Taboada Gjorup AL, Tolentino Júnior JC, van Duinkerken E, Marques AC, do Carmo Filho A, Joaquim AM, Neves VV, Schmidt SL. Association between attention performance and the different dimensions of DSM-5 depression symptoms. Front Psychiatry 2023; 14:1291670. [PMID: 38179242 PMCID: PMC10765948 DOI: 10.3389/fpsyt.2023.1291670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
Objective Depressive symptoms can be assessed with self-reported questionnaires, such as the Patient Health Questionary-9 (PHQ-9). Previous studies have suggested that the PHQ-9 items can be grouped into somatic and non-somatic clusters. However, the classification of the PHQ-9 item "concentration difficulties" into somatic or non-somatic is still controversial. This controversy may be explained by difficulties experienced by subjects in accurately evaluating their attention problems. The primary objective of this study was to determine the correlation between objective attentional performance and the two clusters of depressive symptoms in hospital employees working in stressful conditions. Methods The participants filled out the PHQ-9 to identify their depressive symptoms. Based on the PHQ-9, the somatic or non-somatic symptoms were measured without considering the question about subjective concentration difficulties. Then, a brief version of the Continuous Visual Attention Test (CVAT) was applied to assess four attentional subdomains. The CVAT is a Go/No-go task that measures number of correct responses (focused attention), number of incorrect responses (behavior-inhibition), average reaction time of correct responses (RT-alertness), and variability of reaction time (VRT-sustained attention). The entire task lasted 90 s. Correlation analyses assessed the relationships between attentional performance and the two dimensions of depressive symptoms. Results After applying the inclusion/exclusion criteria, 359 individuals were selected. Their age ranged from 20 to 70 years (mean = 40.5, SD = 10.37), and the majority was female (67.6%). A predominance in somatic depressive symptoms was present in 231 (64%) participants, whereas 59 (16%) showed a predominance of non-somatic symptoms. Sixty-nine participants (20%) did not show any predominance. Higher somatic scores were associated with higher RTs, whereas higher non-somatic scores were related to an increase in the number of incorrect responses. Conclusion The predominance of the somatic cluster was related to lower alertness, whereas the predominance of non-somatic cluster was associated with impulsivity/hyperactivity. This result may explain the difficulties associated with correctly classifying the item concentration difficulties. A brief attentional task can be used as an auxiliary tool to correctly identify the different dimensions of attention that are associated with different clusters of depressive symptoms.
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Affiliation(s)
- Ana Lucia Taboada Gjorup
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Julio César Tolentino Júnior
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Eelco van Duinkerken
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - André Casarsa Marques
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Aureo do Carmo Filho
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Alan Marques Joaquim
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Vithória Vidotti Neves
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Sergio Luis Schmidt
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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17
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Zhou J, Radojčić MR, Ashton-James CE, Yang H, Chen Z, Wang R, Yang Y, Si J, Yao L, Li G, Chen L. Optimal cut-offs of depression screening tools during the COVID-19 pandemic: a systematic review. BMC Psychiatry 2023; 23:953. [PMID: 38114961 PMCID: PMC10729515 DOI: 10.1186/s12888-023-05455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Studies have reported an increase in the prevalence of depression during the COVID-19 pandemic. The accuracy of screening tools may change with the prevalence and distribution of a disease in a population or sample: the "Spectrum Effect". METHODS First, we selected commonly used screening tools and developed search strategies for the inclusion of original studies during the pandemic. Second, we searched PsycINFO, EMBASE, and MEDLINE from March 2020 to September 2022 to obtain original studies that investigated the accuracy of depression screening tools during the pandemic. We then searched these databases to identify meta-analyses summarizing the accuracy of these tools conducted before the pandemic and compared the optimal cut-offs for depression screening tools during the pandemic with those before. RESULT Four original studies evaluating the optimal cut-offs for four screening tools (Beck Depression Inventory [BDI-II], Hospital Anxiety and Depression Scale-Depression [HADS-D], Patient Health Questionnaire-9 [PHQ-9], and Geriatric Depression Scale-4 [GDS-4]) were published during the pandemic. Four meta-analyses summarizing these tools before the pandemic. We found that the optimal cut-off of BDI-II was 14 during the pandemic (23.8% depression prevalence, screening patients with Type 2 diabetes) and 14.5 before the pandemic (17.6% depression prevalence, screening psychiatric, primary care, and healthy populations); HADS-D was 10 during the pandemic (23.8% depression prevalence, screening patients with type 2 diabetes) and 7 before the pandemic (15.0% depression prevalence, screening medically ill patients); PHQ-9 was 11 during the pandemic (14.5% depression prevalence, screening university students) and 8 before the pandemic (10.9% depression prevalence, screening the unrestricted population), and GDS-4 was 1.8 during the pandemic (29.0% depression prevalence, screening adults seen in a memory clinic setting) and 3 before the pandemic (18.5% depression prevalence, screening older adults). CONCLUSION The optimal cut-off for different screening tools may be sensitive to changes in study populations and reference standards. And potential spectrum effects that should be considered in post-COVID time which aiming to improve diagnostic accuracy.
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Affiliation(s)
- Jieru Zhou
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Maja R Radojčić
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Claire E Ashton-James
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Hanqiao Yang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichua, 610041, People's Republic of China
| | - Ziyi Chen
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Ruijia Wang
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, People's Republic of China
| | - Ying Yang
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Jinhua Si
- Tianjin University of Traditional Chinese Medicine Library, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Ge Li
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China.
| | - Lingxiao Chen
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Sydney Musculoskeletal Health, School of Health Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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Oude Voshaar RC. The 'discontinuity hypothesis' of depression in later life-clinical and research implications. Age Ageing 2023; 52:afad239. [PMID: 38156879 PMCID: PMC10756079 DOI: 10.1093/ageing/afad239] [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: 01/08/2023] [Revised: 01/08/2023] [Indexed: 01/03/2024] Open
Abstract
The term depression is overused as an umbrella term for a variety of conditions, including depressed mood and various psychiatric disorders. According to psychiatric diagnostic criteria, depressive disorders impact nearly all aspects of human life and are a leading cause of disability worldwide. The widespread assumption that different types of depression lie on a continuum of severity has stimulated important research on subthreshold depression in later life. This view assumes that depressed mood is a precursor of a depressive disorder. The present narrative review argues why in later life depressed mood might either (i) lie on a continuum with depressive disorders among people vulnerable for a depressive disorder or (ii) be an ageing-related epiphenomenon of underlying physical illnesses in people who are resilient to depressive disorders ('discontinuity hypothesis'). Three arguments are discussed. First, the course of depressed mood and depressive disorders differs across the life span. Second, screening instruments for depression have low predictive value for depressive disorders in later life. Third, a dose-response relationship has not been consistently found across different types of depression and detrimental health outcomes. Using the umbrella term depression may partly explain why pharmacological treatment is less effective with increasing age, and negative health-related outcomes might be overestimated. The discontinuity hypothesis may prevent pharmacological overtreatment of milder subtypes of depression and may stimulate comprehensive multidisciplinary assessment as well as the development of separate treatment algorithms for depressed mood and depressive disorders.
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Affiliation(s)
- Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherland
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19
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Al Oweidat K, Marie D, Toubasi AA, Jaber DZ, Ahmed KE, Abu Alragheb BO, Albtoosh AS. The prevalence of anxiety and depression in bronchiectasis patients and their association with disease severity: a cross-sectional study. Sci Rep 2023; 13:20886. [PMID: 38017245 PMCID: PMC10684858 DOI: 10.1038/s41598-023-48276-1] [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: 03/26/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
Bronchiectasis is a chronic lung disease characterized by recurrent respiratory symptoms. Several studies demonstrated that psychological comorbidities are common in patients with bronchiectasis. The aim of this study is to investigate the prevalence of anxiety and depression in bronchiectasis patients and assess their association with disease severity. In this cross-sectional study, we included patients diagnosed with bronchiectasis. The study was conducted using an interviewer-administered questionnaire via phone calls and data collected from the electronic medical records at JUH. The questionnaire included patients' demographics and disease characteristics. Anxiety and depression were assessed using GAD7 and PHQ9 respectively. Bronchiectasis disease severity was assessed using BSI and FACED score. The total number of included patients was 133. Moreover, 53.4% of the participants were females while the rest were males (46.6%). PHQ9 demonstrated that 65.4% of the patients had depression. Regarding anxiety, GAD7 scale showed that 54.1% of the patients had anxiety. Pearson correlation showed that bronchiectasis severity index was significantly associated only with PHQ9 depression scores (r = 0.212, P value = 0.014). The prevalence of depression and anxiety is high among patients with bronchiectasis. We believe that patients affected with bronchiectasis should be screened for depression to improve their quality of life.
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Affiliation(s)
- Khaled Al Oweidat
- Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Dana Marie
- Faculty of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ahmad A Toubasi
- Faculty of Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
| | - Dunia Z Jaber
- Faculty of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Khalid E Ahmed
- Faculty of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Bayan O Abu Alragheb
- Faculty of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Asma S Albtoosh
- Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
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Sivertsen B, Knudsen AKS, Kirkøen B, Skogen JC, Lagerstrøm BO, Lønning KJ, Kessler RC, Reneflot A. Prevalence of mental disorders among Norwegian college and university students: a population-based cross-sectional analysis. THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100732. [PMID: 37927428 PMCID: PMC10624983 DOI: 10.1016/j.lanepe.2023.100732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 11/07/2023]
Abstract
Background Self-report data indicate a sharp increase in mental health problems among college and university students in recent years, but accurate prevalence estimates of mental disorders are lacking. The current study used a validated psychiatric diagnostic survey, developed into a self-administered electronic version, to examine the prevalence of common mental disorders in a large national sample of college and university students in Norway. Methods Participants (aged 18-35 years) from the national Students' Health and Wellbeing (SHOT) Study in 2022 were recruited to a follow-up online survey of mental disorders from January to February 2023 (n = 10,460). Current (30-days), 12-months and lifetime prevalence of common mental disorders were examined using a newly developed self-administered electronic version of the Composite International Diagnostic Interview (CIDI 5.0). Findings The prevalence of a current mental disorder was high for both women (39.7% [2737/6886], 95% CI 38.6-40.9) and men (25.7% [751/2918], 95% CI 24.2-27.4). The most common disorders were major depressive episode (females 17.1% [1250/7329] and males 10.8% [331/3059]) and generalized anxiety disorder (females 16.0% [1157/7221] and males 8.2% [250/3032]), while 5.6% [387/6948] and 7.7% [228/2963] of the females and male students, respectively, fulfilled the criteria for an alcohol use disorder. The prevalence estimates for 12-month and lifetime were, as expected, even higher. Interpretation The findings suggest an alarmingly high prevalence of several mental disorders among Norwegian college and university students. Implications and potential methodological and contextual explanations of these findings are discussed. Funding Norwegian Ministry of Education and Research.
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Affiliation(s)
- Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research & Innovation, Helse-Fonna HF, Haugesund, Norway
| | | | - Benedicte Kirkøen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Jens C. Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Bengt Oscar Lagerstrøm
- Division for Social Surveys, Department for Methodology and Data Collection, Statistics Norway, Oslo, Norway
| | - Kari-Jussie Lønning
- The Student Welfare Organization in Oslo and Akershus (SiO), Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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21
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Lenferink LIM, van Dijk I, Eisma MC, Eklund R, Boelen PA, Sveen J. Psychometric evaluation of the Swedish Traumatic Grief Inventory Self-Report Plus (TGI-SR+) in bereaved parents. Clin Psychol Psychother 2023. [PMID: 37872000 DOI: 10.1002/cpp.2922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
The International Classification of Diseases Eleventh Edition (ICD-11), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), now include prolonged grief disorder (PGD). Since criteria for PGD in both classification systems differ from prior proposed grief disorders and each other, the validation of a single instrument to screen for prolonged grief (PG) symptoms of both new diagnoses is critical for bereavement research and care. Therefore, we evaluated the psychometric properties of the Swedish version of the Traumatic Grief Inventory Self-Report Plus (TGI-SR+). Two-hundred and forty-eight bereaved parents completed questions about sociodemographic and loss-related variables, the TGI-SR+, and symptom measures of post-traumatic stress (PTS), depression and an older measure of PG symptoms, the Prolonged Grief Disorder-13 (PG-13). Confirmatory factor analyses showed that a one-factor model best fit DSM-5-TR and ICD-11 PG symptoms and the analyses of the internal consistency and inter-item correlations showed that these symptoms could be reliably assessed. In support of convergent validity, DSM-5-TR and ICD-11 PG symptoms correlated with symptoms of PTS, depression and PG assessed with the PG-13. In support of known-groups validity, DSM-5-TR and ICD-11 PG symptoms were higher among lower educated (vs. higher educated) participants and related negatively to time since loss. ROC analyses showed optimal cut-off score of ≥71 and ≥72 to determine probable caseness for DSM-5-TR and ICD-11 PGD, respectively. Results support the reliability and validity of the Swedish TGI-SR+ as a screening instrument for PG in research and bereavement care.
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Affiliation(s)
- Lonneke I M Lenferink
- Department of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, Enschede, The Netherlands
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Iris van Dijk
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Maarten C Eisma
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Rakel Eklund
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Paul A Boelen
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Josefin Sveen
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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22
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Cooper J, Nirantharakumar K, Crowe F, Azcoaga-Lorenzo A, McCowan C, Jackson T, Acharya A, Gokhale K, Gunathilaka N, Marshall T, Haroon S. Prevalence and demographic variation of cardiovascular, renal, metabolic, and mental health conditions in 12 million english primary care records. BMC Med Inform Decis Mak 2023; 23:220. [PMID: 37845709 PMCID: PMC10580600 DOI: 10.1186/s12911-023-02296-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/14/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Primary care electronic health records (EHR) are widely used to study long-term conditions in epidemiological and health services research. Therefore, it is important to understand how well the recorded prevalence of these conditions in EHRs, compares to other reliable sources overall, and varies by socio-demographic characteristics. We aimed to describe the prevalence and socio-demographic variation of cardiovascular, renal, and metabolic (CRM) and mental health (MH) conditions in a large, nationally representative, English primary care database and compare with prevalence estimates from other population-based studies. METHODS This was a cross-sectional study using the Clinical Practice Research Datalink (CPRD) Aurum primary care database. We calculated prevalence of 18 conditions and used logistic regression to assess how this varied by age, sex, ethnicity, and socio-economic status. We searched the literature for population prevalence estimates from other sources for comparison with the prevalences in CPRD Aurum. RESULTS Depression (16.0%, 95%CI 16.0-16.0%) and hypertension (15.3%, 95%CI 15.2-15.3%) were the most prevalent conditions among 12.4 million patients. Prevalence of most conditions increased with socio-economic deprivation and age. CRM conditions, schizophrenia and substance misuse were higher in men, whilst anxiety, depression, bipolar and eating disorders were more common in women. Cardiovascular risk factors (hypertension and diabetes) were more prevalent in black and Asian patients compared with white, but the trends in prevalence of cardiovascular diseases by ethnicity were more variable. The recorded prevalences of mental health conditions were typically twice as high in white patients compared with other ethnic groups. However, PTSD and schizophrenia were more prevalent in black patients. The prevalence of most conditions was similar or higher in the primary care database than diagnosed disease prevalence reported in national health surveys. However, screening studies typically reported higher prevalence estimates than primary care data, especially for PTSD, bipolar disorder and eating disorders. CONCLUSIONS The prevalence of many clinically diagnosed conditions in primary care records closely matched that of other sources. However, we found important variations by sex and ethnicity, which may reflect true variation in prevalence or systematic differences in clinical presentation and practice. Primary care data may underrepresent the prevalence of undiagnosed conditions, particularly in mental health.
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Affiliation(s)
- Jennifer Cooper
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK.
| | - Francesca Crowe
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
| | | | - Colin McCowan
- School of Medicine, University of St Andrews, Fife, UK
| | - Thomas Jackson
- Clinician Scientist in Geriatric Medicine, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Aditya Acharya
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
| | - Krishna Gokhale
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
| | - Niluka Gunathilaka
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
| | - Tom Marshall
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
| | - Shamil Haroon
- Institute of Applied Health Research, Health Data Science and Public Health, University of Birmingham, Birmingham, UK
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Uriko K, Christoforou A, Motrico E, Moreno-Peral P, Kömürcü Akik B, Žutić M, Lambregtse-van den Berg MP. Paternal peripartum depression: emerging issues and questions on prevention, diagnosis and treatment. A consensus report from the cost action Riseup-PPD. J Reprod Infant Psychol 2023:1-19. [PMID: 37818835 DOI: 10.1080/02646838.2023.2266470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Paternal peripartum depression (P-PPD) is a serious and understudied public health problem associated with impaired family functioning and child development. The lack of recognition of P-PPD may result in limited access to both information and professional help. OBJECTIVE The aim of the study was to review studies on paternal peripartum depression and to identify issues and questions where future research and theory formation are needed. METHODS A literature search for systematic reviews, meta-analyses and primary studies was conducted using PubMed, Web of Science, Embase, Scopus, Medline, PsychInfo and Informit databases. Key results within the retrieved articles were summarised and integrated to address the review objectives. RESULTS Based on the literature, the knowledge related to prevalence, screening, risk factorsunique to fathers, management strategies and outcomes of P-PPD is lacking. Currently, there is no consensual understanding of the definition of P-PPD and recommendations for dealing with P-PPD. Limited data were available regarding the barriers preventing fathers from accessing support systems. CONCLUSION Emerging issues that need to be addressed in future research include: P-PPD definition and pathogenetic pathways; prevention strategies and assessment tools; self-help seeking and engagement with interventions; the cost-effectiveness of P-PPD management; needs of health professionals; effect on child development, and public awareness. Future studies and clinical practice should account the complexities that may arise from the father's perceptions of health care services. Results from this review highlights the critical issues on how to plan, provide and resource health services, to meet the health needs of fathers.
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Affiliation(s)
- Kristiina Uriko
- School of Natural Sciences and Health, Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Andri Christoforou
- Department of Social and Behavioural Sciences, European University Cyprus, Nicosia, Cyprus
| | - Emma Motrico
- Department of Psychology, University Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA). Biomedical Research Institute of Malaga (IBIMA plataforma Bionand), Malaga, Spain
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
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24
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Wagner GJ, Gwokyalya V, Akena D, Nakigudde J, McBain R, Faherty L, Ngo V, Nakku J, Kyohangirwe L, Banegura A, Beyeza-Kashesya J, Wanyenze RK. Stressors and Maladaptive Coping Mechanisms Associated with Elevated Perinatal Depressive Symptoms and Suicidality Among Women Living with HIV in Uganda. Int J Behav Med 2023; 30:743-752. [PMID: 36127627 PMCID: PMC10084842 DOI: 10.1007/s12529-022-10124-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Perinatal depression is highly prevalent among women living with HIV and contributes to nonadherence to the PMTCT (prevention of mother-to-child transmission) care continuum. We examined correlates of elevated depressive symptoms and suicidality in this population. METHOD Baseline data from 391 Ugandan women enrolled in a cluster randomized controlled trial of a depression care intervention were analyzed. Adult women with confirmed sero-positive HIV status were eligible if their gestation period was ≤ 32 weeks, and they had a Patient Health Questionnaire (PHQ-9) score ≥ 5. Correlates of elevated depressive symptoms (PHQ-9 > 9) and moderate-to-severe suicidal ideation (more than half of the days in the prior 2 weeks) were assessed using bivariate and multivariate logistic regression models, controlling for clustering within study sites by using a random effects specification (with study site as the random effect), as well as age and education. RESULTS The mean PHQ-9 score was 12.7 (SD = 5.1); 267 (68.3%) participants had elevated depressive symptoms, and 51 (13.0%) reported moderate-to-severe suicidality. In multiple logistic regression analysis, perceived provider stigma of childbearing [OR (95% CI) = 1.81 (1.16, 2.84)], greater use of negative problem-solving [OR (95% CI) = 1.09 (1.04, 1.15)], and lower general social support [OR (95% CI) = 0.50 (0.30, 0.82)] were correlated with elevated depression symptoms, while moderate-to-severe suicidal ideation was correlated with greater experience of physical interpersonal violence (IPV) and greater use of negative problem-solving. CONCLUSIONS Programs aimed at improving provider support for the childbearing needs of persons living with HIV, supporting women who are experiencing IPV, and helping women to develop effective problem-solving skills and social supports may reduce symptoms of perinatal depression and help optimize PMTCT care outcomes. TRIAL REGISTRATION Clinicaltrials.gov NCT03892915 (registered March 21, 2019).
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Affiliation(s)
| | | | | | | | | | - Laura Faherty
- RAND Corporation, Santa Monica, CA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Victoria Ngo
- RAND Corporation, Santa Monica, CA, USA
- City University of New York Graduate School of Public Health and Health Policy, New York City, NY, USA
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25
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Harrison AG, Edwards MJ. The Ability of Self-Report Methods to Accurately Diagnose Attention Deficit Hyperactivity Disorder: A Systematic Review. J Atten Disord 2023; 27:1343-1359. [PMID: 37366274 DOI: 10.1177/10870547231177470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE To identify and analyze all studies validating rating scales or interview-based screeners commonly used to evaluate ADHD in adults. METHOD A systematic literature search identified all studies providing diagnostic accuracy statistics, including sensitivity and specificity, supplemented by relevant articles or test manuals referenced in reviewed manuscripts. RESULTS Only 20 published studies or manuals provided data regarding sensitivity and specificity when tasked with differentiating those with and without ADHD. While all screening measures have excellent ability to correctly classify non-ADHD individuals (with negative predictive values exceeding 96%), false positive rates were high. At best, positive predictive values in clinical samples reached 61%, but most fell below 20%. CONCLUSION Clinicians cannot rely on scales alone to diagnose ADHD and must undertake more rigorous evaluation of clients who screen positive. Furthermore, relevant classification statistics must be included in publications to help clinicians make statistically defensible decisions. Otherwise, clinicians risk inappropriately diagnosing ADHD.
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26
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Tonia T, Buitrago-Garcia D, Peter NL, Mesa-Vieira C, Li T, Furukawa TA, Cipriani A, Leucht S, Low N, Salanti G. Tool to assess risk of bias in studies estimating the prevalence of mental health disorders (RoB-PrevMH). BMJ MENTAL HEALTH 2023; 26:e300694. [PMID: 37899074 PMCID: PMC10619100 DOI: 10.1136/bmjment-2023-300694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE There is no standard tool for assessing risk of bias (RoB) in prevalence studies. For the purposes of a living systematic review during the COVID-19 pandemic, we developed a tool to evaluate RoB in studies measuring the prevalence of mental health disorders (RoB-PrevMH) and tested inter-rater reliability. METHODS We decided on items and signalling questions to include in RoB-PrevMH through iterative discussions. We tested the reliability of assessments by different users with two sets of prevalence studies. The first set included a random sample of 50 studies from our living systematic review. The second set included 33 studies from a systematic review of the prevalence of post-traumatic stress disorders, major depression and generalised anxiety disorder. We assessed the inter-rater agreement by calculating the proportion of agreement and Kappa statistic for each item. RESULTS RoB-PrevMH consists of three items that address selection bias and information bias. Introductory and signalling questions guide the application of the tool to the review question. The inter-rater agreement for the three items was 83%, 90% and 93%. The weighted kappa scores were 0.63 (95% CI 0.54 to 0.73), 0.71 (95% CI 0.67 to 0.85) and 0.32 (95% CI -0.04 to 0.63), respectively. CONCLUSIONS RoB-PrevMH is a brief, user-friendly and adaptable tool for assessing RoB in studies on prevalence of mental health disorders. Initial results for inter-rater agreement were fair to substantial. The tool's validity, reliability and applicability should be assessed in future projects.
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Affiliation(s)
- Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Diana Buitrago-Garcia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Natalie Luise Peter
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine and Health, Technical University of Munich, München, Germany
| | - Cristina Mesa-Vieira
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Freising, Germany
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Georgia Salanti
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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27
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Lyus R, Buamah C, Pollock A, Cosgrove L, Brhlikova P. Global Burden of Disease 2017 estimates for Major Depressive Disorder: a critical appraisal of the epidemiological evidence. JRSM Open 2023; 14:20542704231197594. [PMID: 37719088 PMCID: PMC10501079 DOI: 10.1177/20542704231197594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Objectives To critically appraise the quality of the studies underpinning the Global Burden of Disease (GBD) 2017 estimates for Major Depressive Disorder (MDD) with respect to i) the GBD 2017 inclusion criteria and ii) population coverage. Design Systematic critical appraisal. Setting Not applicable. Participants Not applicable. Main outcome measures Each study was critically appraised with respect to the four GBD 2017 inclusion criteria: representativeness, study method and sample, diagnostic criteria and publication from 1980 onwards. Population coverage was calculated. Results Less than half of studies (221/467, 47.3%) were nationally representative. Only 262/467 (56.1%) of studies reported specifically on MDD and more than a third did not use DSM or ICD diagnostic criteria: 94/467 (20.1%) did not specify any diagnostic criteria and 68/467 (14.6%) relied on self-reported depression for diagnosis. Only 62/467 (13.3%) of studies were conducted during the period 2011-2017. Only 107/195 (54.9%) of countries had one or more prevalence studies. Conclusions GBD 2017 estimates for MDD are based on incomplete country and population coverage. The inclusion of studies with non-representative populations, that do not use diagnostic criteria and the lack of specific data on MDD reduces the reliability of estimates and limits their value for policy making.
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Affiliation(s)
- R. Lyus
- Population Health Sciences Institute, Newcastle University, UK
| | - C. Buamah
- Population Health Sciences Institute, Newcastle University, UK
| | - A.M. Pollock
- Population Health Sciences Institute, Newcastle University, UK
| | | | - P. Brhlikova
- Population Health Sciences Institute, Newcastle University, UK
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28
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Taxiarchi VP, Senior M, Ashcroft DM, Carr MJ, Hope H, Hotopf M, Kontopantelis E, McManus S, Patalay P, Steeg S, Webb RT, Abel KM, Pierce M. Changes to healthcare utilisation and symptoms for common mental health problems over the first 21 months of the COVID-19 pandemic: parallel analyses of electronic health records and survey data in England. THE LANCET REGIONAL HEALTH. EUROPE 2023; 32:100697. [PMID: 37671125 PMCID: PMC10477036 DOI: 10.1016/j.lanepe.2023.100697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 09/07/2023]
Abstract
Background Few studies have investigated the effect of the COVID-19 pandemic on mental health beyond 2020. This study quantifies changes to healthcare utilisation and symptoms for common mental health problems over the pandemic's first 21 months. Methods Parallel cohort studies using primary care database and survey data for adults (≥16 years) in England from January 2015 to December 2021: 16,551,842 from the Clinical Practice Research Datalink (CPRD) and 40,699 from the UK Household Longitudinal Survey (UKHLS). Interrupted time-series models estimated changes in monthly prevalence of presentations and prescribed medications for anxiety and depression (CPRD); and self-reported psychological distress (UKHLS). The pandemic period was divided into five phases: 1st Wave (April-May 2020); post-1st Wave (June-September 2020); 2nd Wave (October 2020-February 2021); post 2nd Wave (March-May 2021); 3rd Wave (June-December 2021). Findings Primary care presentations for depression or anxiety dropped during the first wave (4.6 fewer monthly appointments per 1000 patients, 4.4-4.8) and remained lower than expected throughout follow-up. Self-reported psychological distress exceeded expected levels during the first (Prevalence Ratio = 1.378, 95% CI 1.289-1.459) and second waves (PR = 1.285, 1.189-1.377), returning towards expected levels during the third wave (PR = 1.038, 0.929-1.154). Increases in psychological distress and declines in presentations were greater for women. The decrease in primary care presentations for depression and anxiety exceeded that for physical health conditions (rheumatoid arthritis, diabetes, urinary tract infections). Anxiety and depression prescriptions returned to pre-pandemic levels during the second wave due to increased repeat prescriptions. Interpretation Despite periods of distress during the pandemic, we did not find an enduring effect on common mental health problems. The fall in primary care presentations for anxiety or depression suggests changing healthcare utilisation for mental distress and a potential treatment gap. Funding National Institute for Health and Care Research (NIHR).
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Affiliation(s)
- Vicky P. Taxiarchi
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Morwenna Senior
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Darren M. Ashcroft
- Faculty of Biology, Medicine and Health, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), University of Manchester, UK
| | - Matthew J. Carr
- Faculty of Biology, Medicine and Health, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), University of Manchester, UK
| | - Holly Hope
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Evangelos Kontopantelis
- Faculty of Biology, Medicine and Health, Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Sally McManus
- Violence and Society Centre, City, University of London, London EC1V 0HB, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Sarah Steeg
- Division of Psychology & Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
- NIHR School for Primary Care Research, UK
| | - Roger T. Webb
- National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), University of Manchester, UK
- Division of Psychology & Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Kathryn M. Abel
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Matthias Pierce
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
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Brehaut E, Neupane D, Levis B, Wu Y, Sun Y, Ioannidis JPA, Markham S, Cuijpers P, Patten SB, Benedetti A, Thombs BD. 'Optimal' cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study. Int J Methods Psychiatr Res 2023; 32:e1956. [PMID: 36461893 PMCID: PMC10485315 DOI: 10.1002/mpr.1956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/13/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screening results. We evaluated how depression screening tool studies select optimal cutoffs. METHODS We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation. RESULTS Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies (76%) identified an optimal cutoff other than the standard; most did not make use recommendations (N = 56; 43%) or recommended using a non-standard cutoff (N = 53; 40%). Only 4 studies cited a reporting guideline, and 4 described a protocol with optimal cutoff selection methods, but none used the protocol method in the published study. CONCLUSIONS Research is needed to guide how selection of cutoffs for depression screening tools can be standardized and reflect clinical considerations.
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Affiliation(s)
- Eliana Brehaut
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
| | - Dipika Neupane
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
| | - Brooke Levis
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Centre for Prognosis ResearchSchool of MedicineKeele UniversityStaffordshireUK
| | - Yin Wu
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of PsychiatryMcGill UniversityMontréalQuébecCanada
| | - Ying Sun
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
| | - John P. A. Ioannidis
- Department of MedicineDepartment of Epidemiology and Population HealthDepartment of Biomedical Data ScienceDepartment of Statisticsand Meta‐Research Innovation Center at Stanford (METRICS)Stanford UniversityStanfordCaliforniaUSA
| | - Sarah Markham
- Department of Biostatistics and Health InformaticsKing's College LondonLondonUK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije UniversiteitAmsterdamThe Netherlands
| | - Scott B. Patten
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
- Department of MedicineMcGill UniversityMontréalQuébecCanada
- Respiratory Epidemiology and Clinical Research UnitMcGill University Health CentreMontréalQuébecCanada
| | - Brett D. Thombs
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
- Department of PsychiatryMcGill UniversityMontréalQuébecCanada
- Department of MedicineMcGill UniversityMontréalQuébecCanada
- Department of PsychologyMcGill UniversityMontréalQuébecCanada
- Biomedical Ethics UnitMcGill UniversityMontréalQuébecCanada
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30
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Oevreboe TH, Ivarsson A, Sundgot-Borgen J, Knudsen AKS, Reneflot A, Pensgaard AM. Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes. BMJ Open Sport Exerc Med 2023; 9:e001538. [PMID: 37485002 PMCID: PMC10357714 DOI: 10.1136/bmjsem-2023-001538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives To, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with 'at-risk scores' on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between 'at-risk scores' and diagnosed mental disorders. Methods A two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with 'at-risk scores' using the fifth version of the Composite International Diagnostic Interview. Results Two hundred and eighty athletes (74.1%) had an 'at-risk score,' and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews. Conclusions Using self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further.
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Affiliation(s)
- Tom Henning Oevreboe
- Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | | | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Marte Pensgaard
- Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway
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31
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Lohmann J, John D, Dzay A. A scoping review of the methodological quality of research on mental health of healthcare professionals in low- and lower-middle income countries. Wellcome Open Res 2023; 7:169. [PMID: 37614773 PMCID: PMC10442593 DOI: 10.12688/wellcomeopenres.17916.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/25/2023] Open
Abstract
Background: SARS-CoV-2 has resulted in widespread awareness of health workers' work realities and their mental health impacts, and corresponding unprecedented research effort. Reviews of the quantitative literature on mental health of clinical skilled healthcare personnel in low- and lower-middle income countries (LLMIC), however, point at quality issues in the pre-pandemic literature. We used the evidence generated in the context of one pre-pandemic review to understand methodological strengths and weaknesses in detail, with the aim of distilling recommendations for future research. Methods: Our study used the literature identified in a systematic search from inception to the end of 2020, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. Following a scoping review approach, we extracted and charted data on key study characteristics as well as on study quality. In regard to the latter, we developed nine quality criteria on the basis of existing quality checklists, but expanding on issues of particular relevance to the measurement and interpretation of levels of mental health or illness. We collated the charted data in descriptive fashion. Results: We included data from 152 studies, which assessed a range of mental health outcomes, although most burnout. Most studies were conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. We judged only 20% of studies as of high quality due to shortcomings particularly regarding sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. Conclusion: We conclude that despite its impressive size, we can learn comparatively little from the body of literature up to the end of 2020 due to narrow study focus on specific settings and strong limitations in quality. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research. PROSPERO Registration: CRD42019140036.
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Affiliation(s)
- Julia Lohmann
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, WC1H 9SH, UK
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Heidelberg, 69120, Germany
| | - Denny John
- Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bengaluru, 560054, India
- Evidence Synthesis and Implementation for Indigenous Health: A JBI Affiliate Centre, Centre for Public Health Research (CPHR), MANT, Kolkata, 700078, India
| | - Aso Dzay
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, WC1H 9SH, UK
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Fuhr DC, Sikander S, Vanobberghen F, Weobong B, Rahman A, Weiss HA. Predictors of spontaneous remission and recovery among women with untreated perinatal depression in India and Pakistan. Glob Ment Health (Camb) 2023; 10:e34. [PMID: 37854406 PMCID: PMC10579649 DOI: 10.1017/gmh.2023.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/23/2023] [Accepted: 06/08/2023] [Indexed: 10/20/2023] Open
Abstract
Background Mothers with perinatal depression can show different symptom trajectories and may spontaneously remit from depression, however, the latter is poorly understood. This is the first study which sought to investigate predictors of spontaneous remission and longer-term recovery among untreated women with perinatal depression. Methods We analysed data from two randomised controlled trials in women with perinatal depression in India and Pakistan. Analyses were restricted to women in the control groups who did not receive active treatment. Generalised estimating equations and logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for within-person correlation. Results In multivariable analyses, remission was associated with a husband who is not working (adjusted OR, aOR = 2.04, 95% CI 1.02-4.11), lower Patient Health Questionnaire-9 score at baseline (aOR = 0.43, 95% CI 0.20-0.90 for score of ≥20 vs. 10-14) and better social support at baseline (aOR = 2.37, 95% CI 1.32-4.27 for high vs. low social support). Conclusions Women with low baseline severity may remit from perinatal depression with adequate social support from family and friends. These factors are important contributors to the management of perinatal depression and the prevention of clinical worsening, and should be considered when designing low-threshold psychological interventions.
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Affiliation(s)
- Daniela C. Fuhr
- Department of Prevention and Evaluation, Leibniz Institute of Prevention Research and Epidemiology, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
- Department of Health Services and Policy Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Siham Sikander
- Human Development Research Foundation, Rawalpindi, Pakistan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Fiona Vanobberghen
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Benedict Weobong
- Department of Social and Behavioural Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Atif Rahman
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Helen A. Weiss
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Adhikari S, Ma J, Shakya S, Brøndbo PH, Handegård BH, Javo AC. Self-reported emotional and behavioral problems among school-going adolescents in Nepal-A cross-sectional study. PLoS One 2023; 18:e0287305. [PMID: 37352299 PMCID: PMC10289424 DOI: 10.1371/journal.pone.0287305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/03/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Studies on self-reported emotional and behavioral problems (EBPs) among adolescents are still sparse in many low- and middle-income countries. In Nepal, no such studies have been performed on a larger scale, and little is known about self-reported EBPs in the adolescent population. METHODS This cross-sectional, school-based study on EBPs included 1904 adolescents aged 11-18 years, enrolled in government and private schools located in 16 districts in Nepal. The Nepali version of the Youth Self Report form was used to assess self-reported EBPs, and the Teacher Report Form was used to assess academic performance. Analysis of variance (ANOVA) was used for gender comparisons on adolescents' EBPs and on academic competence. Multiple regression analysis was done to explore correlates of self-reported EBPs. RESULTS The overall prevalence of self-reported EBPs was 14.2%; 15.6% in boys and 12.9% in girls. The mean Total Problems score was 39.27 (standard deviation = 24.16); no gender differences were observed. Boys scored higher on Externalizing Problems and girls scored higher on Internalizing Problems. The effect sizes for gender comparisons were small with Hedges' g ranging from -0.29 to 0.28. Physical illness and negative/traumatic life events were positively correlated with self-reported EBPs, whereas academic performance was negatively correlated. However, the effect sizes were small (η2 < 0.02). CONCLUSION This study helps to narrow the knowledge gap on the prevalence, magnitude, and types of self-reported EBPs in Nepali adolescents. It demonstrated an association between self-reported EBPs and academic performance and linked self-reported EBPs to other factors such as negative/traumatic life events and physical illness. The findings might assist health authorities in the planning of mental health services and may also provide valuable background information to clinicians dealing with adolescent mental health problems.
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Affiliation(s)
- Sirjana Adhikari
- Department of Psychology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
- Child & Adolescent Psychiatry Unit, Kanti Children’s Hospital, Kathmandu, Nepal
| | - Jasmine Ma
- Child & Adolescent Psychiatry Unit, Kanti Children’s Hospital, Kathmandu, Nepal
| | - Suraj Shakya
- Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Per Håkan Brøndbo
- Department of Psychology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare—North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Anne Cecilie Javo
- Sami National Competence Center for Mental Health (SANKS), Sami Klinihkka, Finnmark Hospital Trust, Karasjok, Norway
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Nassar EL, Abdulkareem DA, Thombs BD. Results from a living systematic review of the prevalence of mood and anxiety disorders and factors associated with symptoms in systemic sclerosis. Sci Rep 2023; 13:5181. [PMID: 36997795 PMCID: PMC10063612 DOI: 10.1038/s41598-023-31919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
We aimed to synthesize evidence on (1) the prevalence of mood and anxiety disorders and (2) factors associated with symptoms in systemic sclerosis (SSc). We searched MEDLINE, CINAHL, EMBASE, Cochrane CENTRAL, and PsycINFO via an ongoing living systematic review with automated monthly searches. We identified 6 eligible studies through March 1, 2023. Based on 3 studies (N = 93 to 345), current or 30-day major depressive disorder prevalence was 4% (95% confidence interval [CI] 2%, 6%) in a sample of Canadian outpatients (N = 345), 18% (95% CI 12%, 27%) in a study of Indian outpatients (N = 93), 10% (95% CI 4%, 21%) for French patient conference attendees (N = 51), and 29% (95% CI 18%, 42%) for French inpatients (N = 49). Current or 30-day prevalence of any anxiety disorder was 49% (95% CI 36%, 62%) for French conference attendees and 51% (95% CI 38%, 64%) for French inpatients; current or 30-day prevalence of generalized anxiety disorder was 3% for Indian outpatients (95% CI 1%, 9%; N = 93). In 3 studies (N = 114 to 376) that examined factors associated with depressive symptoms, higher education and being married or living as married were associated with lower symptoms and pulmonary involvement, breathing problems, and tender joint counts with higher symptoms; age and disease severity markers were not associated. Only 1 study (N = 114) assessed factors associated with anxiety symptoms and found no statistically significant associations. Limitations included heterogeneous populations and assessment methods, small samples, and substantial risk of bias concerns. Mood and anxiety disorder prevalence appear high in SSc, but estimates vary, and existing studies have important limitations. Future research should assess mood and anxiety prevalence and factors associated with symptoms using large representative samples and validated classification and assessment methods.Review registration: PROSPERO (CRD 42021251339).
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Affiliation(s)
- Elsa-Lynn Nassar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Pavilion H4.83, Montreal, QC, H3T 1E2, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Dalal A Abdulkareem
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Pavilion H4.83, Montreal, QC, H3T 1E2, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Pavilion H4.83, Montreal, QC, H3T 1E2, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
- Department of Psychology, McGill University, Montreal, QC, Canada.
- Department of Medicine, McGill University, Montreal, QC, Canada.
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada.
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Sun Y, Wu Y, Fan S, Dal Santo T, Li L, Jiang X, Li K, Wang Y, Tasleem A, Krishnan A, He C, Bonardi O, Boruff JT, Rice DB, Markham S, Levis B, Azar M, Thombs-Vite I, Neupane D, Agic B, Fahim C, Martin MS, Sockalingam S, Turecki G, Benedetti A, Thombs BD. Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ 2023; 380:e074224. [PMID: 36889797 PMCID: PMC9992728 DOI: 10.1136/bmj-2022-074224] [Citation(s) in RCA: 48] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVE To synthesise results of mental health outcomes in cohorts before and during the covid-19 pandemic. DESIGN Systematic review. DATA SOURCES Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies comparing general mental health, anxiety symptoms, or depression symptoms assessed from 1 January 2020 or later with outcomes collected from 1 January 2018 to 31 December 2019 in any population, and comprising ≥90% of the same participants before and during the covid-19 pandemic or using statistical methods to account for missing data. Restricted maximum likelihood random effects meta-analyses (worse covid-19 outcomes representing positive change) were performed. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies. RESULTS As of 11 April 2022, 94 411 unique titles and abstracts including 137 unique studies from 134 cohorts were reviewed. Most of the studies were from high income (n=105, 77%) or upper middle income (n=28, 20%) countries. Among general population studies, no changes were found for general mental health (standardised mean difference (SMD)change 0.11, 95% confidence interval -0.00 to 0.22) or anxiety symptoms (0.05, -0.04 to 0.13), but depression symptoms worsened minimally (0.12, 0.01 to 0.24). Among women or female participants, general mental health (0.22, 0.08 to 0.35), anxiety symptoms (0.20, 0.12 to 0.29), and depression symptoms (0.22, 0.05 to 0.40) worsened by minimal to small amounts. In 27 other analyses across outcome domains among subgroups other than women or female participants, five analyses suggested that symptoms worsened by minimal or small amounts, and two suggested minimal or small improvements. No other subgroup experienced changes across all outcome domains. In three studies with data from March to April 2020 and late 2020, symptoms were unchanged from pre-covid-19 levels at both assessments or increased initially then returned to pre-covid-19 levels. Substantial heterogeneity and risk of bias were present across analyses. CONCLUSIONS High risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues, with study results posted online (https://www.depressd.ca/covid-19-mental-health). REVIEW REGISTRATION PROSPERO CRD42020179703.
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Affiliation(s)
- Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Suiqiong Fan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Tiffany Dal Santo
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Letong Li
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Xiaowen Jiang
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kexin Li
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yutong Wang
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Amina Tasleem
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Olivia Bonardi
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada
| | - Danielle B Rice
- Department of Psychology, St Joseph's Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ian Thombs-Vite
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Branka Agic
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Christine Fahim
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Michael S Martin
- School of Epidemiology and Public Health, University of Ottawa; Ontario, Canada
- Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
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Shevlin M, Hyland P, Butter S, McBride O, Hartman TK, Karatzias T, Bentall RP. The development and initial validation of self-report measures of ICD-11 depressive episode and generalized anxiety disorder: The International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ). J Clin Psychol 2023; 79:854-870. [PMID: 36215152 PMCID: PMC10092474 DOI: 10.1002/jclp.23446] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/11/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The new International Classification of Diseases came into effect in 2022 (ICD-11; World Health Organization, 2022) and included updated descriptions and diagnostic rules for "Depressive Episode" and "Generalized Anxiety Disorder." No self-report measures align with these disorders so this study reports the development and initial validation of the "International Depression Questionnaire" (IDQ) and "International Anxiety Questionnaire" (IAQ). METHODS Items were developed that aligned to the ICD-11 descriptions and their performance was assessed using data from a community sample (N = 2058) that was representative of the United Kingdom adult population. RESULTS Item response theory models indicated that the two scales were unidimensional, and the items performed well in terms of difficulty and discrimination. Estimates of internal reliability were high. Based on ICD-11 derived diagnostic algorithms, 7.4% met requirements for ICD-11 Depressive Episode and 7.1% for Generalized Anxiety Disorder. CONCLUSIONS The IDQ and the IAQ are short, easy to use, self-report measures aligned to the new and updated ICD-11 diagnostic descriptions. This study provides initial evidence that the scales produce scores that are reliable and valid.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, Scotland
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
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Lockett H, Luckman A, Jury A, Postelnik T, Lacey C. Whakairo: A values-led approach to psychiatric epidemiology. Aust N Z J Psychiatry 2023; 57:157-160. [PMID: 36708280 DOI: 10.1177/00048674231151778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Helen Lockett
- Te Pou, Wellington, New Zealand.,Department of Public Health, University of Otago, Wellington Te Whare Wānanga o Otāgo ki Poneke, Wellington, New Zealand
| | | | | | | | - Cameron Lacey
- Department of Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch Te Whare Wānanga o Otāgo ki Ōtautahi, Christchurch, New Zealand
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Fischer F, Zocholl D, Rauch G, Levis B, Benedetti A, Thombs B, Rose M, Kostoulas P. Prevalence estimates of major depressive disorder in 27 European countries from the European Health Interview Survey: accounting for imperfect diagnostic accuracy of the PHQ-8. BMJ MENTAL HEALTH 2023; 26:e300675. [PMID: 37024144 PMCID: PMC10083787 DOI: 10.1136/bmjment-2023-300675] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/06/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Cut-offs on self-report depression screening tools are designed to identify many more people than those who meet criteria for major depressive disorder. In a recent analysis of the European Health Interview Survey (EHIS), the percentage of participants with Patient Health Questionnaire-8 (PHQ-8) scores ≥10 was reported as major depression prevalence. OBJECTIVE We used a Bayesian framework to re-analyse EHIS PHQ-8 data, accounting for the imperfect diagnostic accuracy of the PHQ-8. METHODS The EHIS is a cross-sectional, population-based survey in 27 countries across Europe with 258 888 participants from the general population. We incorporated evidence from a comprehensive individual participant data meta-analysis on the accuracy of the PHQ-8 cut-off of ≥10. We evaluated the joint posterior distribution to estimate the major depression prevalence, prevalence differences between countries and compared with previous EHIS results. FINDINGS Overall, major depression prevalence was 2.1% (95% credible interval (CrI) 1.0% to 3.8%). Mean posterior prevalence estimates ranged from 0.6% (0.0% to 1.9%) in the Czech Republic to 4.2% (0.2% to 11.3%) in Iceland. Accounting for the imperfect diagnostic accuracy resulted in insufficient power to establish prevalence differences. 76.4% (38.0% to 96.0%) of observed positive tests were estimated to be false positives. Prevalence was lower than the 6.4% (95% CI 6.2% to 6.5%) estimated previously. CONCLUSIONS Prevalence estimation needs to account for imperfect diagnostic accuracy. CLINICAL IMPLICATIONS Major depression prevalence in European countries is likely lower than previously reported on the basis of the EHIS survey.
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Affiliation(s)
- Felix Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dario Zocholl
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Geraldine Rauch
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Quèbec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quèbec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quèbec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Brett Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Quèbec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quèbec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
- Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
| | - Matthias Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Gnanapragasam SN, Tinch-Taylor R, Scott HR, Hegarty S, Souliou E, Bhundia R, Lamb D, Weston D, Greenberg N, Madan I, Stevelink S, Raine R, Carter B, Wessely S. Multicentre, England-wide randomised controlled trial of the 'Foundations' smartphone application in improving mental health and well-being in a healthcare worker population. Br J Psychiatry 2023; 222:58-66. [PMID: 36040419 PMCID: PMC10895508 DOI: 10.1192/bjp.2022.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/27/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Healthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated. AIMS We aimed to determine the effectiveness of the 'Foundations' application (app) on general (non-psychotic) psychiatric morbidity. METHOD We conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD). RESULTS Between 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44⋅3 years (interquartile range (IQR) 34-53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = -1.39, 95% CI -2.05 to -0.74), improvement in well-being (aMD = 0⋅54, 95% CI 0⋅20 to 0⋅89) and reduction in insomnia (adjusted odds ratio (aOR) = 0⋅36, 95% CI 0⋅21 to 0⋅60). No other significant findings were found, or adverse events reported. CONCLUSIONS The app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.
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Affiliation(s)
- Sam N. Gnanapragasam
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Rose Tinch-Taylor
- Department of Biostatistics and Health Informatics and King's Clinical Trials Unit, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK
| | - Hannah R. Scott
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Siobhan Hegarty
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Emilia Souliou
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Rupa Bhundia
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Danielle Lamb
- Department of Applied Health Research, University College London, UK
| | - Danny Weston
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Neil Greenberg
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Ira Madan
- Department of Occupational Health, Guy's and St Thomas’ NHS Foundation Trust, UK
| | - Sharon Stevelink
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics and King's Clinical Trials Unit, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK
| | - Simon Wessely
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK
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Sanchez K, Hall LR, da Graca B, Bennett MM, Powers MB, Warren AM. The experience of COVID-19 among people with depression: Impact on daily life and coping strategies. J Affect Disord 2023; 321:59-65. [PMID: 36283536 PMCID: PMC9595490 DOI: 10.1016/j.jad.2022.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The prevalence of depression symptoms among U.S. adults increased dramatically during the early months of the COVID-19 pandemic. We sought to understand the impact of the pandemic on people with a history of depression. METHODS In June 2020, a national sample of 5023 U.S. adults, including 760 reporting past/current diagnoses of depression, completed survey measures related to the COVID experience, coping, anxiety, depression, and PTSD. RESULTS After adjusting for sociodemographic characteristics, a history of depression increased the odds of negative effects of pandemic on multiple aspects of life: routines, access to mental health treatment, alcohol use, prescription painkiller use, and other drug use. Those with a history of depression also scored significantly higher on the PHQ-8, GAD-7, and PDS-5 (all ps < 0.0001). Greater use of adaptive coping strategies was significantly associated with lower scores, and greater use of maladaptive strategies with higher scores. Individuals reporting a history of depression reported greater use of both adaptive and maladaptive strategies. CONCLUSIONS Adaptive coping strategies appear to be protective and help regulate symptomatology, suggesting that particular focus during the clinical encounter on developing tools to promote well-being, alleviate stress, and decrease perceptions of helplessness could mitigate the effects.
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Affiliation(s)
- Katherine Sanchez
- Baylor Scott & White Research Institute, Dallas, TX, United States of America; University of Texas at Arlington, School of Social Work, Arlington, TX, United States of America.
| | - Lauren R. Hall
- Baylor Scott & White Research Institute, Dallas, TX, United States of America
| | - Briget da Graca
- Baylor Scott & White Research Institute, Dallas, TX, United States of America
| | - Monica M. Bennett
- Baylor Scott & White Research Institute, Dallas, TX, United States of America
| | - Mark B. Powers
- Baylor Scott & White Research Institute, Dallas, TX, United States of America,Baylor University Medical Center, Dallas, TX, United States of America,Texas A&M University – College of Medicine, Dallas, TX, United States of America
| | - Ann Marie Warren
- Baylor Scott & White Research Institute, Dallas, TX, United States of America,Baylor University Medical Center, Dallas, TX, United States of America,Texas A&M University – College of Medicine, Dallas, TX, United States of America
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Morissette SB, Blessing A, Russell P, Hale W. Cannabis use disorder uniquely predicts educational impairment in college students over and above other mental health disorders. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 36595591 DOI: 10.1080/07448481.2022.2155058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/20/2022] [Accepted: 09/25/2022] [Indexed: 06/17/2023]
Abstract
Objective: The impact of cannabis use disorder (CUD) on education functioning and GPA was examined within the context of co-occurring alcohol use disorder (AUD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Participants: Undergraduates (N = 210) who reported using cannabis within the past six months were recruited. Methods: Hierarchical multiple regression analyses were used to determine whether CUD symptom severity and presence of probable CUD diagnosis predicted educational impairment and current GPA, over and above other mental health conditions. Results: CUD symptom severity, but not probable CUD, significantly predicted greater educational impairment, over and above probable PTSD and MDD, which were also significant predictors. CUD symptom severity, but not probable CUD, significantly predicted lower GPA. Conclusion: In addition to other common mental health conditions, CUD may be an important area of assessment and intervention for university counseling centers to foster student academic success.
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Affiliation(s)
| | - Alexis Blessing
- The University of Texas at San Antonio, San Antonio, Texas, USA
| | | | - Willie Hale
- The University of Texas at San Antonio, San Antonio, Texas, USA
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Blessing A, Russell PD, DeBeer BB, Kimbrel NA, Meyer EC, Morissette SB. The influence of cannabis use disorder on post-traumatic stress disorder symptoms, depression symptoms, and non-suicidal self-injury among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 36595655 DOI: 10.1080/07448481.2022.2155471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
Objective: The interrelationships between cannabis use disorder (CUD), post-traumatic stress disorder (PTSD) and depressive symptoms, and non-suicidal self-injury (NSSI) were examined. Participants: Undergraduates (N = 363) who reported using cannabis within the past six months were recruited. Method: Mediation analyses was conducted to examine if CUD symptoms were indirectly associated with greater risk for engagement in current NSSI through more severe PTSD and depression symptoms. A factor comprised of PTSD-depression symptoms was created given PTSD and depression symptoms were highly correlated. Results: Greater CUD symptom severity indirectly increased risk for current NSSI via more severe PTSD-depression symptoms, after accounting for gender and alcohol use disorder symptoms. Conclusion: The current study provides preliminary evidence for the negative consequences of CUD on college students' mental health symptoms and engagement in NSSI, and future longitudinal research is needed to examine the dynamic relationships between CUD, PTSD-depression symptoms, and NSSI over time.
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Affiliation(s)
- Alexis Blessing
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Patricia D Russell
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA
| | - Bryann B DeBeer
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Eric C Meyer
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sandra B Morissette
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, USA
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Scott HR, Stevelink SAM, Gafoor R, Lamb D, Carr E, Bakolis I, Bhundia R, Docherty MJ, Dorrington S, Gnanapragasam S, Hegarty S, Hotopf M, Madan I, McManus S, Moran P, Souliou E, Raine R, Razavi R, Weston D, Greenberg N, Wessely S. Prevalence of post-traumatic stress disorder and common mental disorders in health-care workers in England during the COVID-19 pandemic: a two-phase cross-sectional study. Lancet Psychiatry 2023; 10:40-49. [PMID: 36502817 PMCID: PMC9731576 DOI: 10.1016/s2215-0366(22)00375-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies on the impact of the COVID-19 pandemic on the mental health of health-care workers have relied on self-reported screening measures to estimate the point prevalence of common mental disorders. Screening measures, which are designed to be sensitive, have low positive predictive value and often overestimate prevalence. We aimed to estimate prevalence of common mental disorders and post-traumatic stress disorder (PTSD) among health-care workers in England using diagnostic interviews. METHODS We did a two-phase, cross-sectional study comprising diagnostic interviews within a larger multisite longitudinal cohort of health-care workers (National Health Service [NHS] CHECK; n=23 462) during the COVID-19 pandemic. In the first phase, health-care workers across 18 NHS England Trusts were recruited. Baseline assessments were done using online surveys between April 24, 2020, and Jan 15, 2021. In the second phase, we selected a proportion of participants who had responded to the surveys and conducted diagnostic interviews to establish the prevalence of mental disorders. The recruitment period for the diagnostic interviews was between March 1, 2021 and Aug 27, 2021. Participants were screened with the 12-item General Health Questionnaire (GHQ-12) and assessed with the Clinical Interview Schedule-Revised (CIS-R) for common mental disorders or were screened with the 6-item Post-Traumatic Stress Disorder Checklist (PCL-6) and assessed with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD. FINDINGS The screening sample contained 23 462 participants: 2079 participants were excluded due to missing values on the GHQ-12 and 11 147 participants due to missing values on the PCL-6. 243 individuals participated in diagnostic interviews for common mental disorders (CIS-R; mean age 42 years [range 21-70]; 185 [76%] women and 58 [24%] men) and 94 individuals participated in diagnostic interviews for PTSD (CAPS-5; mean age 44 years [23-62]; 79 [84%] women and 15 [16%] men). 202 (83%) of 243 individuals in the common mental disorders sample and 83 (88%) of 94 individuals in the PTSD sample were White. GHQ-12 screening caseness for common mental disorders was 52·8% (95% CI 51·7-53·8). Using CIS-R diagnostic interviews, the estimated population prevalence of generalised anxiety disorder was 14·3% (10·4-19·2), population prevalence of depression was 13·7% (10·1-18·3), and combined population prevalence of generalised anxiety disorder and depression was 21·5% (16·9-26·8). PCL-6 screening caseness for PTSD was 25·4% (24·3-26·5). Using CAPS-5 diagnostic interviews, the estimated population prevalence of PTSD was 7·9% (4·0-15·1). INTERPRETATION The prevalence estimates of common mental disorders and PTSD in health-care workers were considerably lower when assessed using diagnostic interviews compared with screening tools. 21·5% of health-care workers met the threshold for diagnosable mental disorders, and thus might benefit from clinical intervention. FUNDING UK Medical Research Council; UCL/Wellcome; Rosetrees Trust; NHS England and Improvement; Economic and Social Research Council; National Institute for Health and Care Research (NIHR) Biomedical Research Centre at the Maudsley and King's College London (KCL); NIHR Protection Research Unit in Emergency Preparedness and Response at KCL.
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Affiliation(s)
- Hannah R Scott
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sharon A M Stevelink
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Rafael Gafoor
- Department of Applied Health Research, University College London, London, UK
| | - Danielle Lamb
- Department of Applied Health Research, University College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rupa Bhundia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Sarah Dorrington
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Sam Gnanapragasam
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Siobhan Hegarty
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Ira Madan
- Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sally McManus
- NatCen Social Research, London, UK; Violence and Society Centre City, University of London, London, UK
| | - Paul Moran
- Department of Population Health Sciences, Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emilia Souliou
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Reza Razavi
- Wellcome/EPSRC Centre For Medical Engineering, London, UK
| | - Danny Weston
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Teusen C, Hapfelmeier A, von Schrottenberg V, Gökce F, Pitschel-Walz G, Henningsen P, Gensichen J, Schneider A. Combining the GP's assessment and the PHQ-9 questionnaire leads to more reliable and clinically relevant diagnoses in primary care. PLoS One 2022; 17:e0276534. [PMID: 36269712 PMCID: PMC9586376 DOI: 10.1371/journal.pone.0276534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
Abstract
Background Screening questionnaires are not sufficient to improve diagnostic quality of depression in primary care. The additional consideration of the general practitioner’s (GP’s) assessment could improve the accuracy of depression diagnosis. The aim of this study was to examine whether the GP rating supports a reliable depression diagnosis indicated by the PHQ-9 over a period of three months. Methods We performed a secondary data analysis from a previous study. PHQ-9 scores of primary care patients were collected at the time of recruitment (t1) and during a follow-up 3 months later (t2). At t1 GPs independently made a subjective assessment whether they considered the patient depressive (yes/no). Two corresponding groups with concordant and discordant PHQ-9 and GP ratings at t1 were defined. Reliability of the PHQ-9 results at t1 and t2 was assessed within these groups and within the entire sample by Cohen’s Kappa, Pearson’s correlation coefficient and Bland-Altman plots. Results 364 consecutive patients from 12 practices in the region of Upper Bavaria/Germany participated in this longitudinal study. 279 patients (76.6%) sent back the questionnaire at t2. Concordance of GP rating and PHQ-9 at t1 led to higher replicability of PHQ-9 results between t1 and t2. The reliability of PHQ-9 was higher in the concordant subgroup (κ = 0.507) compared to the discordant subgroup (κ = 0.211) (p = 0.064). The Bland-Altman Plot showed that the deviation of PHQ-9 scores at t1 and t2 decreased by about 15% in the concordant subgroup. Pearson’s correlation coefficient between PHQ-9 scores at t1 and t2 increased significantly if the GP rating was concordant with the PHQ-9 at t1 (r = 0.671) compared to the discordant subgroup (r = 0.462) (p = 0.044). Conclusions The combination of PHQ-9 and GP rating might improve diagnostic decision making regarding depression in general practices. PHQ-9 positive results might be more reliable and accurate, when a concordant GP rating is considered.
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Affiliation(s)
- Clara Teusen
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
- * E-mail:
| | - Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
- Institute for AI and Informatics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
| | - Victoria von Schrottenberg
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
| | - Feyza Gökce
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
| | - Gabriele Pitschel-Walz
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
| | - Peter Henningsen
- Dept. of Psychosomatic Medicine and Psychotherapy, University Hospital TU Munich, Munich, Bavaria, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians-University of Munich, Munich, Bavaria, Germany
| | - Antonius Schneider
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich, Munich, Bavaria, Germany
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Bedaso A, Adams J, Peng W, Xu F, Sibbritt D. An examination of the association between marital status and prenatal mental disorders using linked health administrative data. BMC Pregnancy Childbirth 2022; 22:735. [PMID: 36182904 PMCID: PMC9526285 DOI: 10.1186/s12884-022-05045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background International research shows marital status impacts the mental health of pregnant women, with prenatal depression and anxiety being higher among non-partnered women. However, there have been few studies examining the relationship between marital status and prenatal mental disorders among Australian women. Methods This is a population-based retrospective cohort study using linked data from the New South Wales (NSW) Perinatal Data Collection (PDC) and Admitted Patients Data Collection (APDC). The cohort consists of a total of 598,599 pregnant women with 865,349 admissions. Identification of pregnant women for mental disorders was conducted using the 10th version International Classification of Diseases and Related Health Problems, Australian Modification (ICD-10-AM). A binary logistic regression model was used to estimate the relationship between marital status and prenatal mental disorder after adjusting for confounders. Results Of the included pregnant women, 241 (0.04%), 107 (0.02%) and 4359 (0.5%) were diagnosed with depressive disorder, anxiety disorder, and self-harm, respectively. Non-partnered pregnant women had a higher likelihood of depressive disorder (Adjusted Odds Ratio (AOR) = 2.75; 95% CI: 2.04, 3.70) and anxiety disorder (AOR = 3.16, 95% CI: 2.03, 4.91), compared with partnered women. Furthermore, the likelihood of experiencing self-harm was two times higher among non-partnered pregnant women (AOR = 2.00; 95% CI: 1.82, 2.20) than partnered pregnant women. Conclusions Non-partnered marital status has a significant positive association with prenatal depressive disorder, anxiety disorder and self-harm. This suggests it would be highly beneficial for maternal health care professionals to screen non-partnered pregnant women for prenatal mental health problems such as depression, anxiety and self-harm. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05045-8.
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Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Fenglian Xu
- Data Analysis & Surgical Outcomes Unit, Royal North Shore Hospital, Sydney, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Huang E, Edgar NE, MacLean SE, Hatcher S. Workplace Assessment Scale: Pilot Validation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12408. [PMID: 36231726 PMCID: PMC9566622 DOI: 10.3390/ijerph191912408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
First responders, such as police officers, paramedics, and firefighters are at an increased risk of experiencing negative mental health outcomes compared to the general population. This predisposition can partially be attributed to common occupational stressors, which may provoke strong feelings of betrayal and humiliation. The Workplace Assessment Scale (WAS) was developed as there is currently no appropriate measure to assess such feelings in the first responder population. Initial development of the WAS included a Betrayal Subscale and the Humiliation Subscale, each comprised of 5 Likert scale questions which ask participants to report the frequency at which they experience specific feelings associated with their workplace. This pilot validation study was conducted to determine if there is preliminary evidence to support a large-scale validation study. To determine this, we assessed the internal structure and the convergent, concurrent, and predictive validity of the WAS. Based on 21/22 (95%) participant responses, a factor analysis did not support the two-factor model we anticipated, with only one factor and seven items retained from the original version of the scale. However, the internal consistency of the remaining items was strong. The validity analysis found moderate convergent validity and weak predictive validity based on correlations between the WAS and other psychometric scales. Minimal concurrent validity was noted. Additional research is needed for further analysis and validation of the WAS.
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Affiliation(s)
- Eileen Huang
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - Nicole E. Edgar
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - Sarah E. MacLean
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
- School of Journalism and Communication, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada
| | - Simon Hatcher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
- Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada
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Wild J, McKinnon A, Wilkins A, Browne H. Post-traumatic stress disorder and major depression among frontline healthcare staff working during the COVID-19 pandemic. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:859-866. [PMID: 34713436 PMCID: PMC8646304 DOI: 10.1111/bjc.12340] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/10/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES High rates of probable post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) have been reported for frontline healthcare staff during the COVID-19 pandemic. However, rates determined by diagnostic assessment are unknown, as are the onset of symptoms and associated index events. METHODS We assessed frontline healthcare staff with the Structured Clinical Interview for DSM-5. RESULTS Forty-four percent met criteria for PTSD and 39% met criteria for MDD. Twenty-four percent reported COVID-19 trauma as their index event, with the majority of staff reporting trauma that pre-dated the pandemic. While PTSD was likely to be pre-existing, MDD was more likely to develop during pandemic working. CONCLUSION These findings indicate the propensity of healthcare staff to experience a range of occupational and personal trauma associated with PTSD and the need to assess index trauma when diagnosing psychopathology in order to best understand the needs of this workforce. PRACTITIONER POINTS We found high diagnostic rates of PTSD (44%) and major depression (39%) among frontline healthcare staff working during the COVID-19 pandemic. Although major depression developed during the pandemic, PTSD was more likely to be pre-existing. When assessing pandemic-related psychopathology, it is important to assess the onset and index event related to symptoms. Healthcare workers appear to have high rates of PTSD related to occupational and personal trauma, which warrants specific focus in service planning.
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Affiliation(s)
- Jennifer Wild
- Department of Experimental PsychologyUniversity of OxfordUK
| | - Aimee McKinnon
- Department of Experimental PsychologyUniversity of OxfordUK
| | - Abbie Wilkins
- Department of Experimental PsychologyUniversity of OxfordUK
| | - Haddi Browne
- Department of Experimental PsychologyUniversity of OxfordUK
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Factors Associated With Past-year and Lifetime Prevalence of Cannabis Withdrawal: A Secondary Analysis. CANADIAN JOURNAL OF ADDICTION 2022. [DOI: 10.1097/cxa.0000000000000155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Kiewa J, Meltzer-Brody S, Milgrom J, Bennett E, Mackle T, Guintivano J, Hickie IB, Colodro-Conde L, Medland SE, Martin N, Wray N, Byrne E. Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression. BMJ Open 2022; 12:e059300. [PMID: 35973706 PMCID: PMC9621163 DOI: 10.1136/bmjopen-2021-059300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression. DESIGN AND SETTING The Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms. PARTICIPANTS In a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures. RESULTS The prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005). CONCLUSIONS The majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.
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Affiliation(s)
- Jacqueline Kiewa
- Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
| | | | - Jeannette Milgrom
- Parent-Infant Research Institute, Heidelberg Heights, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Jerry Guintivano
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Nick Martin
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Naomi Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Enda Byrne
- Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
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González-Blanch C, Gleeson JF, McEnery C, O'Sullivan S, Ayesa-Arriola R, D'Alfonso S, Valentine L, Tremain H, Bell I, Bendall S, Alvarez-Jimenez M. The impact of persistent social anxiety on social functioning and health-related quality of life in young people with remitted first-episode psychosis. Early Interv Psychiatry 2022; 16:868-874. [PMID: 34716667 DOI: 10.1111/eip.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/26/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Comorbid social anxiety is common in psychotic disorders and is associated with multiple negative consequences. However, the long-term effects of persistent social anxiety versus fluctuating or no anxiety on social functioning and health-related quality of life (HR-QoL) have received scant attention. Therefore, we aimed to examine the prevalence of persistent social anxiety to determine its effect on social functioning and HR-QoL in first-episode psychosis (FEP). METHODS One hundred and eight individuals with remitted FEP were classified into three groups (persistent, fluctuating or no social anxiety) according to the Social Interaction Anxiety Scale over an 18-month follow-up period. The three groups were then compared at 18 months follow-up to assess the influence of social anxiety on social functioning and HR-QoL before and after controlling for confounders. RESULTS Of the 108 individuals with FEP, 25 (23.1%) had persistent social anxiety. This group presented lower social functioning and HR-QoL levels compared to the groups with fluctuating or no anxiety symptoms. The effect on HR-QoL remained significant after controlling for positive psychotic and depressive symptoms. CONCLUSIONS In this study, nearly one-quarter of young people with remitted FEP experienced persistent social anxiety symptoms, which had a negative impact on HR-QoL. Thus, individuals with persistent social anxiety constitute a highly vulnerable group and may require targeted interventions to improve their social functioning and HR-QoL.
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Affiliation(s)
- César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John F Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Carla McEnery
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
| | - Shaunagh O'Sullivan
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
| | | | - Simon D'Alfonso
- Orygen, Melbourne, Victoria, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Lee Valentine
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
| | - Hailey Tremain
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
| | - Imogen Bell
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
| | - Sarah Bendall
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen, Melbourne, Victoria, Australia
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