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Ruijne RE, Zarchev M, van Weeghel J, Henrichs J, Garofalo C, Bogaerts S, Mulder CL, Kamperman AM. Experiencing discrimination mediates the relationship between victimization and social withdrawal in patients suffering from a severe mental illness: A cross-sectional study. J Psychiatr Res 2022; 148:14-20. [PMID: 35091356 DOI: 10.1016/j.jpsychires.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/04/2021] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
Psychiatric patients are often victims of crime and discrimination and are often socially withdrawn. This has negative consequences for their health and recovery. We examined whether such discrimination mediates the association between victimization and social withdrawal, and whether these associations differ between men and women. We also determined the prevalence of social withdrawal and the discrimination experienced by patients suffering from a severe mental illness. This study is embedded in the Victimization in Psychiatric Patients study. Information on discrimination, social withdrawal and victimization was obtained using structured self-report questionnaires (N = 949). We reported the 12-month prevalence of these phenomena and used path analysis to estimate the direct path between personal and property victimization and social withdrawal, and the indirect path through the discrimination experienced. The impact of gender was assessed by testing interaction terms. Social withdrawal was reported by 20.6% (95%CI 18.1-23.2) of participants, and being discriminated against in the past 12 months by 75.3% (95%CI: 72.6-78.0%). While crime victimization had no direct effects on social withdrawal, personal crime victimization (B = 0.47; 95%CI 0.25-0.72; p < 0.001) and property crime victimization (B = 0.65; 95%CI 0.42-0.93; p < 0.001) had significant indirect effects on social withdrawal, which were mediated by the discrimination experienced. In men we found a direct negative effect of property crime on social withdrawal (B = -0.68; 95%CI: -1.21to -0.11, p = 0.014). We conclude that personal and property victimization, for both men and women, was associated with higher levels of social withdrawal, and this was fully mediated by the discrimination experienced.
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Affiliation(s)
- R E Ruijne
- Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus University Medical Centre Rotterdam, the Netherlands.
| | - M Zarchev
- Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus University Medical Centre Rotterdam, the Netherlands
| | - J van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO Box 90153, 5000, LE, Tilburg, the Netherlands; Parnassia Psychiatric Institute, The Hague, the Netherlands; Phrenos Center of Expertise, Utrecht, the Netherlands
| | - J Henrichs
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public, Health Research Institute, Amsterdam, the Netherlands
| | - C Garofalo
- Social and Behavioral Sciences, Department of Developmental Psychology, Tilburg University, Fivoor Science and Treatment Innovation, the Netherlands
| | - S Bogaerts
- Social and Behavioral Sciences, Department of Developmental Psychology, Tilburg University, Fivoor Science and Treatment Innovation, the Netherlands
| | - C L Mulder
- Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus University Medical Centre Rotterdam, the Netherlands; Antes, Department of the Parnassia Psychiatric Institute, Rotterdam, the Netherlands
| | - A M Kamperman
- Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus University Medical Centre Rotterdam, the Netherlands
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Birkenhager TK, Roos J, Kamperman AM. Improvement after two sessions of electroconvulsive therapy predicts final remission in in-patients with major depression. Acta Psychiatr Scand 2019; 140:189-195. [PMID: 31104321 PMCID: PMC6771780 DOI: 10.1111/acps.13054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate whether early improvement, measured after two electroconvulsive therapy (ECT) sessions, is a good predictor of eventual remission in severely depressed in-patients receiving ECT. METHOD A prospective cohort study was performed that included 89 major depressive disorder in-patients treated with bilateral ECT. Sensitivity, specificity, and predictive values were computed for various definitions of early improvement (15%, 20%, 25%, and 30% reduction on the Montgomery Asberg depression rating scale (MADRS) score) after 1 week (i.e. two sessions) of ECT regarding prediction of remission (final MADRS score ≤ 9). RESULTS A 15% reduction in MADRS score appeared to be the best definition of early improvement, with modest sensitivity (51%) and relatively good specificity (79%). Kaplan-Meier analysis showed a more than 2-week shorter time to remission in patients with early improvement compared with patients lacking early improvement. CONCLUSION Early improvement during an ECT course may be assessed after two ECT sessions. Such improvement, defined as a 15% reduction in the MADRS score, is a moderately sensitive predictor for eventual remission in an in-patient population with severe major depression.
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Affiliation(s)
- T. K. Birkenhager
- Department of PsychiatryErasmus Medical CentreRotterdamThe Netherlands
| | - J. Roos
- Department of PsychiatryErasmus Medical CentreRotterdamThe Netherlands
| | - A. M. Kamperman
- Department of PsychiatryErasmus Medical CentreRotterdamThe Netherlands
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Vermeiden M, Kamperman AM, Hoogendijk WJG, van den Broek WW, Birkenhäger TK. A randomized clinical trial comparing two two-phase treatment strategies for in-patients with severe depression. Acta Psychiatr Scand 2017; 136:118-128. [PMID: 28478653 DOI: 10.1111/acps.12743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the efficacy of two antidepressant treatment strategies in severely depressed in-patients, that is, imipramine vs. venlafaxine, both with subsequent lithium addition in non-responders. METHOD In-patients (n = 88) with major depressive disorder were randomized to 7-week treatment with imipramine or venlafaxine (phase I). All non-responders (n = 44) received 4-week plasma level-targeted dose lithium addition (phase II). Efficacy was evaluated after 11 weeks of treatment. RESULTS Analyzing phases I and II combined, non-inferiority was established and the difference in the proportion of responders (HAM-D score reduction ≥50%) by the end of phase II demonstrated the venlafaxine-lithium treatment strategy to be significantly superior to the imipramine-lithium treatment strategy (77% vs. 52%) (χ2 (1) = 6.03; P = 0.01). Regarding remission (HAM-D score ≤ 7), 15 of 44 (34%) patients in the imipramine-lithium treatment group were remitters compared to 22 of 44 (50%) patients in the venlafaxine-lithium treatment group, a non-significant difference. Patients in the venlafaxine-lithium treatment group had a non-significant larger mean HAM-D score reduction compared with patients in the imipramine-lithium treatment group (16.1 vs. 13.5 points, respectively; Cohen's d = 0.30). CONCLUSION The venlafaxine-lithium treatment strategy can be considered a valuable alternative for the imipramine-lithium treatment strategy in the treatment of severely depressed in-patients.
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Affiliation(s)
- M Vermeiden
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A M Kamperman
- Department of Psychiatry, Erasmus Medical Center, Epidemiological and Social Psychiatric Research Institute, Rotterdam, The Netherlands
| | - W J G Hoogendijk
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - W W van den Broek
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - T K Birkenhäger
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
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Harlaar JJ, Deerenberg EB, Dwarkasing RS, Kamperman AM, Kleinrensink GJ, Jeekel J, Lange JF. Development of incisional herniation after midline laparotomy. BJS Open 2017; 1:18-23. [PMID: 29951601 PMCID: PMC5989969 DOI: 10.1002/bjs5.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Incisional herniation is a common complication after abdominal surgery associated with considerable morbidity. The aim of this study was to determine whether incisional hernia is an early complication, in order to understand better the aetiology of incisional hernia formation. METHODS This study involved the secondary analysis of a subset of patients included in a large RCT comparing small and large tissue bites (5 mm every 5 mm, or 1 cm every 1 cm) in patients scheduled to undergo elective abdominal surgery by midline laparotomy. The distance between the rectus abdominis muscles (RAM distance) was measured by standardized ultrasound imaging 1 month and 1 year after surgery. The relationship between the 1-year incidence of incisional hernia and the RAM distance at 1 month was investigated. RESULTS Some 219 patients were investigated, 113 in the small-bites and 106 in the large-bites group. At 1 month after surgery the RAM distance was smaller for small bites than for large bites (mean(s.d.) 1·90(1·18) versus 2·39(1·34) cm respectively; P = 0·005). At 1 year, patients with incisional hernia had a longer RAM distance at 1 month than those with no incisional hernia (mean(s.d.) 2·43(1·48) versus 2·03(1·19) cm respectively; relative risk 1·14, 95 per cent c.i. 1·03 to 1·26, P = 0·015). CONCLUSION A RAM distance greater than 2 cm at 1 month after midline laparotomy is associated with incisional hernia. Closure with small bites results in a smaller distance between the muscles.
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Affiliation(s)
- J. J. Harlaar
- Department of SurgeryErasmus University Medical CentreRotterdamThe Netherlands
| | - E. B. Deerenberg
- Department of SurgeryErasmus University Medical CentreRotterdamThe Netherlands
| | - R. S. Dwarkasing
- Department of RadiologyErasmus University Medical CentreRotterdamThe Netherlands
| | - A. M. Kamperman
- Department of PsychiatryErasmus University Medical CentreRotterdamThe Netherlands
| | - G. J. Kleinrensink
- Department of NeuroscienceErasmus University Medical CentreRotterdamThe Netherlands
| | - J. Jeekel
- Department of NeuroscienceErasmus University Medical CentreRotterdamThe Netherlands
| | - J. F. Lange
- Department of SurgeryErasmus University Medical CentreRotterdamThe Netherlands
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Harlaar J, Deerenberg EB, Dwarkasing RS, Kamperman AM, Jeekel J, Lange JF, Samartsev VA, Gavrilov VA, Kuchumov AG, Nyashin YI, Vildeman VE, Slovikov SV, Rubtsova EA, Parshakov AA, Morawski J, Miller A, Kallenberger G, Hannen C, Strey CW, Robin A, López-Monclús J, Melero D, Blazquez L, Moreno A, Palencia N, Cruz A, López-Quindós P, Aguilera A, Jimenez C, Becerra R, García M, Galván A, Gonzalez E, García-Ureña MA, Costa T, Abdalla R, Garcia R, Costa R, Williams Z, Kotwall C, Tenzel P, Alam N, Narang S, Pathak S, Daniels I, Smart N, Guérin G, Ordrenneau C, Bouré L, Turquier F, Abbonante F. Abdominal Wall "Closure". Hernia 2015; 19 Suppl 1:S123-6. [PMID: 26518787 DOI: 10.1007/bf03355338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Harlaar
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - E B Deerenberg
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - R S Dwarkasing
- Department of Radiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - A M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J Jeekel
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - V A Samartsev
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - V A Gavrilov
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - A G Kuchumov
- Perm National Research Polytechnical University, Perm, Russia
| | - Y I Nyashin
- Perm National Research Polytechnical University, Perm, Russia
| | - V E Vildeman
- Perm National Research Polytechnical University, Perm, Russia
| | - S V Slovikov
- Perm National Research Polytechnical University, Perm, Russia
| | - E A Rubtsova
- Perm State National Research University, Perm, Russia
| | - A A Parshakov
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - J Morawski
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - A Miller
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | | | - C Hannen
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - C W Strey
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - A Robin
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - D Melero
- Hospital del Henares, Coslada (Madrid), Spain
| | - L Blazquez
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Moreno
- Hospital del Henares, Coslada (Madrid), Spain
| | - N Palencia
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Cruz
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - A Aguilera
- Hospital del Henares, Coslada (Madrid), Spain
| | - C Jimenez
- Hospital del Henares, Coslada (Madrid), Spain
| | - R Becerra
- Hospital del Henares, Coslada (Madrid), Spain
| | - M García
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Galván
- Hospital del Henares, Coslada (Madrid), Spain
| | - E Gonzalez
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - T Costa
- University of Sao Paulo, Sao Paulo, Brazil
| | - R Abdalla
- University of Sao Paulo, Sao Paulo, Brazil
| | - R Garcia
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - R Costa
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - Z Williams
- New Hanover Regional Medical Center, Wilmington, USA
| | - C Kotwall
- New Hanover Regional Medical Center, Wilmington, USA
| | - P Tenzel
- New Hanover Regional Medical Center, Wilmington, USA
| | - N Alam
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Narang
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Pathak
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - I Daniels
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - N Smart
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | | | | | | | | | - F Abbonante
- Department of Surgery-Plastic Surgery, Catanzaro City Hospital, Catanzaro, Italy
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