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Gökce F, Jais D, Sterner P, Schneider A, Gensichen J, Pitschel-Walz G. The revision and factor analytic evaluation of the German version of the depression literacy scale (D-Lit-R German). BMC Psychol 2024; 12:235. [PMID: 38664847 PMCID: PMC11046899 DOI: 10.1186/s40359-024-01730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Depression is a common mental health disorder and the second leading cause of disability worldwide. In people with depression, low depression literacy, which could be characterized by a poor recognition of depressive symptoms and less knowledge about the availability of treatment options, can hinder adequate therapy for depression. Nevertheless, questionnaires measuring depression literacy in Germany are rare. Consequently, for the present study, the German Depression Literacy Scale (D-Lit) has been revised and evaluated. METHODS First, a team of clinical psychologists revised the D-Lit German scale. Next, cognitive interviews were conducted with patients with depression to improve the comprehensibility of the scale items. Our revision of the D-Lit-R German scale was then subjected to an anonymous online study. Finally, the data went through an exploratory factor analysis, and sociodemographic subgroup analyses were performed. RESULTS N = 524 individuals (age 18-80) completed the D-Lit-R German scale and a questionnaire on their sociodemographic data. Cronbach´s alpha was estimated as α = .72, and McDonald's Omega (categorical) was estimated as ω = .77. The mean Item difficulty was M = .75 (SD = .15). An EFA was performed for a unidimensional model, a 5-factor-model and at last a 3-factor-model. The 5-factorial model showed a good model fit (χ2emp,WLSMV(131) = 92.424, p > .05; CFI = 1, RMSEA = 0, SRMR = .07) but was rejected since the content of the potential 5 factors could not be determined. The 3-factor model showed an arguable model fit. The Chi2 test was significant (χ2emp,WLSMV(168) = 199.912, p < .05), but the CFI and the RMSEA met an acceptable model fit (CFI = .990, RMSEA of .019, 90% CI[.003, .029]). Substantively, the three factors were defined as (1) Distractors and other symptoms, (2) Depressive symptoms, and (3) Pharmacological and psychotherapeutic depression treatment. Furthermore, there were significant differences in sum scores regarding the subgroup's gender, treatment for mental health problems, depression treatment, experience with depression, and different career fields. CONCLUSIONS The D-Lit-R German scale is a time-efficient scale to assess some aspects of the depression literacy construct that can be easily applied. Since there was no perfect model fit, it is recommended to continue to revise the scale. Further evaluation studies could ask for knowledge of the etiological factors of depression. Future studies could then use this instrument to convey depression literacy. This instrument could assess the growth of knowledge after psychoeducational interventions in different settings. TRIAL REGISTRATION This trial was preregistered at the platform osf.io ( https://osf.io/49xdh ). REGISTRATION NUMBER https://doi.org/10.17605/OSF.IO/49XDH Date of registration: 28 April 2022.
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Affiliation(s)
- Feyza Gökce
- School of Medicine and Health, Department of Clinical Medicine, Technical University Munich, Institute of General Practice and Health Services Research, Orleansstraße 47, 81667, Munich, Germany.
| | - Denise Jais
- School of Medicine and Health, Department of Clinical Medicine, Technical University Munich, Institute of General Practice and Health Services Research, Orleansstraße 47, 81667, Munich, Germany
| | - Philipp Sterner
- Department of Psychology, LMU Munich, Leopoldstr. 13, 80802, Munich, Germany
| | - Antonius Schneider
- School of Medicine and Health, Department of Clinical Medicine, Technical University Munich, Institute of General Practice and Health Services Research, Orleansstraße 47, 81667, Munich, Germany
| | - Jochen Gensichen
- Institute of General Practice, LMU Munich, Nußbaumstraße 5, 80336, Munich, Germany
| | - Gabriele Pitschel-Walz
- School of Medicine and Health, Department of Clinical Medicine, Technical University Munich, Institute of General Practice and Health Services Research, Orleansstraße 47, 81667, Munich, Germany
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Koens S, Klein J, Härter M, Strauß A, Scherer M, Schäfer I, von dem Knesebeck O. [Intended utilization of health care services in cases of mental illnesses with varying urgency]. PSYCHIATRISCHE PRAXIS 2024. [PMID: 38359870 DOI: 10.1055/a-2230-3163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To investigate variations in intended utilization in cases of an acute psychotic episode, an alcohol related or depressive disorder depending on different case characteristics. METHODS A telephone survey with case vignettes was conducted (N=1,200). Vignettes varied in terms of urgency of symptoms, daytime, sex of the afflicted person and age/mental disorder. The respondents were asked to indicate whom they would contact first in the described case. RESULTS Outpatient physicians were named most frequently as the first point of contact (61.1%) while only 6.5% of the respondents named emergency medicine including the medical on call service (8.1% in high urgency cases, i. e. emergencies that did not tolerate any delay). Intended utilization varied by urgency and age/mental illness. CONCLUSION More Information about the need to seek medical help immediately in cases of mental illnesses with high urgency should be provided.
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Affiliation(s)
- Sarah Koens
- Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf
| | - Jens Klein
- Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf
| | - Martin Härter
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf
| | - Annette Strauß
- Institut und Poliklinik für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - Martin Scherer
- Institut und Poliklinik für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - Ingo Schäfer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf
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Koens S, Klein J, Scherer M, Strauß A, Härter M, Schäfer I, Lüdecke D, von dem Knesebeck O. Perceived treatment urgency of common mental disorders in the German population. Sci Rep 2023; 13:22711. [PMID: 38123622 PMCID: PMC10733386 DOI: 10.1038/s41598-023-49969-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Perceived treatment urgency of mental disorders are important as they determine utilization of health care. The aim was to analyze variations in perceived treatment urgency in cases of psychosis (adolescents), alcoholism (adults), and depression (older adults) with two levels of severity each by characteristics of the case and the respondents. A telephone survey (N = 1200) with vignettes describing cases of psychosis, alcoholism, and depression was conducted in Hamburg, Germany. Vignettes varied by symptom severity and sex. Perceived treatment urgency was assessed by three items. A sum scale was calculated. Linear regression models were computed to analyze differences in perceived urgency by characteristics of the case (severity, sex) and the respondents (sex, age, education, migration background, illness recognition, personal affliction). Perceived treatment urgency was significantly higher in severe cases and varied by education. Additionally, regarding psychosis, estimated urgency varied significantly by correct illness recognition. With regard to depression, perceived urgency differed significantly by age and correct illness recognition. Interaction effects between case severity and sociodemographic characteristics of the respondents, personal affliction, and correct recognition of the disorder were found. The identified differences should be considered in the development of interventions on mental health literacy with regard to adequate urgency assessment.
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Affiliation(s)
- Sarah Koens
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Jens Klein
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Annette Strauß
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Daniel Lüdecke
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Abi-Jaoudé JG, Naiem AA, Edwards T, Lukaszewski MA, Obrand DI, Steinmetz OK, Bayne JP, MacKenzie KS, Gill HL, Girsowicz E. Comorbid Depression is Associated with Increased Major Adverse Limb Events in Peripheral Arterial Disease: A systematic review and meta-analysis. Eur J Vasc Endovasc Surg 2022; 64:101-110. [PMID: 35483579 DOI: 10.1016/j.ejvs.2022.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/26/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Depression is a significant risk factor for mortality in coronary artery disease. On the contrary, the research surrounding depression and peripheral arterial disease is limited. This review aims to systematically evaluate the available literature on the impact of comorbid depression on adverse outcomes in peripheral arterial disease. DATA SOURCES A systematic review and meta-analysis were performed using the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library from inception until July 2021. REVIEW METHODS Included studies compared depressed and non-depressed patients with peripheral arterial disease. The outcomes included mortality, major adverse cardiovascular events, and major adverse limb events. RESULTS A total of 9 297 articles were searched. Of these, seven studies were identified. Depressed patients were more likely to be women, be diabetic, have a history of smoking, and have chronic limb threatening ischemia, despite being younger than non-depressed patients. There was a 20% increase in major adverse limb events in depressed patients [RR 1.20, 95% CI (1.11 - 1.31), z =3.9, p<.001, GRADE strength: very low] but no increased risk of mortality [RR 1.03, 95% CI (0.72-1.40), z =0.06, p =.95. GRADE strength: very low] or major adverse cardiovascular events [RR 1.16, 95% CI (0.67 - 2.01), z =0.54, p =.59, GRADE strength: very low]. A follow-up meta-regression of various comorbidities and demographic variables did not demonstrate a significant contribution to the observed risk ratio for major adverse limb events. CONCLUSION Depression was reported in 13% of peripheral arterial disease patients, associated with more medical comorbidity, and a 20% increased risk of major adverse limb events. Although the strength of this evidence is very low, the current state of the literature is still limited. Future studies should prospectively assess the impact of depression and its relationship with medical comorbidities and high risk health behaviors.
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Affiliation(s)
- Joanne G Abi-Jaoudé
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada.
| | - Ahmed A Naiem
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada
| | - Thomas Edwards
- University of Ottawa, Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | | | - Daniel I Obrand
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada
| | - Oren K Steinmetz
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada
| | - Jason P Bayne
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada
| | - Kent S MacKenzie
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada
| | - Heather L Gill
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada
| | - Elie Girsowicz
- Division of Vascular Surgery, McGill University, Montréal, Québec, Canada.
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Makowski AC, von dem Knesebeck O. Public depression stigma does not vary by symptom severity. J Ment Health 2022; 32:434-442. [PMID: 35014921 DOI: 10.1080/09638237.2021.2022626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies on public depression stigma did not include different severity levels and thus, did not adequately consider the continuum notion of depressive disorders. AIMS We address the following research questions: 1. Are there differences in public depression stigma according to different severity levels? 2. Is stigma associated with sociodemographic characteristics, experience with depressive symptoms, and symptom severity? METHODS Computer-assisted telephone interviews were conducted in winter 2019/2020 in Germany (N = 1009). Three vignettes representing mild, moderate, and severe depressive symptoms were used. Three indicators of stigma were assessed: negative stereotypes, anger reactions, and desire for social distance. Age, sex, education, and experience with depression (own affliction, contact) were additionally introduced into multiple linear regression analyses. RESULTS Overall, negative stereotypes, anger reactions, and desire for social distance do not significantly vary by depression symptom severity. All components of depression stigma showed positive associations with age, while anger was negatively associated with experiences. CONCLUSIONS Our results do not indicate that public depression stigma is more pronounced when symptoms are more severe. Conclusion is ambivalent: Persons with severe depression do not seem to be additionally burdened by increased stigma, but the German public holds stigmatizing attitudes even towards individuals with mild depressive symptoms.
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Affiliation(s)
- Anna C Makowski
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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