1
|
Wardenaar KJ, Jörg F, Oldehinkel AJ. Explanatory and modifying factors of the association between sex and depression onset during adolescence: An exploratory study. J Affect Disord 2024; 354:424-433. [PMID: 38479503 DOI: 10.1016/j.jad.2024.03.031] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND The prevalence of Major Depressive Disorder (MDD) is twice as high in women as in men and this difference already emerges during adolescence. Because the mechanisms underlying this sex-difference remain poorly understood, we took a bottom-up approach to identify factors explaining the sex-MDD relationship. METHODS Data came from the TRacking Adolescents' Individual Lives Survey (TRAILS), a population study investigating youths' development from age 11 into adulthood. We assessed multiple baseline covariates (e.g., demographic, social and psychological) at ages 11-13 years and MDD onset at ages 19 and 25 years. In regression analyses, each covariate's role in the sex-MDD association as an effect modifier or confounder/explanatory variable was investigated. Replicability was evaluated in an independent sample. RESULTS The analyses identified no effect-modifiers. Baseline internalizing problems, behavioral inhibition, dizziness, comfort in classroom, physical complaints, attention problems, cooperation, self/effortful control, interpersonal life events and computer use partially explained the association between sex and MDD at age 19. The association between sex and MDD at age 25 was explained by largely the same variables, but also by shyness, acne, antisocial behavior, aggression, affection from peers and time spent shopping. The explanatory roles of internalizing problems, behavioral inhibition, negative events involving gossip/rumors and leisure-time spending (computer-use/shopping) were replicated. LIMITATIONS Potentially important baseline variables were not included or had low response rates. Gender roles or identification were not considered. Baseline MDD was not adjusted for. CONCLUSION The sex-MDD association is partially explained by sex differences in symptoms and vulnerability factors already present in early adolescence.
Collapse
Affiliation(s)
- Klaas J Wardenaar
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Child and Family Welfare, Groningen, the Netherlands.
| | - Frederike Jörg
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Emotion Regulation (ICPE), Groningen, the Netherlands; Research Department, GGZ Friesland, Leeuwarden, the Netherlands
| | - Albertine J Oldehinkel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Emotion Regulation (ICPE), Groningen, the Netherlands
| |
Collapse
|
2
|
Brouwer JMJL, Wardenaar KJ, Liemburg EJ, Doornbos B, Mulder H, Cath DC. High persistence and low treatment rates of metabolic syndrome in patients with mood and anxiety disorders: A naturalistic follow-up study. J Affect Disord 2024; 354:451-462. [PMID: 38494132 DOI: 10.1016/j.jad.2024.03.042] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/21/2024] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Patients with affective and anxiety disorders are at risk of metabolic syndrome (MetS) and, consequently, cardiovascular disease and premature death. In this study, the course and treatment of MetS was investigated using longitudinal data from a naturalistic sample of affective- and anxiety-disordered outpatients (Monitoring Outcome of psychiatric PHARmacotherapy [MOPHAR]). METHODS Demographics, clinical characteristics, medication use, and MetS components were obtained for n = 2098 patients at baseline and, in a FU-subsample of n = 507 patients, after a median follow-up (FU) of 11 months. Furthermore, pharmacological treatment rates of MetS were investigated at baseline and FU. Finally, demographic and clinical determinants of change in MetS (component) scores were investigated. RESULTS At baseline, 34.6 % of n = 2098 patients had MetS, 41.4 % of whom received treatment. Of patients with persisting MetS, 46.1 % received treatment for one (or more) MetS component(s) at baseline, and 56.6 % received treatment at FU. Treatment rates of solely elevated blood pressure and reduced HDL-cholesterol did significantly, but modestly, improve. Higher age, male sex, smoking behavior, low education, diabetes, and depressive versus anxiety disorder were predictors of worse outcome at FU on at least one MetS component. LIMITATIONS We did not have data on lifestyle interventions as a form of treatment, which might partly have explained the observed low pharmacotherapeutic treatment rates. CONCLUSION MetS (components) show high persistence rates in affective- and anxiety-disordered patients, and are, despite adequate monitoring, undertreated over time. This indicates that adherence and implementation of monitoring protocols should be crucially improved in psychiatric outpatients in secondary care.
Collapse
Affiliation(s)
- Jurriaan M J L Brouwer
- Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands; GGZ Drenthe Mental Health Services, Assen, the Netherlands; Research School of Behavioral and Cognitive Neurosciences, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
| | - Klaas J Wardenaar
- GGZ Drenthe Mental Health Services, Assen, the Netherlands; Department of Psychiatry, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, Groningen, the Netherlands; Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Edith J Liemburg
- GGZ Drenthe Mental Health Services, Assen, the Netherlands; Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Bennard Doornbos
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands
| | - Hans Mulder
- Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands
| | - Danielle C Cath
- GGZ Drenthe Mental Health Services, Assen, the Netherlands; Research School of Behavioral and Cognitive Neurosciences, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands; Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
3
|
Kos C, Bais L, Klaasen N, Opmeer E, Liemburg E, Wardenaar KJ, van Tol MJ, Knegtering H, Aleman A. Effects of right prefrontal theta-burst transcranial magnetic stimulation or transcranial direct current stimulation on apathy in patients with schizophrenia: A multicenter RCT. Psychiatry Res 2024; 333:115743. [PMID: 38271887 DOI: 10.1016/j.psychres.2024.115743] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
Apathy is a core negative symptom associated with an unfavorable functional outcome. Noninvasive brain stimulation has shown promise in the treatment of schizophrenia but has not been tested specifically for apathy. We conducted a randomized controlled trial of intermittent theta-burst (iTBS) transcranial magnetic stimulation and transcranial direct current stimulation (tDCS) targeted at the right dorsolateral prefrontal cortex (DLPFC) in patients diagnosed with a psychotic disorder suffering from apathy. The study was a multicenter, randomized, placebo-controlled, and rater-blinded trial. Patients (N = 88) were randomized into active iTBS, active tDCS, sham iTBS or sham tDCS treatment, daily for two weeks (excluding weekends). Effects were measured post-treatment and at four week and ten week follow-up. Primary outcome was apathy severity (Apathy Evaluation Scale, clinician-rated). Additional measures included assessment of negative symptoms, depression, anhedonia and quality of life. No significant difference in improvement of apathy or negative symptoms was observed for real versus sham treatment with either iTBS or tDCS, though all groups improved to a small extent. We conclude that two weeks of brain stimulation over the right DLPFC with either iTBS or tDCS is not effective for improving apathy or negative symptoms. Longer and more intensive protocols may yield different results.
Collapse
Affiliation(s)
- Claire Kos
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands; ZorgfocuZ, Groningen, The Netherlands
| | - Leonie Bais
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands; Lentis Research, Lentis Center for Mental Health Care, Hereweg 80, Groningen 9725 AG, The Netherlands
| | - Nicky Klaasen
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands
| | - Esther Opmeer
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands
| | - Edith Liemburg
- Rob Giel Research Center and Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Klaas J Wardenaar
- Rob Giel Research Center and Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Marie-José van Tol
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands
| | - Henderikus Knegtering
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands; Lentis Research, Lentis Center for Mental Health Care, Hereweg 80, Groningen 9725 AG, The Netherlands; Rob Giel Research Center and Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - André Aleman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Antonius Deusinglaan 2, Groningen 9713 AW, The Netherlands.
| |
Collapse
|
4
|
van der Tuin S, Hoekstra RHA, Booij SH, Oldehinkel AJ, Wardenaar KJ, van den Berg D, Borsboom D, Wigman JTW. Relating stability of individual dynamical networks to change in psychopathology. PLoS One 2023; 18:e0293200. [PMID: 37943819 PMCID: PMC10635522 DOI: 10.1371/journal.pone.0293200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/07/2023] [Indexed: 11/12/2023] Open
Abstract
One hypothesis flowing from the network theory of psychopathology is that symptom network structure is associated with psychopathology severity and in turn, one may expect that individual network structure changes with the level of psychopathology severity. However, this expectation has rarely been addressed directly. This study aims to examine (1) the stability of individual contemporaneous symptom networks over a one-year period and (2) whether network stability is associated with a change in psychopathology. We used daily diary data of n = 66 individuals, located along the psychosis severity continuum, from two separate 90-day periods, one year apart (t = 180). Based on the newly developed Individual Network Invariance Test (INIT) to assess symptom-network stability, participants were divided into two groups with stable and unstable networks and we tested whether these groups differed in their absolute change in psychopathology severity. The majority of the sample (n = 51, 77.3%) showed a stable network over time while most individuals showed a decrease in psychopathological severity. We found no significant association between a change in psychopathology severity and individual network stability. Our results call for further critical evaluation of the association between networks and psychopathology to optimize the implementation of clinical applications based on current methods.
Collapse
Affiliation(s)
- Sara van der Tuin
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| | - Ria H. A. Hoekstra
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanne H. Booij
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
- Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands
| | - Albertine J. Oldehinkel
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| | - Klaas J. Wardenaar
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| | - David van den Berg
- Department of Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Denny Borsboom
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Johanna T. W. Wigman
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
5
|
Wedema D, Wardenaar KJ, Alma MA, van Asselt ADI, Korevaar EL, Schoevers RA. A blended module (STAIRS) to promote functional and personal recovery in patients with a major depressive disorder in remission: study protocol of a concurrent mixed methods randomized controlled trial. BMC Psychiatry 2023; 23:727. [PMID: 37805486 PMCID: PMC10560411 DOI: 10.1186/s12888-023-05213-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Despite the availability of a wide variety of evidence-based treatments for major depressive disorder (MDD), many patients still experience impairments in their lives after remission. Programs are needed that effectively support patients in coping with these impairments. The program Storytelling and Training to Advance Individual Recovery Skills (STAIRS) was developed to address this need and combines the use of peer contact, expert-by-experience guidance, family support and professional blended care. The aim of the planned study is (1) to assess the efficacy of the STAIRS program in patients with remitted MDD, (2) to investigate patients' subjective experiences with STAIRS, and (3) to evaluate the program's cost-effectiveness. METHODS A concurrent mixed-methods randomized controlled trial design will be used. Patients aged between 18 and 65 years with remitted MDD (N = 140) will be randomized to either a group receiving care as usual (CAU) + the STAIRS-program or a control group receiving CAU + some basic psychoeducation. Quantitative efficacy data on functional and personal recovery and associated aspects will be collected using self-report questionnaires at the start of the intervention, immediately following the intervention, and at the six-month follow-up. Insights into patients' experiences on perceived effects and the way in which different program elements contribute to this effect, as well as the usability and acceptability of the program, will be gained by conducting qualitative interviews with patients from the experimental group, who are selected using maximum variation sampling. Finally, data on healthcare resource use, productivity loss and quality of life will be collected and analysed to assess the cost-effectiveness and cost-utility of the STAIRS-program. DISCUSSION Well-designed recovery-oriented programs for patients suffering from MDD are scarce. If efficacy and cost-effectiveness are demonstrated with this study and patients experience the STAIRS program as usable and acceptable, this program can be a valuable addition to CAU. The qualitative interviews may give insights into what works for whom, which can be used to promote implementation. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov on 1 July 2021, registration number NCT05440812.
Collapse
Affiliation(s)
- David Wedema
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - Klaas J Wardenaar
- Department of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Antoinette D I van Asselt
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Eliza L Korevaar
- Research and Innovation Centre for Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
6
|
von Klipstein L, Servaas MN, Lamers F, Schoevers RA, Wardenaar KJ, Riese H. Increased affective reactivity among depressed individuals can be explained by floor effects: An experience sampling study. J Affect Disord 2023; 334:370-381. [PMID: 37150221 DOI: 10.1016/j.jad.2023.04.118] [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: 12/15/2022] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
Experience sampling studies into daily-life affective reactivity indicate that depressed individuals react more strongly to both positive and negative stimuli than non-depressed individuals, particularly on negative affect (NA). Given the different mean levels of both positive affect (PA) and NA between patients and controls, such findings may be influenced by floor/ceiling effects, leading to violations of the normality and homoscedasticity assumptions underlying the used statistical models. Affect distributions in prior studies suggest that this may have particularly influenced NA-reactivity findings. Here, we investigated the influence of floor/ceiling effects on the observed PA- and NA-reactivity to both positive and negative events. Data came from 346 depressed, non-depressed, and remitted participants from the Netherlands Study of Depression and Anxiety (NESDA). In PA-reactivity analyses, no floor/ceiling effects and assumption violations were observed, and PA-reactivity to positive events, but not negative events, was significantly increased in the depressed and remitted groups versus the non-depressed group. However, NA-scores exhibited a floor effect in the non-depressed group and naively estimated models violated model assumptions. When these violations were accounted for in subsequent analyses, group differences in NA-reactivity that had been present in the naive models were no longer observed. In conclusion, we found increased PA-reactivity to positive events but no evidence of increased NA-reactivity in depressed individuals when accounting for violations of assumptions. The results indicate that affective-reactivity results are very sensitive to modeling choices and that previously observed increased NA-reactivity in depressed individuals may (partially) reflect unaddressed assumption violations resulting from floor effects in NA.
Collapse
Affiliation(s)
- Lino von Klipstein
- University of Groningen, University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), the Netherlands.
| | - Michelle N Servaas
- University of Groningen, University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), the Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), the Netherlands
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), the Netherlands
| |
Collapse
|
7
|
Borkent J, Ioannou M, Folkertsma TS, Wardenaar KJ, Haarman BCM, van Goor H, Sommer IEC, Bourgonje AR. Serum free thiols in recently diagnosed patients with schizophrenia spectrum disorder: A potentially useful biomarker of oxidative stress. Psychiatry Res 2023; 321:115075. [PMID: 36764120 DOI: 10.1016/j.psychres.2023.115075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/02/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
Schizophrenia spectrum disorders (SSD) have been linked to oxidative stress (OS). Recent findings from our group show that serum free thiols (R-SH, sulfhydryl groups) can function as an accurate biomarker of systemic OS, since they are readily oxidized by reactive species (ROS), thereby serving as potent antioxidants. The aim of this study is to investigate if reduced R-SH levels can be demonstrated in recently diagnosed patients with SSD compared to healthy controls (HC). In this study, 102 patients with recently diagnosed SSD (< three years), and 42 HC were included. Levels of R-SH were quantified and studied for correlations with age, C-reactive protein (CRP) as proxy of inflammation as well as body mass index (BMI) and total cholesterol as indices of metabolic health. R-SH levels were significantly lower in patients when compared to HC. When correcting for age the difference was borderline significant (p=0.05). Moreover, R-SH correlated significantly with age (r = -0.29) and CRP (r = -0.29) in patients with SSD, but not in the HC. R-SH levels are reduced in SSD as compared to HC and correlate negatively with CRP and age in SSD. Future studies are required to further investigate R-SH and its role in SSD.
Collapse
Affiliation(s)
- Jenny Borkent
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands.
| | - Magdalini Ioannou
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Tessa S Folkertsma
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Bartholomeus C M Haarman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Iris E C Sommer
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands
| | - Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
8
|
Tigchelaar C, Muller WD, Atmosoerodjo SD, Wardenaar KJ, Kema IP, Absalom AR, van Faassen M. Concentration gradients of monoamines, their precursors and metabolites in serial lumbar cerebrospinal fluid of neurologically healthy patients determined with a novel LC-MS/MS technique. Fluids Barriers CNS 2023; 20:13. [PMID: 36782208 PMCID: PMC9923930 DOI: 10.1186/s12987-023-00413-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Potential biomarkers for neuropsychiatric disorders are cerebrospinal fluid (CSF) monoamines and their corresponding precursors and metabolites. During CSF sampling, CSF flows towards the lumbar sampling site from more cranial regions. To compare the results of studies in which different CSF volumes were acquired, it is important to know if ventricular-lumbar concentration gradients exist. This has only been addressed for a few biogenic amines, and almost exclusively in neurologically unwell patients due to the burden of a lumbar puncture (necessary to obtain CSF). The aim of our study was to determine if concentration gradients exist for routinely measured CSF constituents and biogenic amines in neurologically healthy patients. We applied a novel ultrasensitive liquid chromatography mass spectrometry (LC-MS/MS) method for the simultaneous quantification of multiple monoamines, precursors and metabolites in CSF and plasma. METHODS CSF and blood samples were collected from twenty neurologically healthy patients undergoing spinal anaesthesia. Ten mL of lumbar CSF was collected in five consecutive two mL fractions. We determined leucocyte and erythrocyte counts, glucose, albumin and protein concentrations and quantified monoamines, precursors and metabolites on each of the fractions using LC-MS/MS. RESULTS In twenty patients (60% male; median age: 46 years), dopamine, DOPAC, 3-MT, HVA, noradrenaline, normetanephrine and 5-HIAA concentrations increased from the first to the last CSF fraction (all p < 0.001). CSF adrenaline concentrations were below the detection limit, whereas serotonin measurements were regarded as unreliable. Albumin and total protein levels decreased significantly across CSF fractions. CONCLUSIONS A ventricular-lumbar CSF concentration gradient existed for most of the investigated analytes. This is a novel finding for dopamine, noradrenaline, 3-MT and normetanephrine. These results contribute to the understanding of the neurobiology and underline the importance of standardized procedures for CSF handling to allow comparisons between studies.
Collapse
Affiliation(s)
- Celien Tigchelaar
- Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Willemien D. Muller
- grid.4830.f0000 0004 0407 1981Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Sawal D. Atmosoerodjo
- grid.4830.f0000 0004 0407 1981Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Klaas J. Wardenaar
- grid.4830.f0000 0004 0407 1981Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ido P. Kema
- grid.4830.f0000 0004 0407 1981Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anthony R. Absalom
- grid.4830.f0000 0004 0407 1981Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Martijn van Faassen
- grid.4830.f0000 0004 0407 1981Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
9
|
Djordjevic M, Brink V, Wardenaar KJ, Scholte-Stalenhoef AN, Visser E, van Driel C, Veling W, Castelein S, Bartels-Velthuis AA, Bruggeman R, Jörg F, Pijnenborg GH. Personality traits and coping strategies in recent-onset psychosis: Associations with symptom severity and psychosocial functioning. Schizophr Res 2022; 250:143-151. [PMID: 36410291 DOI: 10.1016/j.schres.2022.10.010] [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: 09/27/2021] [Revised: 08/23/2022] [Accepted: 10/30/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Personality and coping may be related to symptom severity and psychosocial functioning in patients with recent-onset psychosis. This study aimed to investigate associations of personality traits and coping strategies with concurrent and follow-up symptom severity and functioning in those patients, and identify whether coping mediates relations between personality and symptoms or functioning. METHODS At baseline, 527 recent-onset psychosis patients (73 % male, mean age = 28 years) received assessments on personality (Neuroticism-Extraversion-Openness - Five-Factor Inventory), coping (Utrecht Coping List), symptom severity (Positive And Negative Syndrome Scale) and psychosocial functioning (Global Assessment of Functioning Scale). Of those, 149 also received symptom and functioning assessments at follow-up. Multivariable linear regression analyses were performed to assess cross-sectional associations of personality and coping with symptoms and functioning at baseline. Longitudinal associations of baseline personality and coping with follow-up symptomatic remission and functioning were analyzed with multivariable linear and binary logistic regression analyses, respectively. Lastly, it was investigated whether coping mediated associations between personality and symptoms or functioning. RESULTS Higher baseline Agreeableness (B = -0.019, [95%CI: -0.031; -0.007]) and Neuroticism (B = -0.017, [95%CI: -0.028; -0.006]) were associated with lower concurrent symptom severity. Reassuring Thoughts were associated with better functioning at baseline (B = 0.833, [95%CI: 0.272; 1.393]). Neither personality nor coping were associated with follow-up symptomatic remission or functioning. Coping did not mediate associations between personality and symptoms or functioning. CONCLUSION Only the coping strategy Reassuring Thoughts is associated with better baseline functioning in patients with recent-onset psychosis. Personality traits seem to have limited clinically relevant relations with symptom severity or functioning.
Collapse
Affiliation(s)
- Matej Djordjevic
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands.
| | - Vera Brink
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands
| | - Anne Neeltje Scholte-Stalenhoef
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; Department of Psychiatry, ZiekenhuisGroep Twente, Zilvermeeuw 1, 7609 PP Almelo, the Netherlands
| | - Ellen Visser
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, PO Box 30.001, 9700 RB Groningen, the Netherlands
| | | | | | - Catheleine van Driel
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands.
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands.
| | | | | | | | | | | |
Collapse
|
10
|
Ballering AV, Wardenaar KJ, olde Hartman TC, Rosmalen JGM. Female sex and femininity independently associate with common somatic symptom trajectories. Psychol Med 2022; 52:2144-2154. [PMID: 33168107 PMCID: PMC9386437 DOI: 10.1017/s0033291720004043] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/23/2020] [Accepted: 10/13/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multiple predictors have been associated with persistent somatic symptoms. However, previous studies problematically defined the persistence of symptoms, conflated participants' sex and gender, and focused on patient populations. Therefore, we studied associations between predictors, especially sex and gender, and longitudinal patterns of somatic symptoms in the general adult population. We also assessed whether predictors for persisting symptoms differ between sexes. METHOD To identify developmental trajectories of somatic symptoms, assessed by the SCL-90 SOM, we used latent class trajectory modeling in the Dutch Lifelines Cohort Study [N = 150 494; 58.6% female; median time to follow-up: 46.0 (min-max: 22.0-123.0) months]. To identify predictors of trajectories, we applied multiple logistic regression analyses. Predictors were measured by surveys at baseline and a composite gender index was previously developed. RESULTS A five-class linear LCGA model fitted the data best: 93.7% of the population had a stable symptom trajectory, whereas 1.5% and 4.8% of the population had a consistently increasing or decreasing symptom trajectory, respectively. Female sex predicted severe, stable symptom severity (OR 1.74, 95% CI 1.36-2.22), but not increasing symptom severity (OR 1.15, 95% CI 0.99-1.40). Femininity was protective hereof (OR 0.60, 95% CI 0.44-0.82 and OR 0.66, 95% CI 0.51-0.85, respectively). Merely a few predictors of symptom severity, for instance hours of paid employment and physical functioning, differed in strength between sexes. Yet, effect sizes were small. CONCLUSION Female sex and femininity predict symptom trajectories. No large sex differences in the strength of additional predictors were found, thus it may not be clinically useful to distinguish between predictors specific to male or female patients of persistent somatic symptoms.
Collapse
Affiliation(s)
- Aranka V. Ballering
- University of Groningen, University Medical Center of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Klaas J. Wardenaar
- University of Groningen, University Medical Center of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Tim C. olde Hartman
- Department of Primary and Community Care, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Judith G. M. Rosmalen
- University of Groningen, University Medical Center of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| |
Collapse
|
11
|
Beijers L, van Loo HM, Romeijn JW, Lamers F, Schoevers RA, Wardenaar KJ. Investigating data-driven biological subtypes of psychiatric disorders using specification-curve analysis. Psychol Med 2022; 52:1089-1100. [PMID: 32779563 PMCID: PMC9069352 DOI: 10.1017/s0033291720002846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 04/20/2020] [Accepted: 07/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cluster analyses have become popular tools for data-driven classification in biological psychiatric research. However, these analyses are known to be sensitive to the chosen methods and/or modelling options, which may hamper generalizability and replicability of findings. To gain more insight into this problem, we used Specification-Curve Analysis (SCA) to investigate the influence of methodological variation on biomarker-based cluster-analysis results. METHODS Proteomics data (31 biomarkers) were used from patients (n = 688) and healthy controls (n = 426) in the Netherlands Study of Depression and Anxiety. In SCAs, consistency of results was evaluated across 1200 k-means and hierarchical clustering analyses, each with a unique combination of the clustering algorithm, fit-index, and distance metric. Next, SCAs were run in simulated datasets with varying cluster numbers and noise/outlier levels to evaluate the effect of data properties on SCA outcomes. RESULTS The real data SCA showed no robust patterns of biological clustering in either the MDD or a combined MDD/healthy dataset. The simulation results showed that the correct number of clusters could be identified quite consistently across the 1200 model specifications, but that correct cluster identification became harder when the number of clusters and noise levels increased. CONCLUSION SCA can provide useful insights into the presence of clusters in biomarker data. However, SCA is likely to show inconsistent results in real-world biomarker datasets that are complex and contain considerable levels of noise. Here, the number and nature of the observed clusters may depend strongly on the chosen model-specification, precluding conclusions about the existence of biological clusters among psychiatric patients.
Collapse
Affiliation(s)
- Lian Beijers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Hanna M. van Loo
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Jan-Willem Romeijn
- Faculty of Philosophy, University of Groningen, Groningen, The Netherlands
| | - Femke Lamers
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences, Groningen, The Netherlands
| | - Klaas J. Wardenaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| |
Collapse
|
12
|
Beijers L, van Loo HM, Romeijn JW, Lamers F, Schoevers RA, Wardenaar KJ. Investigating Data-driven Biological Subtypes of Psychiatric Disorders Using Specification-Curve Analysis - ERRATUM. Psychol Med 2022; 52:1200. [PMID: 33632352 PMCID: PMC9069349 DOI: 10.1017/s0033291721000660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Lian Beijers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Hanna M van Loo
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Jan-Willem Romeijn
- Faculty of Philosophy, University of Groningen, Groningen, The Netherlands
| | - Femke Lamers
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences, Groningen, The Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| |
Collapse
|
13
|
Wijekoon Mudiyanselage KW, Bastiaansen JA, Stewart R, Wardenaar KJ, Penninx BWJH, Schoevers RA, van Hemert AM, Jörg F. Identifying mismatch and match between clinical needs and mental healthcare use trajectories in people with anxiety and depression: Results of a longitudinal study. J Affect Disord 2022; 297:657-670. [PMID: 34763294 DOI: 10.1016/j.jad.2021.09.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 04/26/2021] [Revised: 08/27/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mismatch between need and mental healthcare (MHC) use (under-and overuse) has mainly been studied with cross-sectional designs, not accurately capturing patterns of persistence or change in clinical burden and MHC-use among persons with depressive and/or anxiety disorders. AIMS Determining and describing [mis]match of longitudinal trajectories of clinical burden and MHC-use. METHODS Six-year longitudinal burden and MHC-use data came from the Netherlands Study of Depression and Anxiety (n=2981). The sample was split into four subgroups: I) no clinical burden but constant MHC use, II) constant clinical burden but no MHC-use, III) changing clinical burden and MHC-use, and IV) healthy non-users. Within subgroups I)-III), specific clinical burden and MHC trajectories were identified (growth mixture modeling). The resulting classes' associations with predisposing, enabling, and need factors were investigated (regression analysis). RESULTS Subgroups I-III revealed different trajectories. I) increasing MHC without burden (4.1%). II) slightly increasing (1.9%), strongly increasing (2.4%), and decreasing (9.5%) burden without MHC. III) increasing (41.4%) or decreasing (19.4%) burden and concurrently increasing MHC use (first underuse, then matched care), thus revealing delayed MHC-use. Only having suicidal ideation (p<.001, Cohen's d= .6-1.5) was a significant determinant of being in latter classes compared to underusers (strongly increasing burden without MHC-use). LIMITATIONS More explanatory factors are needed to explain [mis]match. CONCLUSION Mismatch occurred as constant underuse or as delayed MHC-use in a high-income country (Netherlands). Additionally, no meaningful class revealed constantly matched care on average. Presence of suicidal ideation could influence the probability of symptomatic individuals receiving matched MHC or not.
Collapse
Affiliation(s)
- Kalpani Wijekoon Wijekoon Mudiyanselage
- Leibniz Institute for Prevention Research and Epidemiology - BIPS. Department of Prevention and Evaluation, Achterstr. 30, 28359 Bremen, Germany; Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, the Netherlands.
| | - Jojanneke A Bastiaansen
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, the Netherlands; Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands.
| | - Roy Stewart
- Department of Health Sciences, Community & Occupational Medicine, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, the Netherlands; Department of Psychiatry/EMGO Institute/Institute for Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Albert M van Hemert
- Department of Psychiatry/EMGO Institute/Institute for Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Frederike Jörg
- Leibniz Institute for Prevention Research and Epidemiology - BIPS. Department of Prevention and Evaluation, Achterstr. 30, 28359 Bremen, Germany; Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands.
| |
Collapse
|
14
|
Monden R, Rosmalen JGM, Wardenaar KJ, Creed F. Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: the lifelines study. Psychol Med 2022; 52:112-120. [PMID: 32546287 PMCID: PMC8711101 DOI: 10.1017/s0033291720001774] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/08/2020] [Accepted: 05/16/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND It has been claimed that functional somatic syndromes share a common etiology. This prospective population-based study assessed whether the same variables predict new onsets of irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS) and fibromyalgia (FM). METHODS The study included 152 180 adults in the Dutch Lifelines study who reported the presence/absence of relevant syndromes at baseline and follow-up. They were screened at baseline for physical and psychological disorders, socio-demographic, psycho-social and behavioral variables. At follow-up (mean 2.4 years) new onsets of each syndrome were identified by self-report. We performed separate analyses for the three syndromes including participants free of the relevant syndrome or its key symptom at baseline. LASSO logistic regressions were applied to identify which of the 102 baseline variables predicted new onsets of each syndrome. RESULTS There were 1595 (1.2%), 296 (0.2%) and 692 (0.5%) new onsets of IBS, CFS, and FM, respectively. LASSO logistic regression selected 26, 7 and 19 predictors for IBS, CFS and FM, respectively. Four predictors were shared by all three syndromes, four predicted IBS and FM and two predicted IBS and CFS but 28 predictors were specific to a single syndrome. CFS was more distinct from IBS and FM, which predicted each other. CONCLUSIONS Syndrome-specific predictors were more common than shared ones and these predictors might form a better starting point to unravel the heterogeneous etiologies of these syndromes than the current approach based on symptom patterns. The close relationship between IBS and FM is striking and requires further research.
Collapse
Affiliation(s)
- Rei Monden
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Francis Creed
- Neuroscience and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
15
|
Wedema D, Siero J, Korevaar EL, Wardenaar KJ, Alma MA, Schoevers RA. Storytelling and training to advance individual recovery skills (STAIRS). A feasibility study of a blended program to support personal recovery among patients with a major depressive disorder in remission. Front Psychiatry 2022; 13:984104. [PMID: 36213919 PMCID: PMC9539704 DOI: 10.3389/fpsyt.2022.984104] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Because major depressive disorder (MDD) has a strong negative impact on patients' lives, well-designed treatment programs are needed that address the lasting effects of MDD. Previous work has shown that such programs should not only focus on symptomatic recovery, but also on the subsequent personal recovery process. Currently, few programs with this specific focus exist. Therefore, this study aimed to assess the feasibility of a newly developed blended program to support the personal recovery process of MDD patients: Storytelling and Training to Advance Individual Recovery Skills (STAIRS). STAIRS is a program using peer support and guidance by experts by experience and clinicians, which can be added to regular depression treatment when symptomatic recovery is almost reached. Topics addressed in this program are: (1) effects of depression and treatment; (2) structure; (3) (self) stigma; (4) self-image; (5) meaning of life; (6) connection to others; (7) physical health; (8) relaxation; and (9) preventing relapse. Experiences with the STAIRS program were collected from five participating patients with questionnaires and a focus-group interview, as well as from four trainers using semi-structured interviews. Participants valued the topics addressed in STAIRS, the used working methods, the presence of an expert by experience and the ability to share experiences with peers. The use of an online platform and the involvement of others is seen as potentially supportive but turned out to be more challenging. Perceived effects of STAIRS include positive changes in participants' daily lives and their contacts with others. Overall, the results indicate that when implemented accessibly, STAIRS is a promising and feasible program to foster personal recovery among patients recovering from MDD.
Collapse
Affiliation(s)
- David Wedema
- Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Joanieke Siero
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Eliza L Korevaar
- Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Klaas J Wardenaar
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Robert A Schoevers
- Research School of Behavioural and Cognitive Neurosciences (BCN), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
16
|
Solis EC, van Hemert AM, Carlier IVE, Wardenaar KJ, Schoevers RA, Beekman ATF, Penninx BWJH, Giltay EJ. The 9-year clinical course of depressive and anxiety disorders: New NESDA findings. J Affect Disord 2021; 295:1269-1279. [PMID: 34706441 DOI: 10.1016/j.jad.2021.08.108] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Received: 01/18/2021] [Revised: 08/06/2021] [Accepted: 08/30/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND In longitudinal research, switching between diagnoses should be considered when examining patients with depression and anxiety. We investigated course trajectories of affective disorders over a nine-year period, comparing a categorical approach using diagnoses to a dimensional approach using symptom severity. METHOD Patients with a current depressive and/or anxiety disorder at baseline (N = 1701) were selected from the Netherlands Study of Depression and Anxiety (NESDA). Using psychiatric diagnoses, we described 'consistently recovered,' 'intermittently recovered,' 'intermittently recurrent', and 'consistently chronic' at two-, four-, six-, and nine-year follow-up. Additionally, latent class growth analysis (LCGA) using depressive, anxiety, fear, and worry symptom severity scores was used to identify distinct classes. RESULTS Considering the categorical approach, 8.5% were chronic, 32.9% were intermittently recurrent, 37.6% were intermittently recovered, and 21.0% remained consistently recovered from any affective disorder at nine-year follow-up. In the dimensional approach, 66.6% were chronic, 25.9% showed partial recovery, and 7.6% had recovered. LIMITATIONS 30.6% of patients were lost to follow-up. Diagnoses were rated by the interviewer and questionnaires were completed by the participant. CONCLUSIONS Using diagnoses alone as discrete categories to describe clinical course fails to fully capture the persistence of affective symptoms that were observed when using a dimensional approach. The enduring, fluctuating presence of subthreshold affective symptoms likely predisposes patients to frequent relapse. The commonness of subthreshold symptoms and their adverse impact on long-term prognoses deserve continuous clinical attention in mental health care as well further research.
Collapse
Affiliation(s)
- Ericka C Solis
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands.
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, Groningen, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, Groningen, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; Department of Psychiatry, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, Groningen, the Netherlands; Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
17
|
Wardenaar KJ, Riese H, Giltay EJ, Eikelenboom M, van Hemert AJ, Beekman AF, Penninx BWJH, Schoevers RA. Common and specific determinants of 9-year depression and anxiety course-trajectories: A machine-learning investigation in the Netherlands Study of Depression and Anxiety (NESDA). J Affect Disord 2021; 293:295-304. [PMID: 34225209 DOI: 10.1016/j.jad.2021.06.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 03/15/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Given the strong relationship between depression and anxiety, there is an urge to investigate their shared and specific long-term course determinants. The current study aimed to identify and compare the main determinants of the 9-year trajectories of combined and pure depression and anxiety symptom severity. METHODS Respondents with a 6-month depression and/or anxiety diagnosis (n=1,701) provided baseline data on 152 sociodemographic, clinical and biological variables. Depression and anxiety symptom severity assessed at baseline, 2-, 4-, 6- and 9-year follow-up, were used to identify data-driven course-trajectory subgroups for general psychological distress, pure depression, and pure anxiety severity scores. For each outcome (class-probability), a Superlearner (SL) algorithm identified an optimally weighted (minimum mean squared error) combination of machine-learning prediction algorithms. For each outcome, the top determinants in the SL were identified by determining variable-importance and correlations between each SL-predicted and observed outcome (ρpred) were calculated. RESULTS Low to high prediction correlations (ρpred: 0.41-0.91, median=0.73) were found. In the SL, important determinants of psychological distress were age, young age of onset, respiratory rate, participation disability, somatic disease, low income, minor depressive disorder and mastery score. For course of pure depression and anxiety symptom severity, similar determinants were found. Specific determinants of pure depression included several types of healthcare-use, and of pure-anxiety course included somatic arousal and psychological distress. LIMITATIONS Limited sample size for machine learning. CONCLUSIONS The determinants of depression- and anxiety-severity course are mostly shared. Domain-specific exceptions are healthcare use for depression and somatic arousal and distress for anxiety-severity course.
Collapse
Affiliation(s)
- Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands.
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Merijn Eikelenboom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Albert J van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Aartjan F Beekman
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| |
Collapse
|
18
|
Lugtenburg A, Zuidersma M, Wardenaar KJ, Aprahamian I, Rhebergen D, Schoevers RA, Oude Voshaar RC. Subtypes of Late-Life Depression: A Data-Driven Approach on Cognitive Domains and Physical Frailty. J Gerontol A Biol Sci Med Sci 2021; 76:141-150. [PMID: 32442243 DOI: 10.1093/gerona/glaa110] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND With increasing age, symptoms of depression may increasingly overlap with age-related physical frailty and cognitive decline. We aim to identify late-life-related subtypes of depression based on measures of depressive symptom dimensions, cognitive performance, and physical frailty. METHODS A clinical cohort study of 375 depressed older patients with a DSM-IV depressive disorder (acronym NESDO). A latent profile analysis was applied on the three subscales of the Inventory of Depressive Symptomatology, as well as performance in five cognitive domains and two proxies for physical frailty. For each class, we investigated remission, dropout, and mortality at 2-year follow-up as well as change over time of depressive symptom severity, cognitive performance, and physical frailty. RESULTS A latent profile analysis model with five classes best described the data, yielding two subgroups suffering from pure depression ("mild" and "severe" depression, 55% of all patients) and three subgroups characterized by a specific profile of cognitive and physical frailty features, labeled as "amnestic depression," "frail-depressed, physically dominated," and "frail-depressed, cognitively dominated." The prospective analyses showed that patients in the subgroup of "mild depression" and "amnestic depression" had the highest remission rates, whereas patients in both frail-depressed subgroups had the highest mortality rates. CONCLUSIONS Late-life depression can be subtyped by specific combinations of age-related clinical features, which seems to have prospective relevance. Subtyping according to the cognitive profile and physical frailty may be relevant for studies examining underlying disease processes as well as to stratify treatment studies on the effectiveness of antidepressants, psychotherapy, and augmentation with geriatric rehabilitation.
Collapse
Affiliation(s)
- Astrid Lugtenburg
- Department Old Age Psychiatry, GGZ Drenthe Mental Health Institute, Assen, The Netherlands.,University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Marij Zuidersma
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Klaas J Wardenaar
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Ivan Aprahamian
- Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Faculty of Medicine of Jundiaí, São Paulo, Brazil
| | - Didi Rhebergen
- Amsterdam University Medical Center, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Robert A Schoevers
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Richard C Oude Voshaar
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| |
Collapse
|
19
|
Snippe E, Doornbos B, Schoevers RA, Wardenaar KJ, Wichers M. Individual and common patterns in the order of symptom improvement during outpatient treatment for major depression. J Affect Disord 2021; 290:81-88. [PMID: 33993084 DOI: 10.1016/j.jad.2021.04.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/28/2019] [Revised: 02/19/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Research so far provided few clues on the order in which depressive symptoms typically remit during treatment. This study examined which depressive symptoms improve first, and whether symptoms changed before, simultaneous with, or after the core symptoms of depression (i.e., sad mood, loss of pleasure, and loss of interest). METHODS Participants were 176 patients with Major Depressive Disorder (MDD) receiving outpatient treatment (a combination of pharmacotherapy and psychological interventions) for depression. Participants filled out the Inventory of Depressive Symptomatology - Self Report (IDS-SR) for 16 to 20 consecutive weeks. For each symptom, the timing of onset of a persistent improvement was determined for each single-subject separately. RESULTS Which symptoms improved first differed markedly across patients. The core depression symptoms improved 1.5 to 2 times more often before (48% - 60%) than after (19% -28%) depressive cognitions ('view of myself' and 'view of the future'), anxiety symptoms ('feeling irritable' and 'feeling anxious / tense') and vegetative symptoms ('loss of energy', 'slowed down', and 'physical energy'). Only improvements in suicidal thoughts were more likely to occur before (46% - 48%) than after (29%) improvements in the depression core symptoms. LIMITATIONS Not all 'core depression-non-core symptom' combinations could be tested because some symptoms did not improve in a sufficient number of patients. CONCLUSIONS Which improvements mark the start of symptom remission differed between patients. Improvements in the core depression symptoms 'sad mood', 'loss of interest', and 'loss of pleasure' were more likely to occur before than after improvements in non-core symptoms.
Collapse
Affiliation(s)
- Evelien Snippe
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands.
| | - Bennard Doornbos
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands; GGZ Drenthe Mental Health Institute, Department Affective disorders, Assen, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands; GGZ Drenthe Mental Health Institute, Department Affective disorders, Assen, The Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - Marieke Wichers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| |
Collapse
|
20
|
Tigchelaar C, Atmosoerodjo SD, van Faassen M, Wardenaar KJ, De Deyn PP, Schoevers RA, Kema IP, Absalom AR. The Anaesthetic Biobank of Cerebrospinal fluid: a unique repository for neuroscientific biomarker research. Ann Transl Med 2021; 9:455. [PMID: 33850852 PMCID: PMC8039635 DOI: 10.21037/atm-20-4498] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background The pathophysiology of numerous central nervous system disorders remains poorly understood. Biomarker research using cerebrospinal fluid (CSF) is a promising way to illuminate the neurobiology of neuropsychiatric disorders. CSF biomarker studies performed so far generally included patients with neurodegenerative diseases without an adequate control group. The Anaesthetic Biobank of Cerebrospinal fluid (ABC) was established to address this. The aims are to (I) provide healthy-control reference values for CSF-based biomarkers, and (II) to investigate associations between CSF-based candidate biomarkers and neuropsychiatric symptoms. Methods In this cross-sectional study, we collect and store CSF and blood from adult patients undergoing spinal anaesthesia for elective surgery. Blood (20.5 mL) is collected during intravenous cannulation and CSF (10 mL) is aspirated prior to intrathecal local anaesthetic injection. A portion of the blood and CSF is sent for routine laboratory analyses, the remaining material is stored at -80 °C. Relevant clinical, surgical and anaesthetic data are registered. A neurological examination and Montreal Cognitive Assessment (MoCA) are performed pre-operatively and a subset of patients fill in questionnaires on somatic and mental health (depression, anxiety and stress). Results Four-hundred-fifty patients (58% male; median age: 56 years) have been enrolled in the ABC. The planned spinal anaesthetic procedure was not attempted for various reasons in eleven patients, in fourteen patients the spinal puncture failed and in twelve patients CSF aspiration was unsuccessful. A mean of 9.3 mL CSF was obtained in the remaining 413 of patients. Most patients had a minor medical history and 60% scored in the normal range on the MoCA (median score: 26). Conclusions The ABC is an ongoing biobanking project that can contribute to CSF-based biomarker research. The large sample size with constant sampling methods and extensive patient phenotyping provide excellent conditions for future neuroscientific research.
Collapse
Affiliation(s)
- Celien Tigchelaar
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sawal D Atmosoerodjo
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martijn van Faassen
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Laboratory of Neurochemistry and Behavior, Department of Biomedical Sciences, Institute Born-Bunge, University of Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.,Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Robert A Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anthony R Absalom
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
21
|
Kuzminskaite E, Vinkers CH, Elzinga BM, Wardenaar KJ, Giltay EJ, Penninx BWJH. Childhood trauma and dysregulation of multiple biological stress systems in adulthood: Results from the Netherlands Study of Depression and Anxiety (NESDA). Psychoneuroendocrinology 2020; 121:104835. [PMID: 32889492 DOI: 10.1016/j.psyneuen.2020.104835] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 05/08/2020] [Revised: 07/06/2020] [Accepted: 08/06/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Childhood trauma (CT) is a risk factor for depressive and anxiety disorders. Although dysregulated biological stress systems may underlie the enduring effect of CT, the relation between CT and separate and cumulative activity of the major stress systems, namely, the hypothalamic-pituitary-adrenal (HPA)-axis, the immune-inflammatory system, and the autonomic nervous system (ANS), remains inconclusive. METHODS In the Netherlands Study of Depression and Anxiety (NESDA, n = 2778), we determined whether self-reported CT (as assessed by the Childhood Trauma Interview) was associated with separate and cumulative markers of the HPA-axis (cortisol awakening response, evening cortisol, dexamethasone suppression test cortisol), the immune-inflammatory system (C-reactive protein, interleukin-6, tumor necrosis factor-α), and the ANS (heart rate, respiratory sinus arrhythmia, pre-ejection period) in adulthood. RESULTS Almost all individuals with CT (n = 1330) had either current or remitted depressive and/or anxiety disorder (88.6%). Total-sample analyses showed little evidence for CT being significantly associated with the separate or cumulative stress systems' activity in adulthood. These findings were true for individuals with and without depressive and/or anxiety disorders. To maximize contrast, individuals with severe CT were compared to healthy controls without CT. This yielded slight, but significantly higher levels of cortisol awakening response (AUCg, β = .088, p = .007; AUCi, β = .084, p = .010), cumulative HPA-axis markers (β = .115, p = .001), C-reactive protein (β = .055, p = .032), interleukin-6 (β = .053, p = .038), cumulative inflammation (β = .060, p = .020), and cumulative markers across all systems (β = .125, p = .0003) for those with severe CT, partially explained by higher rates of smoking, body mass index, and chronic diseases. CONCLUSION While our findings do not provide conclusive evidence on CT directly dysregulating stress systems, individuals with severe CT showed slight indications of dysregulations, partially explained by an unhealthy lifestyle and poorer health.
Collapse
Affiliation(s)
- Erika Kuzminskaite
- Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, Amsterdam, the Netherlands.
| | - Christiaan H Vinkers
- Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, Amsterdam, the Netherlands; Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Vrije University, Amsterdam, the Netherlands.
| | - Bernet M Elzinga
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands.
| | - Klaas J Wardenaar
- University Medical Center Groningen, University of Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands.
| | - Erik J Giltay
- Leiden University Medical Center, Department of Psychiatry, Leiden, the Netherlands.
| | - Brenda W J H Penninx
- Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, Amsterdam, the Netherlands.
| |
Collapse
|
22
|
Mayle SA, de Klerk-Sluis JM, Lin A, Yung AR, Wardenaar KJ, Broekman SRJ, Pluim WH, Wigman JTW. Validation of the Dutch version of the Multidimensional Adolescent Functioning Scale (MAFS). Health Qual Life Outcomes 2020; 18:306. [PMID: 32943061 PMCID: PMC7496202 DOI: 10.1186/s12955-020-01517-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background The Multidimensional Adolescent Functioning Scale (MAFS) is a 23-item, self-report questionnaire assessing psychosocial functioning in adolescents aged 12–17 years. It captures three domains of functioning: ‘general functioning’, ‘family-related functioning’, and ‘peer-related functioning’. The original English version has good psychometric properties. The aim of the current paper was to translate the MAFS to Dutch and to investigate the psychometric properties of this translation. Methods After translation, the Dutch MAFS was assessed in 397 adolescents aged 12–17 years, assessed at schools. Internal consistency, factor structure and correlations with other questionnaires assessing functioning, psychopathology and well-being were investigated. Results A hierarchical/bifactor model with a general factor that loads on all items (MAFS-general) and three group factors, loading respectively on the GF, FF and PF items, was found to describe the data best. Internal consistency of the MAFS total score (α = 0.87) was good and of the subscales (α = 0.74–0.80) acceptable. Comparable alphas were found in males and females. Correlations between MAFS subscales ranged from 0.33 to 0.43, indicating sufficient differentiation. The MAFS general factor score and group factor scores showed positive correlations with other measures of good functioning and well-being, and negative correlations with measures of psychopathology, supporting convergent and divergent validity. Conclusions The Dutch translation of the MAFS has adequate psychometric properties to assess three domains of functioning in adolescents from the general population aged 12–17 years. The MAFS is freely accessible in the Appendix and easy to administer.
Collapse
Affiliation(s)
- Sally A Mayle
- Interdisciplinary Centre for Psychopathology and Emotion regulation, University Medical Center Groningen, Groningen, The Netherlands
| | - Jessica M de Klerk-Sluis
- Interdisciplinary Centre for Psychopathology and Emotion regulation, University Medical Center Groningen, Groningen, The Netherlands
| | - Ashleigh Lin
- Telethon Kids Institute, the University of Western Australia, West Perth, Australia
| | - Alison R Yung
- School of Health Sciences, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Klaas J Wardenaar
- Interdisciplinary Centre for Psychopathology and Emotion regulation, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne R J Broekman
- Interdisciplinary Centre for Psychopathology and Emotion regulation, University Medical Center Groningen, Groningen, The Netherlands
| | - W Heleen Pluim
- Interdisciplinary Centre for Psychopathology and Emotion regulation, University Medical Center Groningen, Groningen, The Netherlands
| | - Johanna T W Wigman
- Interdisciplinary Centre for Psychopathology and Emotion regulation, University Medical Center Groningen, Groningen, The Netherlands. .,Faculty of Medical Sciences, Academic Centre of Psychiatry, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands.
| |
Collapse
|
23
|
Kuranova A, Booij SH, de Jonge P, Jeronimus B, Lin A, Wardenaar KJ, Wichers M, Wigman JTW. Don't worry, be happy: Protective factors to buffer against distress associated with psychotic experiences. Schizophr Res 2020; 223:79-86. [PMID: 32473933 DOI: 10.1016/j.schres.2020.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/24/2019] [Revised: 03/12/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Around 6-7% of the general population report psychotic experiences (PEs). Positive PEs (e.g. hearing voices) may increase the risk of development of psychotic disorder. An important predictor of the transition to a psychotic disorder is secondary distress associated with PEs. We examined the moderating effect of potential protective factors on this secondary distress. METHODS Data come from 2870 individuals of the HowNutsAreTheDutch study. PEs were assessed with the Community Assessment of Psychic Experience (CAPE) questionnaire and were divided into three subdomains ("Bizarre experiences", "Delusional ideations", and "Perceptual anomalies"). Protective factors explored were having a partner, having a pet, benevolent types of humor, optimism and the high levels of personality traits emotional stability (reversed neuroticism), extraversion, openness to experience, conscientiousness, and agreeableness. We examined whether these protective factors moderated (lowered) the association between frequency of PEs and PE-associated distress. RESULTS Due to low prevalence of perceptual anomalies in the sample, this domain was excluded from analysis. No moderating effects were observed of protective factors on the association between bizarre experiences and distress. Having a partner and high levels of optimism, self-enhancing humor, openness, extraversion and emotional stability moderated the association between delusional ideations and secondary distress, leading to lower levels of distress. CONCLUSIONS Several protective factors were found to moderate the association between frequency and secondary distress of delusional ideations, with high levels of the protective factors being associated with lower levels of distress. A focus on protective factors could be relevant for interventions and prevention strategies regarding psychotic phenomena.
Collapse
Affiliation(s)
- Anna Kuranova
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands.
| | - Sanne H Booij
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, the Netherlands; Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands
| | - Peter de Jonge
- University of Groningen, Department of Developmental Psychology, Groningen, the Netherlands
| | - Bertus Jeronimus
- University of Groningen, Department of Developmental Psychology, Groningen, the Netherlands
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Australia
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| | - Marieke Wichers
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| | - Johanna T W Wigman
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, the Netherlands
| |
Collapse
|
24
|
Yin H, Wardenaar KJ, Wang Y, Wang N, Chen W, Zhang Y, Xu G, Schoevers RA. Mobile Mental Health Apps in China: Systematic App Store Search. J Med Internet Res 2020; 22:e14915. [PMID: 32716301 PMCID: PMC7418006 DOI: 10.2196/14915] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 03/23/2020] [Accepted: 06/03/2020] [Indexed: 01/16/2023] Open
Abstract
Background Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. Objective The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. Methods A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. Results Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. Conclusions Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.
Collapse
Affiliation(s)
- Huifang Yin
- Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Nan Wang
- Tianjin Anding Hospital, Tianjin, China
| | | | - Yan Zhang
- Tianjin Anding Hospital, Tianjin, China
| | | | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| |
Collapse
|
25
|
Yin H, Wardenaar KJ, Xu G, Tian H, Schoevers RA. Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study. BMC Psychiatry 2020; 20:323. [PMID: 32571270 PMCID: PMC7310154 DOI: 10.1186/s12888-020-02705-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/28/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Little is known about the public stigma on mental illness and mental health knowledge (MHK) in China, public stigma and low MHK can negatively affect patients' health and increase the burden of mental disorders on society. This study aimed at investigating the rates of stigma and MHK, the correlates of stigma and MHK, and the association between MHK and stigma among a Chinese population. METHODS The data is from the Tianjin Mental Health Survey (TJMHS), which involved a large and a representative sample of adult community residents in the Chinese municipality of Tianjin (n = 11,748). In a 12% random subsample (n = 1775) the Perceived Discrimination and Devaluation scale (PDD) and a Mental Health Knowledge Questionnaire (MHKQ) were administered. First, percentages of the responses to the individual items of the PDD and MHKQ were investigated. Second, sociodemographic correlates of PDD and MHK, and the association between stigma and MHK were investigated. RESULTS We found that a sizable proportion of participants responded that others would hold a negative attitude towards (former) mental patients, especially with regard to engaging in closer personal relationships. Most people were not familiar about the causes, treatments and prevention of mental illness. Resident area, age, education level, Per capita family income and employment status were related to devaluation score and MHKQ score. MHK was negatively associated with public stigma. CONCLUSIONS There is room for improvement with regard to levels of public stigma and MHK in China. Providing psychoeducation to improve public MHK could also contribute to reduction of public stigma.
Collapse
Affiliation(s)
- Huifang Yin
- grid.440287.d0000 0004 1764 5550Tianjin Mental Health Institute, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi District, Tianjin, 300222 China ,grid.4494.d0000 0000 9558 4598Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Klaas J. Wardenaar
- grid.4494.d0000 0000 9558 4598Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Guangming Xu
- Tianjin Mental Health Institute, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi District, Tianjin, 300222, China.
| | - Hongjun Tian
- grid.440287.d0000 0004 1764 5550Tianjin Mental Health Institute, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi District, Tianjin, 300222 China
| | - Robert A. Schoevers
- grid.4494.d0000 0000 9558 4598Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| |
Collapse
|
26
|
Oerlemans AM, Wardenaar KJ, Raven D, Hartman CA, Ormel J. The association of developmental trajectories of adolescent mental health with early-adult functioning. PLoS One 2020; 15:e0233648. [PMID: 32520969 PMCID: PMC7286481 DOI: 10.1371/journal.pone.0233648] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 05/10/2020] [Indexed: 11/28/2022] Open
Abstract
Background Mental health problems during adolescence may create a problematic start into adulthood for affected individuals. Usually, categorical indicators of adolescent mental health issues (yes/no psychiatric disorder) are used in studies into long-term functional outcomes. This however does not take into account the full spectrum of mental health, nor does it consider the trajectory of mental health problem development over time. The aim of this study was twofold: (1) to identify distinct developmental trajectories of (co-occurring) internalizing and externalizing mental health symptoms over the course of adolescence (ages 11–19), and (2) to document the associations between these adolescent trajectories and economic, social, and health outcomes in young adulthood (age 22), unadjusted and adjusted for childhood functioning, putative confounders and current mental health. Methods Data were used from the Dutch TRAILS cohort study (subsample n = 1524, 47.3% males). Self-reported INT and EXT symptoms using the Youth/Adult Self Report were assessed four times (ages 11y, 13y, 16y, 19y). Adolescent mental health trajectories were estimated using Parallel-Processes Latent Class Growth Analyses. Self-reported economic, social, and health outcomes and parent-reported current mental health (using Adult Behaviour Checklist) were assessed at age 22. Multiple logistic regression analyses were performed to test associations between trajectories and outcomes. Results Four distinct trajectory classes were identified: (1) a normative class with decreasing-low INT+EXT symptoms (n = 460), (2) continuous moderately-high INT+EXT (n = 298), (3) continuous moderate, INT>EXT (n = 414), and (4) decreasing moderate, EXT>INT (n = 352). Compared to the normative class, the other three trajectories generally predicted less optimal early-adult outcomes, with the strongest effects observed for individuals with continuous moderate-high levels of both INT and EXT symptoms throughout adolescence. The associations largely remained after adjustment for pre-adolescent functioning, selected confounders and current mental health. Conclusions Both adolescent trajectories and current mental health had substantial independent effects on early-adult functioning.
Collapse
Affiliation(s)
- Anoek M. Oerlemans
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Klaas J. Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dennis Raven
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Catharina A. Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan Ormel
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
27
|
Liemburg EJ, Enriquez-Geppert S, Wardenaar KJ, Bruggeman R, Aleman A. Expressive deficits and amotivation as mediators of the associations between cognitive problems and functional outcomes: Results from two independent cohorts. Schizophr Res 2020; 218:283-291. [PMID: 31948899 DOI: 10.1016/j.schres.2019.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 05/17/2019] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
Many individuals with severe mental disorders have difficulties in vocational and social functioning, which are regarded the most important outcomes, together with clinical symptoms. To understand the underlying mechanisms, research is increasingly focused on factors influencing functional outcomes. One established association has been shown between cognition and community functioning with negative symptoms as a possible mediator. Although it has been shown that negative symptoms consist of two subdomains, thus far negative symptoms have been assessed as one unitary construct. This study considers for the first time subdomains of negative symptoms as putative mediators (expressive deficits, amotivation) of the association between cognition (neuro- and social cognition) and functional outcome (living situation, occupation, social functioning). We expected that specific subdomains of negative symptoms (e.g. amotivation) would mediate the effect of cognition on specific functional outcomes (e.g. social functioning) independently from illness duration. To assess this, we included two independent cohorts, consisting of participants with different illness duration. These two independent cohorts consisted of patients with a recent-onset psychotic disorder: PROGR-S (first time treated; N = 1129) and GROUP (illness duration preferably <5 years; N = 1200). Using linear regression, mediation analyses were performed with two cognition domains (neurocognition and social cognition) as predictors, negative symptoms (Expressive deficits and Amotivation as indexed with items from the Positive and Negative Syndrome Scale) as mediators and three measures of functional outcomes (living situation, occupation and social functioning) as outcome measures. The analyses were repeated with the same outcome measures three years later. Three main results were obtained. I) Both in the cross-sectional and longitudinal analyses, the associations of neurocognition (both cohorts) and social cognition (GROUP) with social functioning were mediated by amotivation. II) The association between cognition and living situation was mediated by Expressive deficits in one cohort (GROUP) but not in the cohort assessing first-episode psychosis (PROGR-S). III) The association between cognition and occupation was mediated by Amotivation in PROGR-S and by Expressive deficits in GROUP. CONCLUSION: The current results show a less robust mediating role for specific negative symptom domains regarding the associations of cognition with occupation and living situation that may depend on the duration of psychotic illness. However, Amotivation, mediates the association between cognition and social functioning, which holds true for patients experiencing a first-onset and patients with a longer illness duration alike. The results may have implications for the development of therapeutic approaches focusing on amotivation to improve social functioning. GENERAL SCIENTIFIC SUMMARY: This study stresses the importance of distinguishing subdomains of negative symptoms, cognition and functioning. Our results show that specific negative symptom dimensions mediate the effects of cognition on specific functional outcomes.
Collapse
Affiliation(s)
- Edith J Liemburg
- University of Groningen, University Medical Center Groningen, Department of Neuroscience and BCN Neuroimaging Center, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Rob Giel Research center, CC72, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, CC80, Postbox 30.001, 9700 RB Groningen, the Netherlands.
| | - Stefanie Enriquez-Geppert
- University of Groningen, University Medical Center Groningen, Department of Neuroscience and BCN Neuroimaging Center, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, Department of Psychology, Grote Kruisstraat 2/1, 9712 TS, the Netherlands.
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Rob Giel Research center, CC72, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, CC80, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, CC72, Postbox 30.001, 9700 RB, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, the Netherlands.
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, Rob Giel Research center, CC72, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, Department of Psychology, Grote Kruisstraat 2/1, 9712 TS, the Netherlands.
| | - André Aleman
- University of Groningen, University Medical Center Groningen, Department of Neuroscience and BCN Neuroimaging Center, Postbox 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, Department of Psychology, Grote Kruisstraat 2/1, 9712 TS, the Netherlands.
| | | | | |
Collapse
|
28
|
Brink V, van Driel C, el Bouhaddani S, Wardenaar KJ, van Domburgh L, Schaefer B, van Beilen M, Bartels-Velthuis AA, Veling W. Spontaneous discontinuation of distressing auditory verbal hallucinations in a school-based sample of adolescents: a longitudinal study. Eur Child Adolesc Psychiatry 2020; 29:777-790. [PMID: 31455976 PMCID: PMC7305260 DOI: 10.1007/s00787-019-01393-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 09/30/2018] [Accepted: 08/17/2019] [Indexed: 11/24/2022]
Abstract
Auditory verbal hallucinations (AVH) can be transiently present in both clinical and healthy adolescent populations. It is not yet fully understood why AVH discontinue in some adolescents and persist in others. The aim of this explorative study is to investigate predictors of spontaneous discontinuation of distressing AVH in a school-based sample of adolescents. 1841 adolescents (mean age 12.4 years, 58% female) completed self-report questionnaires at baseline. The current study included 123 adolescents (7%; 63% female) who reported at least mild distressing AVH at baseline and completed follow-up measurements. LASSO analyses were used to uncover predictors of spontaneous discontinuation of distressing AVH. During follow-up, 43 adolescents (35%) reported having experienced distressing AVH during the last 12 months, while 80 adolescents did not. Spontaneous discontinuation of distressing AVH was predicted by never having used cannabis, parents not being divorced in the past year, never having been scared by seeing a deceased body, less prosocial behaviour, school grade repetition, having the feeling that others have it in for you, having anxiety when meeting new people, having lived through events exactly as if they happened before and having the feeling as if parts of the body have changed. No associations between spontaneous discontinuation of distressing AVH and age or ethnicity were found. Distressing AVH in non-clinical adolescents are mostly transient. Discontinuation was predicted up to a certain extent. However, several predictors were difficult to interpret and do not provide leads for preventive measures, except for discouraging cannabis use.
Collapse
Affiliation(s)
- Vera Brink
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB, Groningen, The Netherlands.
| | - Catheleine van Driel
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| | | | - Klaas J. Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, , PO Box 30.001, Groningen, 9700 RB The Netherlands
| | - Lieke van Domburgh
- Department of Child and Adolescent Psychiatry, VU University Medical Center, PO Box 303, 1115 ZG Duivendrecht, The Netherlands ,Department of Research and Development, Pluryn-Intermetzo, PO Box 53, 6500 AB Nijmegen, The Netherlands
| | - Barbara Schaefer
- Parnassia Institute, Carnissesingel 51, 3083 JA Rotterdam, The Netherlands
| | - Marije van Beilen
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| | - Agna A. Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| |
Collapse
|
29
|
Brink V, van Driel C, el Bouhaddani S, Wardenaar KJ, van Domburgh L, Schaefer B, van Beilen M, Bartels-Velthuis AA, Veling W. Correction to: Spontaneous discontinuation of distressing auditory verbal hallucinations in a school‑based sample of adolescents: a longitudinal study. Eur Child Adolesc Psychiatry 2020; 29:897-900. [PMID: 31595437 PMCID: PMC7645534 DOI: 10.1007/s00787-019-01413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the Original Publication Table 2 was incorrectly published. The correct table is given below.
Collapse
Affiliation(s)
- Vera Brink
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB, Groningen, The Netherlands.
| | - Catheleine van Driel
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| | | | - Klaas J. Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB The Netherlands
| | - Lieke van Domburgh
- Department of Child and Adolescent Psychiatry, VU University Medical Center, PO Box 303, 1115 ZG Duivendrecht, The Netherlands ,Department of Research and Development, Pluryn-Intermetzo, PO Box 53, 6500 AB Nijmegen, The Netherlands
| | - Barbara Schaefer
- Parnassia Institute, Carnissesingel 51, 3083 JA Rotterdam, The Netherlands
| | - Marije van Beilen
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| | - Agna A. Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, PO Box 30.001 (HPC CC60), 9700 RB Groningen, The Netherlands
| |
Collapse
|
30
|
Wassink-Vossen S, Collard RM, Wardenaar KJ, Verhaak PF, Rhebergen D, Naarding P, Voshaar RCO. Trajectories and determinants of functional limitations in late-life
depression: A 2-year prospective cohort study. Eur Psychiatry 2020; 62:90-96. [DOI: 10.1016/j.eurpsy.2019.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 10/25/2022] Open
Abstract
Abstract
Background:
In mental health research, functional recovery is increasingly
valued as an important outcome in addition to symptomatic
remission.
Methods:
Course types of functional limitations among depressed older
patients and its relation with symptomatic remission were explored in a
naturalistic cohort study (Netherlands Study of Depression in Older
persons). 378 depressed older patients (≥60 years) and 132 non-depressed
persons were included. Depressive disorders were assessed with Composite
International Diagnostic Interview at baseline and two-year follow-up.
Functional limitations were assessed every 6 months with the World
Health Organization Disability Assessment II.
Results:
Depressed patients had more functional limitations compared to their
non-depressed counterparts. Growth Mixture Modeling among depressed
patients identified two trajectories of functional limitations, both
starting at a high disability level. The largest subgroup (81.2%) was
characterized by a course of high disability levels over time. The
smaller subgroup (18.8%) had an improving course (functional recovery).
After two years, the main predictor of functional recovery was the
remission of depression. Among symptomatic remitted patients, female
sex, higher level of education, higher gait speed, and less severe
depression were associated with no functional recovery. Non-remitted
patients without functional recovery were characterized by the presence
of more chronic somatic diseases, a lower sense of mastery, and a higher
level of anxiety.
Conclusions:
1 in 5 depressed older patients have a course with functional
recovery. Combining functional and symptomatic recovery points to a
subgroup of older patients that might profit from more rigorous
psychiatric treatment targeted at psychiatric comorbidity and a group of
frail depressed older patients that might profit from integrated
geriatric rehabilitation.
Collapse
|
31
|
Chisholm K, Pelton M, Duncan N, Kidd K, Wardenaar KJ, Upthegrove R, Broome MR, Lin A, Wood SJ. A cross-sectional examination of the clinical significance of autistic traits in individuals experiencing a first episode of psychosis. Psychiatry Res 2019; 282:112623. [PMID: 31685288 DOI: 10.1016/j.psychres.2019.112623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 05/03/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 11/28/2022]
Abstract
Autism traits are found at elevated rates in individuals with schizophrenia spectrum disorders, however, there is a lack of evidence regarding potential clinical impact. The current research aimed to examine potential associations between autism traits and symptoms of psychosis, social and role functioning, and quality of life. 99 individuals experiencing a first episode of psychosis took part in a cross-sectional interview and self-report questionnaire which assessed current symptoms of psychosis, autism traits, functioning, and quality of life. Participants were found to have a high level of autism traits. Higher autism traits were associated with poorer quality of life, functioning, and current psychotic symptoms. Receiver operating characteristic curve (ROC) analyses indicated that optimal AQ cut-off scores to predict severity of psychosis symptoms, functioning, and quality of life were lower than those used to suggest likely autism-spectrum diagnosis. Results suggest that autism traits are associated with poorer clinical presentation in first-episode psychosis populations, even in those whose traits fall below potentially diagnostic thresholds for autism. Psychosis services should be prepared to adequately address the needs of individuals with higher autism traits.
Collapse
Affiliation(s)
- Katharine Chisholm
- Department of Psychology, Aston University, United Kingdom; School of Psychology and Institute for Mental Health, University of Birmingham, United Kingdom.
| | - Mirabel Pelton
- School of Psychology and Institute for Mental Health, University of Birmingham, United Kingdom; Centre for Innovative Research Across the Life course (CIRAL), Coventry University, United Kingdom
| | - Nikita Duncan
- School of Psychology and Institute for Mental Health, University of Birmingham, United Kingdom
| | - Katherine Kidd
- School of Psychology and Institute for Mental Health, University of Birmingham, United Kingdom
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Netherlands
| | - Rachel Upthegrove
- School of Psychiatry, Institute of Clinical Sciences, and Institute for Mental Health, University of Birmingham. Forward Thinking Birmingham and Birmingham and Solihull Mental Health Foundation Trust, United Kingdom
| | - Matthew R Broome
- School of Psychology and Institute for Mental Health, University of Birmingham, United Kingdom; Department of Psychiatry, University of Oxford, UK; Faculty of Philosophy, University of Oxford, UK, Oxford Health NHS Foundation Trust, United Kingdom
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Australia
| | - Stephen J Wood
- School of Psychology and Institute for Mental Health, University of Birmingham, United Kingdom; Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, Australia, & the Centre for Youth Mental Health, University of Melbourne, Australia, & School of Psychology, University of Birmingham, United Kingdom
| |
Collapse
|
32
|
Yin H, Wardenaar KJ, Xu G, Tian H, Schoevers RA. Help-seeking behaviors among Chinese people with mental disorders: a cross-sectional study. BMC Psychiatry 2019; 19:373. [PMID: 31783825 PMCID: PMC6883558 DOI: 10.1186/s12888-019-2316-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Failure to seek treatment for mental health disorders is a serious public health concern. Unfortunately, there is little insight into help-seeking and its associated factors in China which has undergone rapid economic development in the past 30 years and has an increasing prevalence of mental disorder. Therefore, this study aimed to (1) investigate help-seeking rates in healthcare and non-healthcare settings and (2) investigate the correlates of help-seeking behavior in a large Chinese survey. METHODS Data came from the Tianjin Mental Health Survey (TJMHS), a representative sample of adult community residents in the Chinese municipality of Tianjin (n = 11,748). Of these, 1759 individuals had ≥1 axis-I diagnosis according to the Diagnostic and Statistical manual- fourth edition (DSM-IV) and were administered a Help-Seeking Questionnaire. RESULTS 15.7% of patients reported that they had ever sought help during their entire lifetime before the interview, with 4.5% seeking help in mental healthcare, 3.2% in other healthcare and 8.1% in non-healthcare settings (e.g., family, friends, and spiritual advisor). Among help-seekers, the first help was mostly sought in non-healthcare settings (58.4%), followed by healthcare (27.5%) and mental healthcare settings (24.5%). Female gender, younger age, having 7-9 years vs 0-6 years of education, a low income, a psychotic disorder and having ≥2 disorders were associated with increased help-seeking. Older age, being married and having a psychotic or organic disorder were associated with increased help-seeking in healthcare vs. non-healthcare settings. CONCLUSION A small percentage of persons with mental disorders in the Tianjin region seek help and among those who do, variations in the types of help-seeking may be partially explained by demographic and clinical characteristics.
Collapse
Affiliation(s)
- Huifang Yin
- grid.440287.dTianjin Mental Health Institute, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi district, Tianjin, 300222 China ,0000 0000 9558 4598grid.4494.dDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Klaas J. Wardenaar
- 0000 0000 9558 4598grid.4494.dDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Guangming Xu
- Tianjin Mental Health Institute, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi district, Tianjin, 300222, China.
| | - Hongjun Tian
- grid.440287.dTianjin Mental Health Institute, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi district, Tianjin, 300222 China
| | - Robert A. Schoevers
- 0000 0000 9558 4598grid.4494.dDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| |
Collapse
|
33
|
Burgos Ochoa L, Rijnhart JJ, Penninx BW, Wardenaar KJ, Twisk JW, Heymans MW. Performance of methods to conduct mediation analysis with time‐to‐event outcomes. STAT NEERL 2019. [DOI: 10.1111/stan.12191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- Lizbeth Burgos Ochoa
- Department of Obstetrics and GynaecologyErasmus MC, University Medical Centre Rotterdam Rotterdam The Netherlands
| | - Judith J.M. Rijnhart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteAmsterdam UMC, VU University Medical Center Amsterdam The Netherlands
| | - Brenda W. Penninx
- Department of PsychiatryAmsterdam UMC, VU University Medical Center Amsterdam The Netherlands
| | - Klaas J. Wardenaar
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE)University of Groningen, University Medical Center Groningen (UMCG) Groningen The Netherlands
| | - Jos W.R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteAmsterdam UMC, VU University Medical Center Amsterdam The Netherlands
| | - Martijn W. Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteAmsterdam UMC, VU University Medical Center Amsterdam The Netherlands
| |
Collapse
|
34
|
Yang C, Wardenaar KJ, Bosker FJ, Li J, Schoevers RA. Inflammatory markers and treatment outcome in treatment resistant depression: A systematic review. J Affect Disord 2019; 257:640-649. [PMID: 31357161 DOI: 10.1016/j.jad.2019.07.045] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [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: 02/28/2019] [Revised: 06/03/2019] [Accepted: 07/04/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND A substantial percentage of depressed patients do not respond satisfactorily to conventional antidepressant treatment. This treatment resistant depression (TRD) may be partly related to inflammatory processes in the central nervous system. Accordingly, peripheral inflammatory markers might serve to predict treatment response with novel but still experimental forms of antidepressant treatment. METHODS A literature search on treatment of TRD and inflammatory markers was performed using the PubMed/Medline database on November 8th 2018, and 95 articles were retrieved initially, which were subsequently screened and selected only when the inclusion and exclusion criteria were met. RESULTS Ten studies were recruited. In five studies higher baseline interleukin-6 (IL-6) or C-reactive protein (CRP)/high-sensitivity-CRP (hsCRP) in blood predicted better response to medication with anti-inflammatory characteristics, such as ketamine and infliximab. One study found that higher IL-6 predicted worse response to antidepressant treatment in patients with TRD. No evidence was found for the predictive value of other inflammatory markers (e.g., Tumor Necrosis Factor-α, Interferon-γ). LIMITATIONS The number of available studies was limited; included studies showed considerable methodological variation and used different definitions for TRD. CONCLUSION The inflammatory markers IL-6 and CRP/hsCRP could hold promise as markers for the prediction of treatment response in TRD. Clearly, this field of research is still far from mature but it could pave the way for novel and efficacious treatments for at least the inflammatory type of TRD with more well-designed studies and more convincing results.
Collapse
Affiliation(s)
- Chenghao Yang
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China; University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Fokko J Bosker
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands
| | - Jie Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China
| | - Robert A Schoevers
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands.
| |
Collapse
|
35
|
Beijers L, Wardenaar KJ, Bosker FJ, Lamers F, van Grootheest G, de Boer MK, Penninx BW, Schoevers RA. Biomarker-based subtyping of depression and anxiety disorders using Latent Class Analysis. A NESDA study. Psychol Med 2019; 49:617-627. [PMID: 29860945 PMCID: PMC6393228 DOI: 10.1017/s0033291718001307] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Etiological research of depression and anxiety disorders has been hampered by diagnostic heterogeneity. In order to address this, researchers have tried to identify more homogeneous patient subgroups. This work has predominantly focused on explaining interpersonal heterogeneity based on clinical features (i.e. symptom profiles). However, to explain interpersonal variations in underlying pathophysiological mechanisms, it might be more effective to take biological heterogeneity as the point of departure when trying to identify subgroups. Therefore, this study aimed to identify data-driven subgroups of patients based on biomarker profiles. METHODS Data of patients with a current depressive and/or anxiety disorder came from the Netherlands Study of Depression and Anxiety, a large, multi-site naturalistic cohort study (n = 1460). Thirty-six biomarkers (e.g. leptin, brain-derived neurotrophic factor, tryptophan) were measured, as well as sociodemographic and clinical characteristics. Latent class analysis of the discretized (lower 10%, middle, upper 10%) biomarkers were used to identify different patient clusters. RESULTS The analyses resulted in three classes, which were primarily characterized by different levels of metabolic health: 'lean' (21.6%), 'average' (62.2%) and 'overweight' (16.2%). Inspection of the classes' clinical features showed the highest levels of psychopathology, severity and medication use in the overweight class. CONCLUSIONS The identified classes were strongly tied to general (metabolic) health, and did not reflect any natural cutoffs along the lines of the traditional diagnostic classifications. Our analyses suggested that especially poor metabolic health could be seen as a distal marker for depression and anxiety, suggesting a relationship between the 'overweight' subtype and internalizing psychopathology.
Collapse
Affiliation(s)
- Lian Beijers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Klaas J. Wardenaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Fokko J. Bosker
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Femke Lamers
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Gerard van Grootheest
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Marrit K. de Boer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W.J.H. Penninx
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
36
|
de Jonge P, Wardenaar KJ, Lim CCW, Aguilar-Gaxiola S, Alonso J, Andrade LH, Bunting B, Chatterji S, Ciutan M, Gureje O, Karam EG, Lee S, Medina-Mora ME, Moskalewicz J, Navarro-Mateu F, Pennell BE, Piazza M, Posada-Villa J, Torres Y, Kessler RC, Scott K. The cross-national structure of mental disorders: results from the World Mental Health Surveys. Psychol Med 2018; 48:2073-2084. [PMID: 29254513 PMCID: PMC6008201 DOI: 10.1017/s0033291717003610] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the placement of eating disorders, bipolar disorder and psychotic experiences (PEs) in this structure. METHODS We evaluated the structure of mental disorders with data from the World Health Organization Composite International Diagnostic Interview, including 15 lifetime mental disorders and six PEs. Respondents (n = 5478-15 499) were included from 10 high-, middle- and lower middle-income countries across the world aged 18 years or older. Confirmatory factor analyses (CFAs) were used to evaluate and compare the fit of different factor structures to the lifetime disorder data. Measurement invariance was evaluated with multigroup CFA (MG-CFA). RESULTS A second-order model with internalizing and externalizing factors and fear and distress subfactors best described the structure of common mental disorders. MG-CFA showed that this model was stable across countries. Of the uncommon disorders, bipolar disorder and eating disorder were best grouped with the internalizing factor, and PEs with a separate factor. CONCLUSIONS These results indicate that cross-national patterns of lifetime common mental-disorder comorbidity can be explained with a second-order underlying structure that is stable across countries and can be extended to also cover less common mental disorders.
Collapse
Affiliation(s)
- Peter de Jonge
- Developmental Psychology,Department of Psychology,Rijksuniversiteit Groningen,Groningen,Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry,Interdisciplinary Center Psychopathology and Emotion Regulation,University Medical Center Groningen,Groningen,Netherlands
| | - Carmen C W Lim
- Department of Psychological Medicine,University of Otago,Dunedin, Otago,New Zealand
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities,UC Davis Health System,Sacramento, California,USA
| | - Jordi Alonso
- Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica - LIM 23,Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade,de São Paulo,Brazil
| | | | - Somnath Chatterji
- Department of Information,Evidence and Research, World Health Organization,Geneva,Switzerland
| | - Marius Ciutan
- National School of Public Health,Management and Development,Bucharest,Romania
| | - Oye Gureje
- Department of Psychiatry,University College Hospital,Ibadan,Nigeria
| | - Elie G Karam
- Department of Psychiatry and Clinical Psychology,St George Hospital University Medical Center, Balamand University,Faculty of Medicine,Beirut,Lebanon
| | - Sing Lee
- Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong
| | | | | | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud; IMIB-Arrixaca; CIBERESP-Murcia,Murcia,Spain
| | - Beth-Ellen Pennell
- Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor, Michigan,USA
| | | | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences,Bogota,Colombia
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University,Medellin,Colombia
| | - Ronald C Kessler
- Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA
| | - Kate Scott
- Department of Psychological Medicine,University of Otago,Dunedin, Otago,New Zealand
| |
Collapse
|
37
|
Yang C, Tiemessen KM, Bosker FJ, Wardenaar KJ, Lie J, Schoevers RA. Interleukin, tumor necrosis factor-α and C-reactive protein profiles in melancholic and non-melancholic depression: A systematic review. J Psychosom Res 2018; 111:58-68. [PMID: 29935756 DOI: 10.1016/j.jpsychores.2018.05.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 02/08/2018] [Revised: 05/10/2018] [Accepted: 05/12/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The current diagnostic criteria for major depressive disorder (MDD) do not allow prediction of prognosis and therapeutic response. A possible strategy to improve this situation is the identification of depression subtypes on the bases of biomarkers reflecting underlying pathological processes such as neuro-inflammation. METHODS The PubMed/Medline database was searched until Apr 25th, 2017. In the initial search 1018 articles were retrieved, which were subsequently screened and only selected when the inclusion and exclusion criteria were fulfilled. RESULTS Eight eligible studies were found. Overall, serum interleukin-6 and 1β values were increased in the melancholic MDD subtype compared to controls and the non-melancholic MDD subtype. C-reactive protein was increased in non-melancholic MDD in 2 out of 4 studies, while there was no difference for tumor necrosis factor-α and interleukin-2 and 10. CONCLUSION Given the paucity of eligible studies the tentative conclusion must be drawn that peripheral inflammation markers have limited added value thus far to distinguish between melancholic and non-melancholic depression. To allow for a more definitive conclusion, further research is warranted using a broader panel of inflammatory markers in MDD subtypes, preferably based on a general consensus regarding diagnostic criteria and subtype definitions.
Collapse
Affiliation(s)
- Chenghao Yang
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China; University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, The Netherlands
| | - Kim M Tiemessen
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Fokko J Bosker
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, The Netherlands.
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Jie Lie
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China
| | - Robert A Schoevers
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, The Netherlands
| |
Collapse
|
38
|
Abstract
BACKGROUND Depressive patients can present with complex and different symptom patterns in clinical care. Of these, some may report patterns that are inconsistent with typical patterns of depressive symptoms. This study aimed to evaluate the validity of person-fit statistics to identify inconsistent symptom reports and to assess the clinical usefulness of providing clinicians with person-fit score feedback during depression assessment. METHODS Inconsistent symptom reports on the Inventory of Depressive Symptomatology Self-Report (IDS-SR) were investigated quantitatively with person-fit statistics for both intake and follow-up measurements in the Groningen University Center of Psychiatry (n = 2036). Subsequently, to investigate the causes and clinical usefulness of on-the-fly person-fit alerts, qualitative follow-up assessments were conducted with three psychiatrists about 20 of their patients that were randomly selected. RESULTS Inconsistent symptom reports at intake (12.3%) were predominantly characterized by reporting of severe symptoms (e.g. psychomotor slowing) without mild symptoms (e.g. irritability). Person-fit scores at intake and follow-up were positively correlated (r = 0.45). Qualitative interviews with psychiatrists resulted in an explanation for the inconsistent response behavior (e.g. complex comorbidity, somatic complaints, and neurological abnormalities) for 19 of 20 patients. Psychiatrists indicated that if provided directly after the assessment, a person-fit alert would have led to new insights in 60%, and be reason for discussion with the patient in 75% of the cases. CONCLUSIONS Providing clinicians with automated feedback when inconsistent symptom reports occur is informative and can be used to support clinical decision-making.
Collapse
Affiliation(s)
- Rob B K Wanders
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rob R Meijer
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
| | - Henricus G Ruhé
- Department of Psychiatry, Mood and Anxiety Disorders, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sjoerd Sytema
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaas J Wardenaar
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
39
|
Wardenaar KJ, Lim CCW, Al-Hamzawi AO, Alonso J. The cross-national epidemiology of specific phobia in the World Mental Health Surveys - CORRIGENDUM. Psychol Med 2018; 48:878. [PMID: 28994357 DOI: 10.1017/s0033291717002975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
40
|
Toonen RB, Wardenaar KJ, Bos EH, van Ockenburg SL, de Jonge P. Using bundle embeddings to predict daily cortisol levels in human subjects. BMC Med Res Methodol 2018; 18:31. [PMID: 29562900 PMCID: PMC5863436 DOI: 10.1186/s12874-018-0485-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 02/27/2018] [Indexed: 11/11/2022] Open
Abstract
Background Many biological variables sampled from human subjects show a diurnal pattern, which poses special demands on the techniques used to analyze such data. Furthermore, most biological variables belong to nonlinear dynamical systems, which may make linear statistical techniques less suitable to analyze their dynamics. The current study investigates the usefulness of two analysis techniques based on nonlinear lagged vector embeddings: sequentially weighted global linear maps (SMAP), and bundle embeddings. Methods Time series of urinary cortisol were collected in 10 participants, in the morning (‘night’ measurement) and the evening (‘day’ measurement), resulting in 126 consecutive measurements. These time series were used to create lagged vector embeddings, which were split into ‘night’ and ‘day’ bundle embeddings. In addition, embeddings were created based on time series that were corrected for the average time-of-day (TOD) values. SMAP was used to predict future values of cortisol in these embeddings. Global (linear) and local (non-linear) predictions were compared for each embedding. Bootstrapping was used to obtain confidence intervals for the model parameters and the prediction error. Results The best cortisol predictions were found for the night bundle embeddings, followed by the full embeddings and the time-of-day corrected embeddings. The poorest predictions were found for the day bundle embeddings. The night bundle embeddings, the full embeddings and the TOD-corrected embeddings all showed low dimensions, indicating the absence of dynamical processes spanning more than one day. The dimensions of the day bundles were higher, indicating the presence of processes spanning more than one day, or a higher amount of noise. In the full embeddings, local models gave the best predictions, whereas in the bundles the best predictions were obtained from global models, indicating potential nonlinearity in the former but not the latter. Conclusions Using a bundling approach on time series of cortisol may reveal differences between the predictions of night and day cortisol that are difficult to find with conventional time-series methods. Combination of this approach with SMAP may especially be useful when analyzing time-series data with periodic components.
Collapse
Affiliation(s)
- Roelof B Toonen
- Department of Developmental Psychology, Heymans Institute for Psychological Research, University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712, TS, Groningen, the Netherlands.
| | - Klaas J Wardenaar
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, CC72, Hanzeplein 1, 9700, RB, Groningen, the Netherlands
| | - Elisabeth H Bos
- Department of Developmental Psychology, Heymans Institute for Psychological Research, University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712, TS, Groningen, the Netherlands
| | - Sonja L van Ockenburg
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, CC72, Hanzeplein 1, 9700, RB, Groningen, the Netherlands
| | - Peter de Jonge
- Department of Developmental Psychology, Heymans Institute for Psychological Research, University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712, TS, Groningen, the Netherlands
| |
Collapse
|
41
|
Affiliation(s)
- H M van Loo
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands.,Department of Psychiatry, Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - R B K Wanders
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - K J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - E I Fried
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Group of Quantitative Psychology and Individual Differences, Leuven, Belgium
| |
Collapse
|
42
|
Yin H, Xu G, Tian H, Yang G, Wardenaar KJ, Schoevers RA. The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS). Psychol Med 2018; 48:473-487. [PMID: 28714421 DOI: 10.1017/s0033291717001878] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND To effectively shape mental healthcare policy in modern-day China, up-to-date epidemiological data on mental disorders is needed. The objective was to estimate the prevalence, age-of-onset (AOO) and sociodemographic correlates of mental disorders in a representative household sample of the general population (age ⩾ 18) in the Tianjin Municipality in China. METHODS Data came from the Tianjin Mental health Survey (TJMHS), which was conducted between July 2011 and March 2012 using a two-phase design. 11 748 individuals were screened with an expanded version of the General Health Questionnaire and 4438 subjects were selected for a diagnostic interview by a psychiatrist, using the Structured Clinical Interview for the Diagnostic and Statistical Manual - fourth edition (SCID). RESULTS The lifetime and 1-month prevalence of any mental disorder were 23.6% and 12.8%, respectively. Mood disorders (lifetime: 9.3%; 1-month: 3.9%), anxiety disorders (lifetime: 4.5% 1-month: 3.1%) and substance-use disorders (lifetime: 8.8%; 1-month: 3.5%) were most prevalent. The median AOO ranged from 25 years [interquartile range (IQR): 23-32] for substance-use disorders to 36 years (IQR: 24-50) for mood disorders. Not being married, non-immigrant status (i.e. local 'Hukou'), being a farmer, having <6 years of education and male gender were associated with a higher lifetime prevalence of any mental disorder. CONCLUSION Results from the current survey indicate that mental disorders are steadily reported more commonly in rapidly-developing urban China. Several interesting sociodemographic correlates were observed (e.g. male gender and non-immigrant status) that warrant further investigation and could be used to profile persons in need of preventive intervention.
Collapse
Affiliation(s)
- H Yin
- Tianjin Mental Health Institute,Tianjin Anding Hospital,Tianjin,China
| | - G Xu
- Tianjin Mental Health Institute,Tianjin Anding Hospital,Tianjin,China
| | - H Tian
- Tianjin Mental Health Institute,Tianjin Anding Hospital,Tianjin,China
| | - G Yang
- Tianjin Mental Health Institute,Tianjin Anding Hospital,Tianjin,China
| | - K J Wardenaar
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),Groningen,The Netherlands
| | - R A Schoevers
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),Groningen,The Netherlands
| |
Collapse
|
43
|
Verhoeven FEA, Wardenaar KJ, Ruhé HGE, Conradi HJ, de Jonge P. Seeing the signs: Using the course of residual depressive symptomatology to predict patterns of relapse and recurrence of major depressive disorder. Depress Anxiety 2018; 35:148-159. [PMID: 29228458 DOI: 10.1002/da.22695] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/06/2016] [Revised: 08/29/2017] [Accepted: 09/09/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by high relapse/recurrence rates. Predicting individual patients' relapse/recurrence risk has proven hard, possibly due to course heterogeneity among patients. This study aimed to (1) identify homogeneous data-driven subgroups with different patterns of relapse/recurrence and (2) identify associated predictors. METHODS For a year, we collected weekly depressive symptom ratings in 213 primary care MDD patients. Latent class growth analyses (LCGA), based on symptom-severity during the 24 weeks after no longer fulfilling criteria for the initial major depressive episode (MDE), were used to identify groups with different patterns of relapse/recurrence. Associations of baseline predictors with these groups were investigated, as were the groups' associations with 3- and 11-year follow-up depression outcomes. RESULTS LCGA showed that heterogeneity in relapse/recurrence after no longer fulfilling criteria for the initial MDE was best described by four classes: "quick symptom decline" (14.0%), "slow symptom decline" (23.3%), "steady residual symptoms" (38.7%), and "high residual symptoms" (24.1%). The latter two classes showed lower self-esteem at baseline, and more recurrences and higher severity at 3-year follow-up than the first two classes. Moreover, the high residual symptom class scored higher on neuroticism and lower on extraversion and self-esteem at baseline. Interestingly, the steady residual symptoms and high residual symptoms classes still showed higher severity of depressive symptoms after 11 years. CONCLUSION Some measures were associated with specific patterns of relapse/recurrence. Moreover, the data-driven relapse/recurrence groups were predictive of long-term outcomes, suggesting that patterns of residual symptoms could be of prognostic value in clinical practice.
Collapse
Affiliation(s)
- Floor E A Verhoeven
- University Medical Center Groningen, RGOc, University of Groningen, Groningen, The Netherlands
| | - Klaas J Wardenaar
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henricus G Eric Ruhé
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry, Warneford Hospital, University of Oxford, United Kingdom
| | - Henk Jan Conradi
- Department of Clinical Psychology, University of Amsterdam, The Netherlands
| | - Peter de Jonge
- Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
44
|
Wardenaar KJ, Wanders RBK, Jeronimus BF, de Jonge P. The Psychometric Properties of an Internet-Administered Version of the Depression Anxiety and Stress Scales (DASS) in a Sample of Dutch Adults. J Psychopathol Behav Assess 2017; 40:318-333. [PMID: 29937624 PMCID: PMC5978836 DOI: 10.1007/s10862-017-9626-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Psychometric work on the widely used Depression Anxiety and Stress Scales (DASS) has mostly used classical psychometrics and ignored common internet-administered versions. Therefore, the present study used not only classical, but also modern psychometrics based on item response theory (IRT) to evaluate an internet-administered version of the DASS (Dutch translation). Internet-administered DASS data were collected as part of a large internet-based study in the Dutch adult population (n = 7972). Initially, external correlates (i.e. demographics other measures) and some classical psychometrics (internal consistency, convergent/divergent validity) of the DASS scales were evaluated. Next, IRT was used to investigate the scales' dimensionality, discrimination and item-functioning. Finally, the DASS depression scale was further investigated by linking it to the more clinically-oriented Quick Inventory of Depressive Symptomatology (QIDS) using item response theory (IRT). Initial classical psychometric analyses supported the scales' internal consistency (alpha = 0.94-0.98) and convergent/divergent validity. IRT analyses showed that each of the DASS scales was only suitable to measure variations in a very narrow and rather mild severity range. Linking the DASS depression scale with the QIDS also showed that the DASS depression scale discriminated best in the mild-moderate severity range, but not at higher severity levels that were covered by the QIDS. In conclusion, the scales of the internet-administered DASS show good internal consistency and validity. However, users should be aware that the scales discriminate best at mild-moderate severity ranges in the general population.
Collapse
Affiliation(s)
- Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen (UMCG), P.O. box 30.001, 9700RB Groningen, The Netherlands
| | - Rob B K Wanders
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen (UMCG), P.O. box 30.001, 9700RB Groningen, The Netherlands.,2Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Bertus F Jeronimus
- 2Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen (UMCG), P.O. box 30.001, 9700RB Groningen, The Netherlands.,2Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
45
|
Yin H, Phillips MR, Wardenaar KJ, Xu G, Ormel J, Tian H, Schoevers RA. The Tianjin Mental Health Survey (TJMHS): study rationale, design and methods. Int J Methods Psychiatr Res 2017; 26:e1535. [PMID: 27766715 PMCID: PMC6877264 DOI: 10.1002/mpr.1535] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 01/11/2016] [Revised: 05/24/2016] [Accepted: 06/28/2016] [Indexed: 11/06/2022] Open
Abstract
Mental health in China is of growing concern to both policy-makers and researchers. The Tianjin Mental Health Survey (TJMHS) was conducted between July 2011 and March 2012 to assess the prevalence and risk factors of mental disorders in the context of recent economic growth and other socio-demographic changes in Tianjin, a municipality of 13 million on China's eastern seaboard. A multistage cluster random sample selected using probability proportionate to size methods participated in a two-phase screening procedure: 11,748 subjects 18 or older were screened for risk of psychopathology and then an enriched risk-proportional subsample of 4,438 subjects was interviewed by psychiatrists using an expanded Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) Axis I disorders (SCID). The study also collected information about the impairment associated with mental disorders, mental health literacy, the stigmatization of mental disorders, and help-seeking behavior for psychological problems. This paper provides a detailed overview of the study rationale, objectives, field procedures, and pattern of response. It highlights several of the methodological challenges of maintaining quality control of a complex epidemiological study in the Chinese setting, issues that are relevant to other community-based epidemiological studies in low- and middle-income countries.
Collapse
Affiliation(s)
- Huifang Yin
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Departments of Psychiatry and Global Health, Emory University, Atlanta, Georgia, USA.,WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital, Beijing, China
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Guangming Xu
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China
| | - Johan Ormel
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hongjun Tian
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China
| | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
46
|
Wardenaar KJ, Lim CC, Al-Hamzawi AO, Alonso J, Andrade LH, Benjet C, Bunting B, de Girolamo G, Demyttenaere K, Florescu SE, Gureje O, Hisateru T, Hu C, Huang Y, Karam E, Kiejna A, Lepine JP, Navarro-Mateu F, Browne MO, Piazza M, Posada-Villa J, ten Have ML, Torres Y, Xavier M, Zarkov Z, Kessler RC, Scott KM, de Jonge P. The cross-national epidemiology of specific phobia in the World Mental Health Surveys. Psychol Med 2017; 47:1744-1760. [PMID: 28222820 PMCID: PMC5674525 DOI: 10.1017/s0033291717000174] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries. METHOD Data came from 25 representative population-based surveys conducted in 22 countries (2001-2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview. RESULTS The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3-21.9% across income groups) and 23.1% reported any treatment (9.6-30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes. CONCLUSIONS Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.
Collapse
Affiliation(s)
- Klaas J. Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| | - Carmen C.W. Lim
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Jordi Alonso
- Health Services Research Unit, Instituto Hospital del Mar de Investigaciones Médicas, Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Laura H. Andrade
- Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Londonderry, United Kingdom
| | | | - Koen Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Silvia E. Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Tachi Hisateru
- National Institute of Mental Health, National Center for Neurology and Psychiatry, Japan
| | - Chiyi Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China
| | - Yueqin Huang
- Institute of Mental Health, Peking University, Beijing, China
| | - Elie Karam
- St George Hospital University Medical Center, Balamand University, Institute for Development, Research, Advocacy, Beirut, Lebanon
| | - Andrzej Kiejna
- Department of Psychiatry Wroclaw Medical University, Wroclaw, Poland
| | - Jean Pierre Lepine
- Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, University Paris Diderot and Paris Descartes Paris, France
| | - Fernando Navarro-Mateu
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca. Centro de Investigación Biomédica en Red. Epidemiología y Salud Pública (CIBERESP)-Murcia. Subdirección General de Salud Mental y Asistencia Psiquiátrica. Servicio Murciano de Salud, El Palmar (Murcia), Spain
| | | | - Maria Piazza
- National Institute of Health, Peru, Universidad Cayetano Hereidia, St Martin de Porres, Peru
| | | | - Margreet L. ten Have
- Trimbos Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - Miguel Xavier
- Nova faculdade ciencias medicas, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Zahari Zarkov
- Directorate Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
| | | | - Kate M. Scott
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Peter de Jonge
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| |
Collapse
|
47
|
Wardenaar KJ, Wanders RBK, Ten Have M, de Graaf R, de Jonge P. Using a hybrid subtyping model to capture patterns and dimensionality of depressive and anxiety symptomatology in the general population. J Affect Disord 2017; 215:125-134. [PMID: 28319689 DOI: 10.1016/j.jad.2017.03.038] [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] [Received: 11/23/2016] [Revised: 01/09/2017] [Accepted: 03/10/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Researchers have tried to identify more homogeneous subtypes of major depressive disorder (MDD) with latent class analyses (LCA). However, this approach does no justice to the dimensional nature of psychopathology. In addition, anxiety and functioning-levels have seldom been integrated in subtyping efforts. Therefore, this study used a hybrid discrete-dimensional approach to identify subgroups with shared patterns of depressive and anxiety symptomatology, while accounting for functioning-levels. METHODS The Comprehensive International Diagnostic Interview (CIDI) 1.1 was used to assess previous-year depressive and anxiety symptoms in the Netherlands Mental Health Survey and Incidence Study-1 (NEMESIS-1; n=5583). The data were analyzed with factor analyses, LCA and hybrid mixed-measurement item response theory (MM-IRT) with and without functioning covariates. Finally, the classes' predictors (measured one year earlier) and outcomes (measured two years later) were investigated. RESULTS A 3-class MM-IRT model with functioning covariates best described the data and consisted of a 'healthy class' (74.2%) and two symptomatic classes ('sleep/energy' [13.4%]; 'mood/anhedonia' [12.4%]). Factors including older age, urbanicity, higher severity and presence of 1-year MDD predicted membership of either symptomatic class vs. the healthy class. Both symptomatic classes showed poorer 2-year outcomes (i.e. disorders, poor functioning) than the healthy class. The odds of MDD after two years were especially increased in the mood/anhedonia class. LIMITATIONS Symptoms were assessed for the past year whereas current functioning was assessed. CONCLUSIONS Heterogeneity of depression and anxiety symptomatology are optimally captured by a hybrid discrete-dimensional subtyping model. Importantly, accounting for functioning-levels helps to capture clinically relevant interpersonal differences.
Collapse
Affiliation(s)
- Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Rob B K Wanders
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Peter de Jonge
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, Groningen, The Netherlands
| |
Collapse
|
48
|
de Vos S, Wardenaar KJ, Bos EH, Wit EC, Bouwmans MEJ, de Jonge P. An investigation of emotion dynamics in major depressive disorder patients and healthy persons using sparse longitudinal networks. PLoS One 2017; 12:e0178586. [PMID: 28570696 PMCID: PMC5453553 DOI: 10.1371/journal.pone.0178586] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 05/16/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Differences in within-person emotion dynamics may be an important source of heterogeneity in depression. To investigate these dynamics, researchers have previously combined multilevel regression analyses with network representations. However, sparse network methods, specifically developed for longitudinal network analyses, have not been applied. Therefore, this study used this approach to investigate population-level and individual-level emotion dynamics in healthy and depressed persons and compared this method with the multilevel approach. METHODS Time-series data were collected in pair-matched healthy persons and major depressive disorder (MDD) patients (n = 54). Seven positive affect (PA) and seven negative affect (NA) items were administered electronically at 90 times (30 days; thrice per day). The population-level (healthy vs. MDD) and individual-level time series were analyzed using a sparse longitudinal network model based on vector autoregression. The population-level model was also estimated with a multilevel approach. Effects of different preprocessing steps were evaluated as well. The characteristics of the longitudinal networks were investigated to gain insight into the emotion dynamics. RESULTS In the population-level networks, longitudinal network connectivity was strongest in the healthy group, with nodes showing more and stronger longitudinal associations with each other. Individually estimated networks varied strongly across individuals. Individual variations in network connectivity were unrelated to baseline characteristics (depression status, neuroticism, severity). A multilevel approach applied to the same data showed higher connectivity in the MDD group, which seemed partly related to the preprocessing approach. CONCLUSIONS The sparse network approach can be useful for the estimation of networks with multiple nodes, where overparameterization is an issue, and for individual-level networks. However, its current inability to model random effects makes it less useful as a population-level approach in case of large heterogeneity. Different preprocessing strategies appeared to strongly influence the results, complicating inferences about network density.
Collapse
Affiliation(s)
- Stijn de Vos
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Klaas J. Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Elisabeth H. Bos
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, the Netherlands
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, Groningen, the Netherlands
| | - Ernst C. Wit
- University of Groningen, Johann Bernoulli Institute of Mathematics and Computer Science, Groningen, the Netherlands
| | - Mara E. J. Bouwmans
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Peter de Jonge
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, the Netherlands
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, Groningen, the Netherlands
| |
Collapse
|
49
|
Ribolsi M, Lin A, Wardenaar KJ, Pontillo M, Mazzone L, Vicari S, Armando M. Clinical presentation of Attenuated Psychosis Syndrome in children and adolescents: Is there an age effect? Psychiatry Res 2017; 252:169-174. [PMID: 28282534 DOI: 10.1016/j.psychres.2017.02.050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 05/27/2016] [Revised: 01/04/2017] [Accepted: 02/15/2017] [Indexed: 01/11/2023]
Abstract
There is limited research on clinical features related to age of presentation of the Attenuated Psychosis Syndrome in children and adolescents (CAD). Based on findings in CAD with psychosis, we hypothesized that an older age at presentation of Attenuated Psychosis Syndrome would be associated with less severe symptoms and better psychosocial functioning than presentation in childhood or younger adolescence. Ninety-four CAD (age 9-18) meeting Attenuated Psychosis Syndrome criteria participated in the study. The sample was divided and compared according to the age of presentation of Attenuated Psychosis Syndrome (9-14 vs 15-18 years). The predictive value of age of Attenuated Psychosis Syndrome presentation was investigated using receiver operating characteristic (ROC)-curve calculations. The two Attenuated Psychosis Syndrome groups were homogeneous in terms of gender distribution, IQ scores and comorbid diagnoses. Older Attenuated Psychosis Syndrome patients showed better functioning and lower depressive scores. ROC curves revealed that severity of functional impairment was best predicted using an age of presentation cut-off of 14.9 years for social functioning and 15.9 years for role functioning. This study partially confirmed our hypothesis; older age at presentation of Attenuated Psychosis Syndrome was associated with less functional impairment, but age was not associated with psychotic symptoms.
Collapse
Affiliation(s)
- Michele Ribolsi
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, 6008 Western Australia, Australia
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Luigi Mazzone
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Marco Armando
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy; Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
| |
Collapse
|
50
|
Van Beek MH, Roest AM, Wardenaar KJ, Van Balkom AJ, Speckens AE, Oude Voshaar RC, Zuidersma M. The Prognostic Effect of Physical Health Complaints With New Cardiac Events and Mortality in Patients With a Myocardial Infarction. Psychosomatics 2017; 58:121-131. [DOI: 10.1016/j.psym.2016.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/26/2016] [Accepted: 10/26/2016] [Indexed: 11/29/2022]
|