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Wijnen BFM, Ten Have M, de Graaf R, van der Hoek HJ, Lokkerbol J, Smit F. The economic burden of mental disorders: results from the Netherlands mental health survey and incidence study-2. Eur J Health Econ 2023:10.1007/s10198-023-01634-2. [PMID: 37872458 DOI: 10.1007/s10198-023-01634-2] [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] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/11/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Currently, there is a paucity of up-to-date estimates of the economic burden caused by mental disorders. Such information could provide vital insight into one of the most serious and costly-yet to some extent preventable-health challenges facing the world today. METHOD Data from a national psychiatric-epidemiological cohort study (NEMESIS-2, N = 6506) were used to provide reliable, relevant, and up-to-date cost estimates (in 2019 Euro) regarding healthcare costs, productivity losses, and patient and family costs associated with DSM-IV mental disorders both at individual level, but also in the general population and in the workforce of the Netherlands (per 1 million population). RESULTS In the general population, the costs of mood disorders, specifically depression, are substantial and rank above those from the anxiety disorders, whilst costs of anxiety disorders are more substantial than those stemming from substance use disorders, even when the per-person costs of drug abuse appear highest of all. In the workforce, specific and social phobias are leading causes of excess costs. The workforce has lower healthcare costs but higher productivity costs than general population. DISCUSSION The findings suggest that (preventive) healthcare interventions targeting the workforce are likely to become cost-effective and underscore the importance for employers to create healthy work environments. Overall, the results highlight the need to strengthen the role of mental health promotion and prevention of mental disorders in the social domain before people require treatment to reduce the staggering and costly burden caused by mental disorders to individuals and society.
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Affiliation(s)
- B F M Wijnen
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.
| | - M Ten Have
- Department of Epidemiology, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - R de Graaf
- Department of Epidemiology, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - H J van der Hoek
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - J Lokkerbol
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Filip Smit
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Academic Medical Center Amsterdam, Location VUmc, Amsterdam, The Netherlands
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de Boer N, Vermeulen J, Lin B, van Os J, ten Have M, de Graaf R, van Dorsselaer S, Bak M, Rutten B, Batalla A, Guloksuz S, Luykx JJ. Longitudinal associations between alcohol use, smoking, genetic risk scoring and symptoms of depression in the general population: a prospective 6-year cohort study. Psychol Med 2023; 53:1409-1417. [PMID: 35023464 PMCID: PMC10009403 DOI: 10.1017/s0033291721002968] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Alcohol consumption, smoking and mood disorders are leading contributors to the global burden of disease and are highly comorbid. Yet, their interrelationships have remained elusive. The aim of this study was to examine the multi-cross-sectional and longitudinal associations between (change in) smoking and alcohol use and (change in) number of depressive symptoms. METHODS In this prospective, longitudinal study, 6646 adults from the general population were included with follow-up measurements after 3 and 6 years. Linear mixed-effects models were used to test multi-cross-sectional and longitudinal associations, with smoking behaviour, alcohol use and genetic risk scores for smoking and alcohol use as independent variables and depressive symptoms as dependent variables. RESULTS In the multi-cross-sectional analysis, smoking status and number of cigarettes per day were positively associated with depressive symptoms (p < 0.001). Moderate drinking was associated with less symptoms of depression compared to non-use (p = 0.011). Longitudinally, decreases in the numbers of cigarettes per day and alcoholic drinks per week as well as alcohol cessation were associated with a reduction of depressive symptoms (p = 0.001-0.028). Results of genetic risk score analyses aligned with these findings. CONCLUSIONS While cross-sectionally smoking and moderate alcohol use show opposing associations with depressive symptoms, decreases in smoking behaviour as well as alcohol consumption are associated with improvements in depressive symptoms over time. Although we cannot infer causality, these results open avenues to further investigate interventions targeting smoking and alcohol behaviours in people suffering from depressive symptoms.
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Affiliation(s)
- N. de Boer
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - J. Vermeulen
- Department of Psychiatry, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - B. Lin
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - J. van Os
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M. ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - R. de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S. van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M. Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- FACT, Mondriaan Mental Health, Maastricht, The Netherlands
| | - B. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A. Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - S. Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - J. J. Luykx
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- GGNet Mental Health, Apeldoorn, The Netherlands
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van der Riet J, Ten Have M, de Graaf R, Batelaan NM. [The relation between sleep problems and the onset and course of anxiety and mood disorders]. Tijdschr Psychiatr 2023; 65:411-417. [PMID: 37756025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND Sleep gets little attention in mental health care treatments. Epidemiological research with regards to the association between sleep problems and anxiety and mood disorders can contribute to good clinical decision making. AIM Based on data from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), we examined the relation between sleep problems and first onset, recurrence and persistence of anxiety and mood disorders within a 3 year period. METHOD Different groups of respondents were selected to examine the relation between sleep problems and different stages of anxiety and mood disorders within three years. DSM-IV diagnoses were determined using the Composite International Diagnostic Interview (CIDI 3.0) and sleep problems with the Women’s Health Initiative Insomnia Rating Scale (IRS; ≥ 9). Logistic regression was performed. Multivariable analysis took into account a large number of potentially confounding variables. RESULTS Almost a quarter of the respondents without an anxiety or mood disorder and almost half of the respondents with an anxiety or mood disorder experience sleep problems. In the multivariable analysis, sleep problems were associated with recurrence of an anxiety disorder (OR 2.10; 95% CI 1.31-3.38), but not with the first onset and persistence of an anxiety disorder. Furthermore, sleep problems appear to be associated with the first onset of a mood disorder (OR 2.18; 95% CI 1.27-3.74) and with the persistence of a mood disorder (OR 2.51; 95% CI 1.17-5.37), but not with recurrence of this disorder. CONCLUSION The results underline the importance of identifying sleep problems of people with (an increased risk of) anxiety and mood disorders. The treatment of sleep problems may contribute to a reduced incidence of these mental disorders and a better and sustainable recovery.
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De Maeseneer M, Kakkos S, Aherne T, Baekgaard N, Black S, Blomgren L, Giannoukas A, Gohel M, de Graaf R, Hamel-Desnos C, Jawien A, Jaworucka-Kaczorowska A, Lattimer C, Mosti G, Noppeney T, van Rijn M, Stansby G, ESVS Guidelines Committee, Kolh P, Bastos Goncalves F, Chakfé N, Coscas R, de Borst G, Dias N, Hinchliffe R, Koncar I, Lindholt J, Trimarchi S, Tulamo R, Twine C, Vermassen F, Wanhainen A, Document Reviewers, Björck M, Labropoulos N, Lurie F, Mansilha A, Nyamekye I, Ramirez Ortega M, Ulloa J, Urbanek T, van Rij A, Vuylsteke M. European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2022.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Botter L, Ten Have M, Gerritsen D, de Graaf R, van Dijk SDM, van den Brink RHS, Oude Voshaar RC. Impact of borderline personality disorder traits on the association between age and health-related quality of life: A cohort study in the general population. Eur Psychiatry 2021; 64:e33. [PMID: 33896434 PMCID: PMC8135108 DOI: 10.1192/j.eurpsy.2021.27] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Increasing age as well as borderline personality pathology are associated with a lower level of health-related quality of life (HR-QoL). Our objective was to investigate whether the presence of borderline personality traits modifies the association between age and HR-QoL in the general population. Methods Cross-sectional data from 5,303 respondents (aged 21–72 years) of the Netherlands Mental Health Survey and Incidence Study-2 were analyzed. Borderline personality traits were assessed with the International Personality Disorder Examination questionnaire. Mental and physical HR-QoL were measured with the Medical Outcomes Study Short Form Health Survey. Multiple linear regression analysis was used to examine the association of borderline personality traits, age and their interaction on mental as well as physical HR-QoL, adjusted for demographic variables as well as somatic and mental disorders. Results A total of 1,520 (28.7%) respondents reported one or more borderline personality traits of which 58 (1.1%) reported five or more indicative of a borderline personality disorder. A higher age was associated with lower physical HR-QoL. This negative association became significantly stronger in the presence of borderline personality traits. The association between increasing age and mental HR-QoL was positive in the absence of borderline personality traits and negative in the presence of borderline personality traits. Conclusion Borderline personality traits negatively interfere with the association between age and HR-QoL irrespective of somatic and mental disorders. Attention of clinicians and researchers for subthreshold borderline personality pathology is needed in middle-aged and older persons.
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Affiliation(s)
- L Botter
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Atlant, Markenhaven, Center for Specialized Chronic Psychiatric Nursing Home Care, Beekbergen, The Netherlands
| | - M Ten Have
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - D Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - R de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S D M van Dijk
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R H S van den Brink
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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de Vries YA, ten Have M, de Graaf R, van Dorsselaer S, de Ruiter NMP, de Jonge P. The relationship between mental disorders and actual and desired subjective social status. Epidemiol Psychiatr Sci 2019; 29:e83. [PMID: 31839021 PMCID: PMC8061247 DOI: 10.1017/s2045796019000805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/02/2019] [Revised: 11/13/2019] [Accepted: 11/24/2019] [Indexed: 12/21/2022] Open
Abstract
AIMS Mental disorders are associated with lower subjective social status (SSS), but a more nuanced understanding of this relationship is needed. We examined the influence of disorder age of onset and recency on SSS and studied whether mental disorders are also associated with the discrepancy between actual and desired SSS. METHOD Data are from the baseline and second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0), while both actual and desired SSS were assessed with a ten-rung ladder. Linear regression was used to examine the association between mental disorders and SSS. RESULTS Of 5303 participants, 2237 had a lifetime mental disorder at baseline. These participants reported significantly lower actual SSS (6.28) at follow-up than healthy participants (6.66, B = -0.38 [95% CI -0.48 to -0.27], p < 0.001) and a significantly greater actual-desired SSS discrepancy (1.14 v. 1.05 after controlling for actual SSS, B = 0.09 [0.01-0.17], p = 0.024). Lower age of onset of the first mental disorder was marginally significantly associated with lower actual SSS (B = 0.006 [0.000-0.012], p = 0.046). More recent disorders were also associated with lower actual SSS (B = 0.015 [0.005-0.026], p = 0.005), such that participants whose disorder remitted ⩾6 years before baseline were statistically indistinguishable from healthy participants. CONCLUSIONS Lifetime mental disorders are associated with lower actual SSS and a slightly greater discrepancy between actual and desired SSS. However, people with mental disorders in (long-term) remission have a similar social status as healthy participants.
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Affiliation(s)
- Y. A. de Vries
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M. ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - R. de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S. van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - N. M. P. de Ruiter
- University College Groningen, University of Groningen, Groningen, The Netherlands
| | - P. de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ten Have M, de Graaf R, van Dorsselaer S, Tuithof M, Kleinjan M, Penninx BWJH. [Recurrence and chronicity of major depressive disorder in the general population: results from the Netherlands Mental Health Survey and Incidence Study-2]. Tijdschr Psychiatr 2019; 61:22-31. [PMID: 30640403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The naturalistic course of major depressive disorder (mdd) and risk indicators for recurrence and chronicity of mdd are best investigated using a psychiatric epidemiological population study without clear selection bias. However, such studies are scarce, thereby limiting clinical decision-making concerning the monitoring and maintenance of treatment.<br/> AIM: To present findings from the Netherlands Mental Health Survey and Incidence Study-2 (nemesis-2) regarding the recurrence and chronicity of mdd and associated risk indicators in the general population.<br/> METHOD: At baseline, two groups were selected to examine the recurrence and chronicity of mdd at follow-up. Diagnoses were assessed with the Composite International Diagnostic Interview (cidi) 3.0.<br/> RESULTS: Among respondents with remitted mdd (n = 746), the cumulative recurrence rate was 4.3% at 5 years, 13.4% at 10 years, and 27.1% at 20 years. Time to recurrence was predicted by vulnerability characteristics (childhood abuse, negative life events, parental psychopathology), physical health, functioning, clinical characteristics of depression (previous episodes, severity, medication use), psychiatric comorbidity and mental health use. Among respondents with current mdd (n = 242), 12% developed a chronic depressive episode over 6 years. The chronic course was predicted by risk indicators similar to those for recurrence, except for vulnerability characteristics and physical health.<br/> CONCLUSION: These risk indicators may help identify depressive patients requiring monitoring and who might benefit from preventive interventions or maintenance treatment.
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Bos EH, Ten Have M, van Dorsselaer S, Jeronimus BF, de Graaf R, de Jonge P. Functioning before and after a major depressive episode: pre-existing vulnerability or scar? A prospective three-wave population-based study. Psychol Med 2018; 48:2264-2272. [PMID: 29331152 DOI: 10.1017/s0033291717003798] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 01/24/2023]
Abstract
BACKGROUND The vulnerability hypothesis suggests that impairments after remission of depressive episodes reflect a pre-existing vulnerability, while the scar hypothesis proposes that depression leaves residual impairments that confer risk of subsequent episodes. We prospectively examined vulnerability and scar effects in mental and physical functioning in a representative Dutch population sample. METHODS Three waves were used from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study with a 6-years follow-up. Mental and physical functioning were assessed with the Medical Outcomes Study Short Form (SF-36). Major depressive disorder (MDD) was assessed with the Composite International Diagnostic Interview 3.0. Vulnerability effects were examined by comparing healthy controls (n = 2826) with individuals who developed a first-onset depressive episode during first follow-up but did not have a lifetime diagnosis of MDD at baseline (n = 181). Scarring effects were examined by comparing pre- and post-morbid functioning in individuals who developed a depressive episode after baseline that was remitted at the third wave (n = 108). RESULTS Both mental (B = -5.4, s.e. = 0.9, p < 0.001) and physical functioning (B = -8.2, s.e. = 1.1, p < 0.001) at baseline were lower in individuals who developed a first depressive episode after baseline compared with healthy controls. This effect was most pronounced in people who developed a severe episode. No firm evidence of scarring in mental or physical functioning was found. In unadjusted analyses, physical functioning was still lowered post-morbidly (B = -5.1, s.e. = 2.1, p = 0.014), but this effect disappeared in adjusted analyses. CONCLUSIONS Functional impairments after remission of depression seem to reflect a pre-existing vulnerability rather than a scar.
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Affiliation(s)
- E H Bos
- Department of Developmental Psychology,Behavioural and Social Sciences,University of Groningen,Groningen,The Netherlands
| | - M Ten Have
- Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - B F Jeronimus
- Department of Developmental Psychology,Behavioural and Social Sciences,University of Groningen,Groningen,The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - P de Jonge
- Department of Developmental Psychology,Behavioural and Social Sciences,University of Groningen,Groningen,The Netherlands
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Ten Have M, de Graaf R, van Dorsselaer S, Tuithof M, Kleinjan M, Penninx BWJH. Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort. Acta Psychiatr Scand 2018; 137:503-515. [PMID: 29577236 DOI: 10.1111/acps.12874] [Citation(s) in RCA: 57] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The naturalistic course of major depressive disorder (MDD) and risk indicators for recurrence and chronicity are best studied using a population sample without clear selection bias. However, such studies are scarce. This limits clinical decision-making concerning monitoring and maintenance treatment. METHOD Data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among a representative adult population. Two groups at baseline were selected to study recurrence and chronicity of MDD at follow-up. Diagnoses were assessed with the Composite International Diagnostic Interview 3.0. RESULTS Among remitted MDD cases (n = 746), the cumulative recurrence rate was 4.3% at 5 years, 13.4% at 10 years and 27.1% at 20 years. Time to recurrence was predicted by vulnerability characteristics (childhood abuse, negative life events, parental psychopathology), physical health, functioning, clinical characteristics of depression (previous episodes, severity, medication use), psychiatric comorbidity and mental health use. Among current MDD cases (n = 242), 12% developed a chronic depressive episode over 6 years. Chronic course was predicted by similar risk indicators as recurrence, except for vulnerability characteristics and physical health. CONCLUSION These risk indicators may help to identify patients requiring monitoring and who could benefit from preventive interventions or maintenance treatment.
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Affiliation(s)
- M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
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van Ditzhuijzen J, Ten Have M, de Graaf R, van Nijnatten CHCJ, Vollebergh WAM. [Abortion and the risk of mental disorders]. Tijdschr Psychiatr 2018; 60:527-535. [PMID: 30132581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research into the potential mental health consequences of abortion yields inconsistent results and is characterized by methodological limitations.<br /> AIM: To offer a more conclusive insight into women's mental health after an abortion by stringently taking both pre-abortion mental health and confounding covariates into account.<br /> METHOD: A prospective longitudinal cohort study, the Dutch Abortion and Mental Health Study (DAMHS), through which women with and without abortion experiences could be compared. The study was designed in a similar way to the large scale Dutch population study into mental health of the Trimbos Institute, the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2).<br /> RESULTS: Women who had an abortion were significantly more likely to have had previous DSM-IV mental disorders. Psychiatric history appeared to be associated with how women experienced and handled the unwanted pregnancy and abortion. A prior history of mental disorders, averse recent life events or an unstable partner relationship increased the risk of developing post abortion mental disorders, while experiencing an abortion did not.<br /> CONCLUSION: Women who have had an abortion more often have a history of mental disorders, yet there is no evidence that an abortion in itself would increase the risk of developing a mental disorder.
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Ten Have M, Penninx BWJH, Tuithof M, van Dorsselaer S, Kleinjan M, Spijker J, de Graaf R. [New numbers on the duration of major and minor depressive episodes in the general population; results from NEMESIS-2]. Tijdschr Psychiatr 2018; 60:364-373. [PMID: 29943793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Relatively little research has been conducted that can reliably be used by psychiatrists, psychologists and general practitioners to estimate the recovery time of their patients suffering from depression. The treatment guideline for depression submits that half of those with mdd will recover within three months.<br /> AIM: To present the findings from nemesis-2 (the Netherlands Mental Health Survey and Incidence Study-2) on both the duration of depressive episodes in the general population and associated risk indicators.<br /> METHOD: The respondents that had developed a depressive episode between the first two follow-up assessments were selected; 286 with a clinical depression according to dsm-iv criteria (mdd) and 107 with a subclinical depression (MinDD). The episode duration was assessed with the Life Chart Interview.<br /> RESULTS: Half of the patients with mdd recovered within 6 months and 12% had not recovered after 3 years. The mean duration for mdd was 10.7 months. Better physical and mental health before depression onset predicted shorter duration. Longer duration was associated with comorbid dysthymia or anxiety disorder. In comparison, the median duration of MinDD was half the length of mdd (3 months), whereas the mean duration (8.7 months), the percentage that had not recovered after 3 years (10%) and risk indicators for episode duration hardly differed.<br /> CONCLUSION: In the guideline for depression it is assumed that half of those with mdd will recover within three months. Our study, however, found the median duration of mdd to be twice as long. Consequently, only a short period without active treatment can be justified. This paper also concludes that MinDD cannot be regarded as a transient, self-limiting mood state.
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Schuurman AR, Bos SA, de Wit K, de Graaf R, Wiersinga WJ. [A day in the life of a medical resident on the ward]. Ned Tijdschr Geneeskd 2018; 161:D2480. [PMID: 29328018] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate how internal medicine residents allocate their time during a hospital dayshift on the wards. DESIGN Prospective observational cohort study (time and motion study). METHODS Data were collected from 36 internal medicine residents working at the Internal Medicine Department of the Academic Medical Centre in Amsterdam, the Netherlands. Trained observers monitored 22 residents using a newly developed smartphone-application, registering their dayshift activities (meetings and education, direct patient contact, administrative tasks, lunch/break, other) and location (workstation, conference room, ward and patient rooms, other). Data of 14 residents on work-related activities during after-hours in the hospital and at home were collected through a questionnaire. RESULTS Residents were observed for a total of 210 hours. The average workday encompassed 9.5 hours. During this dayshift, residents spent an average of 38% of their time on administrative tasks, and 37% on interprofessional consultation and educational activities. Direct patient/family contact accounted for 13% of the workday. After the evening handover at 5 pm, on average another 80 minutes of work was performed in the hospital, of which 73 minutes (91%) entailed administration. At home, they spent on average another 52 minutes on patient care related work, of which 51 minutes (98%) consisted of administration. CONCLUSION The internal medicine residents on the ward spend most of their dayshift on indirect patient care. This comprises mostly computer-based administrative tasks. After the dayshift, many residents continue to work in their own time to finish remaining paperwork. Study limitations are the limited total number of monitored residents, the total observation time and possible self-report bias.
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Affiliation(s)
- A R Schuurman
- Academisch Medisch Centrum-Universiteit van Amsterdam, afd. Inwendige Geneeskunde, Amsterdam
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Boerema AM, ten Have M, Kleiboer A, de Graaf R, Nuyen J, Cuijpers P, Beekman ATF. Demographic and need factors of early, delayed and no mental health care use in major depression: a prospective study. BMC Psychiatry 2017; 17:367. [PMID: 29145820 PMCID: PMC5691833 DOI: 10.1186/s12888-017-1531-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 11/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the availability of evidence based treatments, many people with major depression receive no or delayed professional treatment, which may put them at risk for adverse outcomes. The aim of this study was to examine which demographic and need factors distinguish early, delayed and no treatment use. METHODS Data were obtained from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). People with a diagnosis of major depression in the past 12 months were included (N = 434). Mental health care use was assessed during this same period and at follow up (three years later). Multinomial regression analysis was used to distinguish early, delayed and no mental health care users with respect to demographic and need factors. RESULTS The majority of participants accessed treatment early (62%). Early treatment users were characterized by more severe and persistent symptoms and were more likely not to have a partner compared to no treatment users. The majority of those without treatment reached remission in three years (85%). Delayed treatment users were, compared to early users, characterized by relatively mild symptoms and a persistent or new major depressive disorder at follow up. CONCLUSIONS Early access to treatment and the finding that need factors determine mental health care use among people with depression show that the filters along the pathway to treatment are not influenced by unfavorable determinants like education or age.
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Affiliation(s)
- A. M. Boerema
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - M. ten Have
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - A. Kleiboer
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - R. de Graaf
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - J. Nuyen
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - P. Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - A. T. F. Beekman
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Psychiatry, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Ten Have M, Penninx BWJH, Tuithof M, van Dorsselaer S, Kleinjan M, Spijker J, de Graaf R. Duration of major and minor depressive episodes and associated risk indicators in a psychiatric epidemiological cohort study of the general population. Acta Psychiatr Scand 2017; 136:300-312. [PMID: 28512767 DOI: 10.1111/acps.12753] [Citation(s) in RCA: 44] [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] [Accepted: 04/18/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Hardly any studies exist on the duration of major depressive disorder (MDD) and factors that explain variations in episode duration that lack biases. This limits clinical decision-making and leaves patients wondering when they will recover. METHOD Data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among a nationally representative adult population. Respondents with a newly originated depressive episode were selected: 286 MDD and 107 minor depressive disorder (MinDD) cases. DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview 3.0 and episode duration with the Life Chart Interview. RESULTS Among MDD cases, median episode duration was 6 months, mean duration was 10.7 months, and 12% had not recovered at 36 months. Longer duration was associated with comorbid dysthymia, anxiety disorder, psychotropic medication use (i.e. antidepressants or benzodiazepines prescribed by a mental health professional), mental health care use and suicidal behaviour. Better physical and mental functioning before depression onset predicted shorter duration. Among MinDD cases, shorter median duration (3 months) but similar mean duration (8.7 months), risk of chronicity (10% not recovered at 36 months) and risk indicators for episode duration were found. CONCLUSION As the risk of chronicity was similar for MDD and MinDD, MinDD cannot be dismissed as a merely brief mood state.
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Affiliation(s)
- M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - B W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - M Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - M Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - J Spijker
- Radboud University, Nijmegen, the Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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15
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Madsen IEH, Nyberg ST, Magnusson Hanson LL, Ferrie JE, Ahola K, Alfredsson L, Batty GD, Bjorner JB, Borritz M, Burr H, Chastang JF, de Graaf R, Dragano N, Hamer M, Jokela M, Knutsson A, Koskenvuo M, Koskinen A, Leineweber C, Niedhammer I, Nielsen ML, Nordin M, Oksanen T, Pejtersen JH, Pentti J, Plaisier I, Salo P, Singh-Manoux A, Suominen S, ten Have M, Theorell T, Toppinen-Tanner S, Vahtera J, Väänänen A, Westerholm PJM, Westerlund H, Fransson EI, Heikkilä K, Virtanen M, Rugulies R, Kivimäki M. Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychol Med 2017; 47:1342-1356. [PMID: 28122650 PMCID: PMC5471831 DOI: 10.1017/s003329171600355x] [Citation(s) in RCA: 252] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/28/2016] [Accepted: 12/15/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. METHOD We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. RESULTS We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). CONCLUSIONS Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.
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Affiliation(s)
- I. E. H. Madsen
- National Research Centre for the Working
Environment, DK-2100 Copenhagen Ø,
Denmark
| | - S. T. Nyberg
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | | | - J. E. Ferrie
- Department of Epidemiology and Public
Health, University College London, London
WC1E 6BT, UK
- School of Community and Social Medicine,
University of Bristol, Bristol BS8 2PS,
UK
| | - K. Ahola
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | - L. Alfredsson
- Institute of Environmental Medicine,
Karolinska Institutet, SE-171 77 Stockholm,
Sweden
- Centre for Occupational and Environmental
Medicine, Stockholm County Council, SE-104
22 Stockholm, Sweden
| | - G. D. Batty
- Department of Epidemiology and Public
Health, University College London, London
WC1E 6BT, UK
- Centre for Cognitive Ageing and Cognitive
Epidemiology, University of Edinburgh,
Edinburgh EH8 9JZ, UK
- Alzheimer Scotland Dementia Research
Centre, University of Edinburgh, Edinburgh
EH8 9JZ, UK
| | - J. B. Bjorner
- National Research Centre for the Working
Environment, DK-2100 Copenhagen Ø,
Denmark
| | - M. Borritz
- Department of Occupational and Environmental
Medicine, Bispebjerg University Hospital,
DK-2400 Copenhagen, Denmark
| | - H. Burr
- Federal Institute for Occupational Safety and
Health (BAuA), D-10317 Berlin,
Germany
| | - J.-F. Chastang
- INSERM, U1085, Research Institute for
Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and
Ergonomics (ESTER) Team, F-49000, Angers, France
- University of Angers, Epidemiology in Occupational
Health and Ergonomics (ESTER) Team, F-49000, Angers, France
| | - R. de Graaf
- Netherlands Institute of Mental Health and
Addiction, 3521 VS Utrecht, The
Netherlands
| | - N. Dragano
- Department of Medical Sociology,
University of Düsseldorf, 40225
Düsseldorf, Germany
| | - M. Hamer
- Department of Epidemiology and Public
Health, University College London, London
WC1E 6BT, UK
- National Centre for Sport & Exercise
Medicine, Loughborough University, Loughborough LE11 3TU,
UK
| | - M. Jokela
- Institute of Behavioral Sciences,
University of Helsinki, FI-00014
Helsinki, Finland
| | - A. Knutsson
- Department of Health Sciences,
Mid Sweden University, SE-851 70
Sundsvall, Sweden
| | - M. Koskenvuo
- Department of Public Health,
University of Helsinki, FI-00014
Helsinki, Finland
| | - A. Koskinen
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | - C. Leineweber
- Stress Research Institute, Stockholm
University, SE-106 91 Stockholm,
Sweden
| | - I. Niedhammer
- INSERM, U1085, Research Institute for
Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and
Ergonomics (ESTER) Team, F-49000, Angers, France
- University of Angers, Epidemiology in Occupational
Health and Ergonomics (ESTER) Team, F-49000, Angers, France
| | - M. L. Nielsen
- Unit of Social Medicine,
Frederiksberg University Hospital, DK-2000
Copenhagen, Denmark
| | - M. Nordin
- Stress Research Institute, Stockholm
University, SE-106 91 Stockholm,
Sweden
- Department of Psychology,
Umeå University, SE-901 87 Umeå,
Sweden
| | - T. Oksanen
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | - J. H. Pejtersen
- The Danish National Centre for Social
Research, DK-1052 Copenhagen,
Denmark
| | - J. Pentti
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | - I. Plaisier
- The Netherlands Institute for Social
Research, 2515 XP The Hague, The
Netherlands
| | - P. Salo
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
- Department of Psychology,
University of Turku, FI-20014 Turku,
Finland
| | - A. Singh-Manoux
- Department of Epidemiology and Public
Health, University College London, London
WC1E 6BT, UK
- Inserm U1018, Centre for
Research in Epidemiology and Population Health, F-94807
Villejuif, France
| | - S. Suominen
- Folkhälsan Research Center,
FI-00290 Helsinki, Finland
- Nordic School of Public Health,SE-402 42Göteborg, Sweden
- Department of Public Health,
University of Turku, FI-20014 Turku,
Finland
| | - M. ten Have
- Netherlands Institute of Mental Health and
Addiction, 3521 VS Utrecht, The
Netherlands
| | - T. Theorell
- Stress Research Institute, Stockholm
University, SE-106 91 Stockholm,
Sweden
| | | | - J. Vahtera
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
- Department of Public Health,
University of Turku, FI-20014 Turku,
Finland
- Turku University Hospital,
FI-20520 Turku, Finland
| | - A. Väänänen
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | - P. J. M. Westerholm
- Occupational and Environmental
Medicine, Uppsala University, SE-751 85
Uppsala, Sweden
| | - H. Westerlund
- Stress Research Institute, Stockholm
University, SE-106 91 Stockholm,
Sweden
| | - E. I. Fransson
- Stress Research Institute, Stockholm
University, SE-106 91 Stockholm,
Sweden
- Institute of Environmental Medicine,
Karolinska Institutet, SE-171 77 Stockholm,
Sweden
- School of Health and Welfare,
Jönköping University, SE-551 11
Jönköping, Sweden
| | - K. Heikkilä
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
- Department of Health Services Research and
Policy, London School of Hygiene and Tropical
Medicine, London WC1H 9SH, UK
- Clinical Effectiveness Unit,
The Royal College of Surgeons of England, London
WC2A 3PE, UK
| | - M. Virtanen
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
| | - R. Rugulies
- National Research Centre for the Working
Environment, DK-2100 Copenhagen Ø,
Denmark
- Department of Public Health and Department of
Psychology, University of Copenhagen,
DK-1353 Copenhagen, Denmark
| | - M. Kivimäki
- Finnish Institute of Occupational
Health, FI-00250 Helsinki, Finland
- Department of Epidemiology and Public
Health, University College London, London
WC1E 6BT, UK
- Clinicum, Faculty of Medicine,
University of Helsinki, FI-00014 Helsinki,Finland
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16
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de Wolf MAF, Jalaie H, van Laanen JHH, Kurstjens RLM, Mensinck MJS, de Geus MJ, Gombert A, de Graaf R, Wittens CHA. Endophlebectomy of the common femoral vein and arteriovenous fistula creation as adjuncts to venous stenting for post-thrombotic syndrome. Br J Surg 2017; 104:718-725. [DOI: 10.1002/bjs.10461] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/05/2016] [Accepted: 11/18/2016] [Indexed: 11/05/2022]
Abstract
Abstract
Background
Good results have been reported for angioplasty and stenting of post-thrombotic lesions of the iliac and proximal femoral veins. If lesions at the origin of the superficial femoral and profunda veins are stented, the intraluminal synechiae can be pushed against the orifices of inflow vessels, potentially decreasing stent inflow. Surgical disobliteration of the common femoral vein (endophlebectomy) has been suggested to mitigate this problem. Because of a temporary increase in thrombogenicity, this procedure may be accompanied by arteriovenous fistula creation.
Methods
Data on consecutive patients treated by hybrid venous reconstruction, between December 2010 and May 2015, were analysed. Standard recording consisted of clinical scoring systems (including Villalta scale) and imaging. Patency was assessed with duplex ultrasonography.
Results
Seventy-six legs (70 patients) were included. Median follow-up was 379 (range 73–1508) days. Primary, assisted primary and secondary patency rates at 12 months were 51, 70 and 83 per cent respectively. Sixty per cent of loss of primary patency (24 of 40 legs) was related to common femoral vein stenosis, and the rest to rethrombosis. Other complications included wound infection (29 per cent) and lymphatic leak (39 per cent). The Villalta score had decreased by a median of 7 points at 1-year follow-up.
Conclusion
The combination of venous stenting, endophlebectomy and arteriovenous fistula creation for patients with extensive post-thrombotic vein damage and severe post-thrombotic syndrome is feasible.
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Affiliation(s)
- M A F de Wolf
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - H Jalaie
- Department of Vascular Surgery, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Nordrhein-Westfalen, Aachen, Germany
| | - J H H van Laanen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - R L M Kurstjens
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - M J S Mensinck
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M J de Geus
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A Gombert
- Department of Vascular Surgery, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Nordrhein-Westfalen, Aachen, Germany
| | - R de Graaf
- Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - C H A Wittens
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Vascular Surgery, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Nordrhein-Westfalen, Aachen, Germany
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17
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Schat A, van Noorden MS, Noom MJ, Giltay EJ, van der Wee NJA, de Graaf R, Ten Have M, Vermeiren RRJMM, Zitman FG. A cluster analysis of early onset in common anxiety disorders. J Anxiety Disord 2016; 44:1-8. [PMID: 27665086 DOI: 10.1016/j.janxdis.2016.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/13/2015] [Revised: 08/03/2016] [Accepted: 09/07/2016] [Indexed: 11/24/2022]
Abstract
Early onset is regarded as an important characteristic of anxiety disorders, associated with higher severity. However, previous findings diverge, as definitions of early onset vary and are often unsubstantiated. We objectively defined early onset in social phobia, panic disorder, agoraphobia, and generalised anxiety disorder, using cluster analysis with data gathered in the general population. Resulting cut-off ages for early onset were ≤22 (social phobia), ≤31 (panic disorder), ≤21 (agoraphobia), and ≤27 (generalised anxiety disorder). Comparison of psychiatric comorbidity and general wellbeing between subjects with early and late onset in the general population and an outpatient cohort, demonstrated that among outpatients anxiety comorbidity was more common in early onset agoraphobia, but also that anxiety- as well as mood comorbidity were more common in late onset social phobia. A major limitation was the retrospective assessment of onset. Our results encourage future studies into correlates of early onset of psychiatric disorders.
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Affiliation(s)
- A Schat
- Leiden University Medical Center, Department of Psychiatry, P.O. Box 7500, 2300 RC Leiden, The Netherlands.
| | - M S van Noorden
- Leiden University Medical Center, Department of Psychiatry, P.O. Box 7500, 2300 RC Leiden, The Netherlands
| | - M J Noom
- Zaans Medisch Centrum, Department of Psychiatry, Kon. Julianaplein 58, 1502 DV Zaandam, The Netherlands; Mental Health Center GGZ Eindhoven, dept. of child and adolescent psychiatry, Doctor Poletlaan 40, 5626 ND Eindhoven, The Netherlands
| | - E J Giltay
- Leiden University Medical Center, Department of Psychiatry, P.O. Box 7500, 2300 RC Leiden, The Netherlands
| | - N J A van der Wee
- Leiden University Medical Center, Department of Psychiatry, P.O. Box 7500, 2300 RC Leiden, The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands
| | - M Ten Have
- Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands
| | - R R J M M Vermeiren
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK Oegstgeest, The Netherlands
| | - F G Zitman
- Leiden University Medical Center, Department of Psychiatry, P.O. Box 7500, 2300 RC Leiden, The Netherlands
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18
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Kurstjens R, de Wolf M, Kleijnen J, de Graaf R, Wittens C. The predictive value of haemodynamic parameters for outcome of deep venous reconstructions in patients with chronic deep vein obstruction - A systematic review. Phlebology 2016; 32:532-542. [PMID: 27789765 DOI: 10.1177/0268355516671464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The aim of this study was to investigate the predictive value of haemodynamic parameters on success of stenting or bypass surgery in patients with non-thrombotic or post-thrombotic deep venous obstruction. Methods EMBASE, MEDLINE and trial registries were searched up to 5 February 2016. Studies needed to investigate stenting or bypass surgery in patients with post-thrombotic obstruction or stenting for non-thrombotic iliac vein compression. Haemodynamic data needed to be available with prognostic analysis for success of treatment. Two authors, independently, selected studies and extracted data with risk bias assessment using the Quality in Prognosis Studies tool. Results Two studies using stenting and two using bypass surgery were included. Three investigated plethysmography, though results varied and confounding was not properly taken into account. Dorsal foot vein pressure and venous refill times appeared to be of influence in one study, though confounding by deep vein incompetence was likely. Another investigated femoral-central pressure gradients without finding statistical significance, though sample size was small without details on statistical methodology. Reduced femoral inflow was found to be a predictor for stent stenosis or occlusion in one study, though patients also received additional surgery to improve stent inflow. Data on prediction of haemodynamic parameters for stenting of non-thrombotic iliac vein compression were not available. Conclusions Data on the predictive value of haemodynamic parameters for success of treatment in deep venous obstructive disease are scant and of poor quality. Plethysmography does not seem to be of value in predicting outcome of stenting or bypass surgery in post-thrombotic disease. The relevance of pressure-related parameters is unclear. Reduced flow into the common femoral vein seems to be predictive for in-stent stenosis or occlusion. Further research into the predictive effect of haemodynamic parameters is warranted and the possibility of developing new techniques that evaluate various haemodynamic aspects should be explored.
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Affiliation(s)
- Rlm Kurstjens
- 1 Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands.,2 Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
| | - Maf de Wolf
- 1 Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands.,2 Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
| | - J Kleijnen
- 3 School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - R de Graaf
- 4 Department of Radiology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Cha Wittens
- 1 Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands.,2 Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.,5 Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany
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19
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Jalaie H, Schleimer K, Barbati ME, Gombert A, Grommes J, de Wolf MAF, de Graaf R, Wittens CHA. Interventional treatment of postthrombotic syndrome. Gefasschirurgie 2016; 21:37-44. [PMID: 27546987 PMCID: PMC4974289 DOI: 10.1007/s00772-016-0156-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/25/2022]
Abstract
Background Postthrombotic syndrome (PTS) is the development of symptoms and signs of chronic venous insufficiency following deep vein thrombosis (DVT) and has a significant negative effect on the quality of life. The current understanding is that the clinical manifestation of PTS is related more to venous obstruction than it is to venous reflux. The use of interventional techniques for the treatment of venous obstruction and/or venous occlusion has rapidly increased in recent years. Objective This article summarizes the current concept of endovenous and hybrid interventions and presents the optimized treatment of choice in patients with chronic symptomatic venous obstruction. Methods We performed a systematic literature search in the Medline database to identify relevant studies on the treatment of patients with PTS. Results A meta-analysis of the relevant studies showed that this minimally invasive procedure is an effective treatment option with low morbidity and no mortality. Use of the newly developed dedicated venous stents showed promising results with good mid-term patency rates and a significant decrease in related symptoms. Conclusion Interventional therapy for the treatment of symptomatic chronic venous obstruction has become the method of choice in recent years. More studies are needed to evaluate the long-term success rate of dedicated venous stents.
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Affiliation(s)
- H Jalaie
- Klinik für Gefäßchirurgie, Universitätsklinikum der RWTH Aachen, Europäisches Gefäßzentrum Aachen-Maastricht, Pauwelstr. 30, 52074 Aachen, Germany
| | - K Schleimer
- Klinik für Gefäßchirurgie, Universitätsklinikum der RWTH Aachen, Europäisches Gefäßzentrum Aachen-Maastricht, Pauwelstr. 30, 52074 Aachen, Germany
| | - M E Barbati
- Klinik für Gefäßchirurgie, Universitätsklinikum der RWTH Aachen, Europäisches Gefäßzentrum Aachen-Maastricht, Pauwelstr. 30, 52074 Aachen, Germany
| | - A Gombert
- Klinik für Gefäßchirurgie, Universitätsklinikum der RWTH Aachen, Europäisches Gefäßzentrum Aachen-Maastricht, Pauwelstr. 30, 52074 Aachen, Germany
| | - J Grommes
- Klinik für Gefäßchirurgie, Universitätsklinikum der RWTH Aachen, Europäisches Gefäßzentrum Aachen-Maastricht, Pauwelstr. 30, 52074 Aachen, Germany
| | - M A F de Wolf
- European Vascular Center Aachen-Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R de Graaf
- European Vascular Center Aachen-Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - C H A Wittens
- Klinik für Gefäßchirurgie, Universitätsklinikum der RWTH Aachen, Europäisches Gefäßzentrum Aachen-Maastricht, Pauwelstr. 30, 52074 Aachen, Germany ; European Vascular Center Aachen-Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
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Kurstjens RLM, de Wolf MAF, Konijn HW, Toonder IM, Nelemans PJ, de Graaf R, Wittens CHA. Intravenous pressure changes in patients with postthrombotic deep venous obstruction: results using a treadmill stress test. J Thromb Haemost 2016; 14:1163-70. [PMID: 27061685 DOI: 10.1111/jth.13333] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/02/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED Essentials Little is known about the hemodynamic consequences of deep venous obstructive disease. We investigated pressure changes in 22 patients with unilateral postthrombotic obstruction. Common femoral vein pressure significantly increased after walking, compared to control limbs. Common femoral vein hypertension could explain the debilitating effect of venous claudication. Click to hear Dr Ten Cate's perspective on postthrombotic syndrome SUMMARY Background Little is known about the hemodynamic consequences of deep venous obstructive disease. Objectives The aim of this study was to investigate the hemodynamic effect of postthrombotic obstruction of the iliofemoral veins and to determine what pressure parameters differentiate best between limbs with post-thrombotic obstructive disease of the iliofemoral veins and those without obstruction. Methods Twenty-two participants with unilateral obstruction of the iliac and common femoral veins underwent a standardized treadmill test with simultaneous bilateral invasive pressure measurements in the common femoral vein and dorsal foot vein. Results Mean age was 42.8 ± 11.9 years and 86.4% of participants were female. Postthrombotic limbs showed a mean common femoral vein (CFV) pressure increase of 28.1 ± 21.0 mmHg after walking, compared with 2.1 ± 6.2 mmHg in control limbs (26.0 mmHg difference; 95% confidence interval [CI], 17.1-34.9). Less difference was observed in the dorsal foot vein (net drop of 36.8 ± 22.7 mmHg in affected limbs vs. 48.7 ± 23.1 mmHg in non-affected limbs, 11.9 mmHg difference; 95% CI, -1.3 to 25.0). Change in CFV pressure after walking yielded the best discrimination between affected and non-affected limbs (area under the receiver operated characteristic curve of 0.94 [95% CI, 0.85-1.00], compared with 0.57 [95% CI, 0.37-0.76] in the dorsal foot vein, P < 0.001). Conclusions Common femoral vein pressure significantly increases during ambulation in patients with iliofemoral postthrombotic obstruction, which could explain the debilitating effects of venous claudication. This is an indication that patients with an iliofemoral obstruction may benefit from further treatment that resolves the deep vein obstruction. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/show/NCT01846780.
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Affiliation(s)
- R L M Kurstjens
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
| | - M A F de Wolf
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
| | - H W Konijn
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - I M Toonder
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - P J Nelemans
- Department of Epidemiology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - R de Graaf
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - C H A Wittens
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
- Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany
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van Nierop M, Bak M, de Graaf R, Ten Have M, van Dorsselaer S, van Winkel R. The functional and clinical relevance of childhood trauma-related admixture of affective, anxious and psychosis symptoms. Acta Psychiatr Scand 2016; 133:91-101. [PMID: 25961128 DOI: 10.1111/acps.12437] [Citation(s) in RCA: 16] [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] [Accepted: 04/16/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Previous work has shown that across different patient samples, patients with childhood trauma are more likely to have co-occurrence of affective, anxious and psychosis symptoms than non-traumatized patients. However, the clinical relevance of trauma-related admixture remains to be established. METHOD We examined patients with mood disorder (NEMESIS-2; n = 1260), anxiety disorder (NEMESIS-2; n = 896) or psychotic disorder (GROUP; n = 532) in terms of symptom profiles, quality of life (QOL) and social functioning. RESULTS Results showed that mood disorder patients with both trauma and co-occurrence of affective, anxious and psychosis symptoms had a lower QOL (B-12.6, 95% CI -17.7 to -7.5, P < 0.001), more help-seeking behaviour [odds ratio (OR) 2.5, 95% CI 1.1-5.7, P = 0.031] and higher prevalence of substance use disorders (OR 7.8, 95% CI 1.1-58.0, P = 0.044), compared with patients without trauma history and symptom admixture (Trauma-/CL-). Similar results were found in patients with an anxiety disorder. Traumatized patients with a psychotic disorder and admixture showed lower QOL (B-0.6, 95% CI -0.9 to -0.4, P < 0.001), higher prevalence of drug disorders (OR 2.2, 95% CI 1.2-3.9, P = 0.008) and lower global assessment of functioning (B-12.8, 95% CI -17.1 to -8.5, P < 0.001) than Trauma-/CL- patients. CONCLUSION Stratification according to childhood trauma exposure thus identifies a phenotype characterized by admixture of affective, anxiety and psychotic symptoms that, when combined, has clinical relevance. Identification of functionally meaningful aetiological subgroups may aid clinical practice.
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Affiliation(s)
- M van Nierop
- Department of Psychiatry & Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M Bak
- Department of Psychiatry & Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | | | - R van Winkel
- Department of Psychiatry & Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,University Psychiatric Center KU Leuven, Department of Psychiatry, Leuven, Belgium
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22
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Speetjens P, Thielen F, Ten Have M, de Graaf R, Smit F. [Child maltreatment: long-term economic consequences and implications]. Tijdschr Psychiatr 2016; 58:706-711. [PMID: 27779287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Child maltreatment occurs frequently. This has detrimental effects later in life on mental health and is linked to considerable costs due to health care use and sick leave. Self-mastery, however, is a factor that may well mitigated the effects of child maltreatment . <br/> AIM: To quantify the long-term costs of child abuse and to test the hypothesis that self-mastery can modify the after-effects of maltreatment .<br/> METHOD: Data were obtained from a psychiatric cohort study (n=5618). The risk factors were emotional neglect and mental, physical and sexual abuse before the age of 16.<br/> RESULTS: When individuals are about 39 years old, the various forms of maltreatment to which they were subjected as children are associated with substantially higher health care costs and frequent absenteeism. Higher levels of self-mastery achieved in childhood were indeed associated with lower costs in adulthood. <br/> CONCLUSION: Child maltreatment costs the Netherlands millions of euros annually because it leads to higher health care costs and more frequent sick leave. Active steps to curb child abuse are of both financial and economic significance. More training in self-mastery could perhaps be helpful, but further research is needed in this area.
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van Nierop M, Viechtbauer W, Gunther N, van Zelst C, de Graaf R, Ten Have M, van Dorsselaer S, Bak M, van Winkel R. Childhood trauma is associated with a specific admixture of affective, anxiety, and psychosis symptoms cutting across traditional diagnostic boundaries. Psychol Med 2015; 45:1277-1288. [PMID: 25273550 DOI: 10.1017/s0033291714002372] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [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: 01/25/2023]
Abstract
BACKGROUND Meta-analyses link childhood trauma to depression, mania, anxiety disorders, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life. METHOD We used data from a representative general population sample (NEMESIS-2, n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP, n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture. RESULTS In NEMESIS-2, largely comparable associations were found between childhood trauma and depression, mania, anxiety and psychosis. However, childhood trauma was considerably more strongly associated with their lifetime admixture. These results were confirmed in the patient samples, in which it was consistently found that patients with a history of childhood trauma were more likely to have a combination of multiple symptom domains compared to their non-traumatized counterparts. This pattern was also found in exposed individuals who did not meet criteria for a psychotic, affective or anxiety disorder and who did not seek help for subclinical psychopathology. CONCLUSIONS Childhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries, and this admixture may already be present in the earliest stages of psychopathology. These findings may have significant aetiological, pathophysiological, diagnostic and clinical repercussions.
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Affiliation(s)
- M van Nierop
- Department of Psychiatry and Psychology,School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - W Viechtbauer
- Department of Psychiatry and Psychology,School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - N Gunther
- Faculty of Psychology and Educational Sciences,Open University,The Netherlands
| | - C van Zelst
- Department of Psychiatry and Psychology,School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction,Da Costakade,Utrecht,The Netherlands
| | - M Ten Have
- Netherlands Institute of Mental Health and Addiction,Da Costakade,Utrecht,The Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction,Da Costakade,Utrecht,The Netherlands
| | - M Bak
- Department of Psychiatry and Psychology,School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - R van Winkel
- Department of Psychiatry and Psychology,School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre,Maastricht,The Netherlands
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Hardt J, Bernert S, Matschinger H, Angermeier MC, Vilagut G, Bruffaerts R, de Girolamo G, de Graaf R, Haro JM, Kovess V, Alonso J. Suicidality and its relationship with depression, alcohol disorders and childhood experiences of violence: results from the ESEMeD study. J Affect Disord 2015; 175:168-74. [PMID: 25618003 DOI: 10.1016/j.jad.2014.12.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 10/28/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Suicidality constitutes a major health concern in many countries. The aim of the present paper was to analyse 10 of its risk factors and their interdependence. METHODS Data on suicidality, mental disorders and experience of childhood violence was collected from 8796 respondents in the European Study of the Epidemiology of Mental Disorders (ESEMeD). The CIDI was used to assess mental disorders. Individuals were randomly divided into two subgroups. In one, a Graphical Markov model to predict suicidality was constructed, in the second, predictors were cross-validated. RESULTS Lifetime suicidality was predicted mainly by lifetime depression and early experiences of violence, with a pseudo R-square of 12.8%. In addition, alcohol disorders predicted suicidality, but played a minor role compared with the other risk factors in this sample. CONCLUSION In addition to depression, early experience of violence constitutes an important risk factor of suicidality. LIMITATIONS This is a cross-sectional and retrospective study assessing risk factors for suicidality, not for suicide itself.
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Affiliation(s)
- J Hardt
- Medizinische Psychologie und Medizinische Soziologie, Klinik für Psycho-somatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Germany.
| | - S Bernert
- Institute of Medical Sociology, Department of Rehabilitation Research, Charité - University Medicine Berlin
| | - H Matschinger
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig
| | - M C Angermeier
- Center for Public Mental Health, Gösing am Wagram, Austria; Department of Public Health, University of Cagliari, Italy
| | - G Vilagut
- Health Services Research Unit, IMIM- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - R Bruffaerts
- Department of Psychiatry, University Hospital Gasthuisberg; Leuven, Belgium
| | - G de Girolamo
- IRCCS St John of God Fatebenefratelli, Via Pilastroni, 4, 25125, Brescia, Italy
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos-Instituut), Utrecht, Nl; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - J M Haro
- CIBER en Salud Mental (CIBERSAM), Spain
| | - V Kovess
- EA4069, Paris Descartes University, Ecole des Hautes Etudes en Santé Publique (EHESP), Paris, France
| | - J Alonso
- Health Services Research Unit, IMIM- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
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Kurstjens RLM, de Graaf R, Barbati ME, de Wolf MAF, van Laanen JHH, Wittens CHA, Jalaie H. Arteriovenous fistula geometry in hybrid recanalisation of post-thrombotic venous obstruction. Phlebology 2015; 30:42-9. [DOI: 10.1177/0268355514568270] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Post-thrombotic obstruction can be adequately treated by percutaneous transluminal angioplasty and stenting. When post-thrombotic trabeculations extend below the femoral confluence, proper inflow can be facilitated by endophlebectomy and creation of an arteriovenous fistula. The aim of this study was to investigate whether it is more favourable to place the arteriovenous fistula at the cranial or caudal end of the endophlebectomy to prevent stenosis or occlusion. Methodology We retrospectively analysed the clinical data of all patients who underwent a hybrid procedure in our two centres. Demographics, interventional details and post-operative imaging were collected. Results Data on 42 limbs with cranially and 23 limbs with caudally placed arteriovenous fistulas were collected. Post-thrombotic disease of the profunda femoral vein alone or in combination with the femoral vein was observed more often in the cranial group. The caudal group more often received a smaller sized and straight polytetrafluoroethylene fistula, while the cranial group comprised a significantly higher amount of stented segments. Logistic regression showed that only reduced femoral inflow (hazard ratio 2.934 (95%CI, 1.148–7.494)) was a significant predictor of stent stenosis and/or occlusion. Logistic regression for risk of occlusion showed a significant influence of stent-related complications (hazard ratio 4.691 (95%CI, 1.205–18.260)) and a tendency towards influence of arteriovenous fistula geometry in favour of the cranially placed fistula. Conclusion Placement of the arteriovenous fistula in the cranial part of the endophlebectomy during hybrid recanalisation may result in a more favourable outcome, yet this tendency was not statistically significant. Moreover, femoral inflow is pivotal in maintaining patency and should thus be adequately assessed pre-operatively.
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Affiliation(s)
- RLM Kurstjens
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - R de Graaf
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - ME Barbati
- Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany
| | - MAF de Wolf
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - JHH van Laanen
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - CHA Wittens
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
- Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany
| | - H Jalaie
- Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany
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Kurstjens RLM, de Wolf MAF, van Laanen JHH, de Haan MW, Wittens CHA, de Graaf R. Hemodynamic significance of collateral blood flow in chronic venous obstruction. Phlebology 2015; 30:27-34. [DOI: 10.1177/0268355515569433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Complaints related to the post-thrombotic syndrome do not always correlate well with the extent of post-thrombotic changes on diagnostic imaging. One explanation might be a difference in development of collateral blood flow. The aim of this study is to investigate the hemodynamic effect of collateralisation in deep venous obstruction. Methodology Resting intravenous pressure of the common femoral vein was measured bilaterally in the supine position of patients with unilateral iliofemoral post-thrombotic obstruction. In addition, pressure in control limbs was also measured in the common femoral vein after sudden balloon occlusion in the external iliac vein. Results Fourteen patients (median age 42 years, 12 female) were tested. In eleven limbs post-thrombotic disease extended below the femoral confluence. Median common femoral vein pressure was 17.0 mmHg in diseased limbs compared to 12.8 mmHg in controls (p = 0.001) and 23.5 mmHg in controls after sudden balloon occlusion (p = 0.009). Results remained significant after correcting for non-occlusive post-thrombotic disease. Conclusion This study shows that common femoral vein pressure is increased in post-thrombotic iliofemoral deep venous obstruction, though not as much as after sudden balloon occlusion. The latter difference could explain the importance of collateralisation in deep venous obstructive disease and the discrepancy between complaints and anatomical changes; notwithstanding, the presence of collaterals does not eliminate the need for treatment.
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Affiliation(s)
- RLM Kurstjens
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - MAF de Wolf
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - JHH van Laanen
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - MW de Haan
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - CHA Wittens
- Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
- Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany
| | - R de Graaf
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Catarinella FS, Nieman FHM, de Wolf MAF, Toonder IM, de Graaf R, Wittens CHA. Quality-of-life in interventionally treated patients with post-thrombotic syndrome. Phlebology 2015; 30:89-94. [DOI: 10.1177/0268355515569431] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction New developments in the treatment of complex deep venous disease have become available in the last decade. Besides analysing patencies as a surrogate outcome for these treatments we analysed the Quality-of-Life (QoL) changes for successful and failed deep venous treatments. Materials and methods Patients with proven venous occlusive disease, referred to our department of Venous Surgery at the Maastricht University Medical Centre, were included. After inclusion patients were treated by percutaneous transluminal angioplasty and stenting and when indicated endophlebectomy with an arteriovenous fistula. QoL was assessed with the disease specific VEINES-QOL/Sym and the generic Short-Form (SF)-36 questionnaires preoperatively at baseline and post-operatively after 3, 12 and 24 months. Results One hundred fifty-three interventions were analysed, showing a primary, assisted primary and secondary patency of respectively 65%, 78% and 89% at 24 months. The VEINES-QOL and Sym scores improved at 3, 12 and 24 months. The overall improvement at 24 months is 22.7 for QoL and 18.18 for Sym with respective p values of 0.013 and 0.016. The improvement of the VEINES-QOL and Sym scores after a successful (patent) treatment remained highly significant (QoL: p < 0.001, Sym: p = 0.004). Also the generic QoL (Short-Form 36v2) shows significant improvement after 12 months for physical functioning ( p = 0.004) and role physical ( p = 0.004) scales. Conclusions The overall patencies of interventions for deep venous pathology are exceptionally good after two years. Concomitantly the VEINES-Sym and VEINES-QOL scores improve significantly for 3, 12, and 24 months when compared to the baseline (T0) after treatment. Successful interventions showed, as expected, a significant greater QoL improvement between T0 and T3, T12, T24 for both VEINES-QOL and VEINES-Sym scores when compared to the failed interventions. The one-year linear improvement of two SF-36 scales (PF and RP) is also significant.
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Affiliation(s)
- FS Catarinella
- Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - FHM Nieman
- Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - MAF de Wolf
- Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - IM Toonder
- Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - R de Graaf
- Department of Radiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - CHA Wittens
- Department of Venous Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Vascular Surgery, Universitäts Klinikum, Aachen, Germany
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Ten Have M, van Weeghel J, van Dorsselaer S, Tuithof M, de Graaf R. [The attitude of the general public towards (discharged) psychiatric patients: results from NEMESIS-2]. Tijdschr Psychiatr 2015; 57:785-794. [PMID: 26552925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND In the Netherlands there is no up-to-date information about the attitude of the public to (discharged) psychiatric patients. Also, very little is known about which population groups hold stigmatising views. AIM To measure the public's attitudes to (discharged) psychiatric patients and to find out whether these attitudes differ according to the background characteristics (e.g. demographics, respondent's psychiatric history). METHOD In our study we used attitudes collected via the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological study of the adult general population (n = 6646; aged 18-64 years). The psychiatric history of the respondents was assessed by means of the Composite International Diagnostic Interview 3.0. RESULTS More than 70% of the respondents stated that they had no objection to having a (discharged) psychiatric patient as a neighbour, friend or colleague. However, their ´willingness´ declined markedly, namely to less than 30%, when they were asked if they would be willing to have a (discharged) psychiatric patient as their son-in-law or baby-sitter. A comparison with other earlier Dutch studies indicates that since 1987 the willingness of members of the public to let (ex-)psychiatric patients participate in their private and/or family life has increased only very slightly. CONCLUSION Nowadays, just as in past decades, most Dutch citizens are not opposed to living alongside (discharged) psychiatric patients, but they have reservations about letting such persons participate in their private and family life.
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Kurstjens R, de Wolf M, Toonder I, de Graaf R, Wittens C. Hemodynamic Consequences of Deep Venous Obstructive Disease. J Vasc Surg Venous Lymphat Disord 2015; 3:117. [DOI: 10.1016/j.jvsv.2014.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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de Wolf M, Kurstjens R, Arnoldussen C, Toonder I, de Graaf R, Wittens C. The Diagnostic Value of the Pubic Collateral in Deep Venous Obstructive Disease. J Vasc Surg Venous Lymphat Disord 2015; 3:118. [DOI: 10.1016/j.jvsv.2014.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rhebergen D, van der Steenstraten IM, Sunderland M, de Graaf R, Ten Have M, Lamers F, Penninx BWJH, Andrews G. An examination of generalized anxiety disorder and dysthymic disorder by latent class analysis. Psychol Med 2014; 44:1701-1712. [PMID: 24020863 DOI: 10.1017/s0033291713002225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The nosological status of generalized anxiety disorder (GAD) versus dysthymic disorder (DD) has been questioned. The aim of this study was to examine qualitative differences within (co-morbid) GAD and DD symptomatology. METHOD Latent class analysis was applied to anxious and depressive symptomatology of respondents from three population-based studies (2007 Australian National Survey of Mental Health and Wellbeing; National Comorbidity Survey Replication; and Netherlands Mental Health Survey and Incidence Study-2; together known as the Triple study) and respondents from a multi-site naturalistic cohort [Netherlands Study of Depression and Anxiety (NESDA)]. Sociodemographics and clinical characteristics of each class were examined. RESULTS A three-class (Triple study) and two-class (NESDA) model best fitted the data, reflecting mainly different levels of severity of symptoms. In the Triple study, no division into a predominantly GAD or DD co-morbidity subtype emerged. Likewise, in spite of the presence of pure GAD and DD cases in the NESDA sample, latent class analysis did not identify specific anxiety or depressive profiles in the NESDA study. Next, sociodemographics and clinical characteristics of each class were examined. Classes only differed in levels of severity. CONCLUSIONS The absence of qualitative differences in anxious or depressive symptomatology in empirically derived classes questions the differentiation between GAD and DD.
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Affiliation(s)
- D Rhebergen
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
| | - I M van der Steenstraten
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
| | - M Sunderland
- Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales, Sydney, NSW, Australia
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - F Lamers
- Genetic Epidemiological Research Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - B W J H Penninx
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
| | - G Andrews
- Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales, Sydney, NSW, Australia
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van Nierop M, van Os J, Gunther N, van Zelst C, de Graaf R, ten Have M, van Dorsselaer S, Bak M, Myin-Germeys I, van Winkel R. Does social defeat mediate the association between childhood trauma and psychosis? Evidence from the NEMESIS-2 Study. Acta Psychiatr Scand 2014; 129:467-76. [PMID: 24571736 DOI: 10.1111/acps.12212] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [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] [Accepted: 09/25/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Based on theoretical considerations and animal studies, mediation of 'social defeat' (SD) in the association between childhood trauma (CT) and psychosis was investigated. METHOD Trained interviewers administered a structured interview assessing CT, psychotic experiences and other psychopathology in 6646 participants in the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). RESULTS Childhood trauma was associated with psychotic experiences making up the extended psychosis phenotype (EPP), as well as with a diagnosis of psychotic disorder (PD). Similarly, CT was associated with a priori selected items indexing SD (discouraged, hopeless, worthless, loss of self-confidence, low self-esteem, better off dead, suicidal thoughts) and with a measure of affective dysregulation (AD), which in turn were also associated with psychosis. While SD and AD individually acted as mediators in the association between CT and EPP, only SD acted as a mediator in the association between CT and PD. Cannabis use did not mediate the association between CT and EPP or PD. CONCLUSION The present results suggest a developmental model implicating SD as an important mediator in the link between childhood adverse experiences and later development of psychotic experiences. The combined mediation by SD and AD is compatible with an 'affective pathway' to early psychosis.
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Affiliation(s)
- M van Nierop
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
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Jalaie H, Arnoldussen CWKP, Barbati ME, Kurstjens RLM, de Graaf R, Grommes J, Greiner A, de Wolf MA, Wittens CHA. What predicts outcome after recanalization of chronic venous obstruction: hemodynamic factors, stent geometry, patient selection, anticoagulation or other factors? Phlebology 2014; 29:97-103. [DOI: 10.1177/0268355514529510] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this review we evaluated the effect of different suggested factors associate with the outcome after recanalization of chronic venous obstruction (CVO). Hemodynamic factors: Based upon literature no clear suggestions can be made to identify the risk of stent occlusion in association with the hemodynamic effects. However it is evident that ensuring optimal in- and outflow of the stented tract is key in maintaining the patency. Patient selection: Noninvasive imaging modalities are used to divide patients in three subgroups based on the place and extension of post-thrombotic changes. Moreover it should be noted that AV fistula in selected patients can reduce the risk of thrombosis or re-occlusion. Geometry: Excessive oversizing of the stent and stent compression from outside are considered to be associated with stent occlusion. Additionally, overlapping rigid stents, unnatural angel between stents and in-stent kinking are other geometrical factors related to worse outcome after venous recanalization. Anticoagulation: Adequate peri-and postoperative anticoagulation has a crutial role in stent patency. There is no data regarding the duration of anticoagulation therapy and recommendations vary between 6 weeks to 6 months. Result: impaired inflow or outflow, presence of a hypercoagulability, total number of treated segments and use of stents designed for implantation in arterial system are associated with decreased stent patency.
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Affiliation(s)
- H Jalaie
- European Vascular Center Aachen-Maastricht, University Hospital of the RWTH Aachen, Germany
| | - CWKP Arnoldussen
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
- Department of Radiology, Viecuri Medical Centre, Venlo, The Netherlands
| | - ME Barbati
- European Vascular Center Aachen-Maastricht, University Hospital of the RWTH Aachen, Germany
| | - RLM Kurstjens
- European Vascular Center Aachen-Maastricht, Maastricht University Medical Centre, The Netherlands
| | - R de Graaf
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - J Grommes
- European Vascular Center Aachen-Maastricht, University Hospital of the RWTH Aachen, Germany
| | - A Greiner
- European Vascular Center Aachen-Maastricht, University Hospital of the RWTH Aachen, Germany
| | - MA de Wolf
- European Vascular Center Aachen-Maastricht, Maastricht University Medical Centre, The Netherlands
| | - CHA Wittens
- European Vascular Center Aachen-Maastricht, University Hospital of the RWTH Aachen, Germany
- European Vascular Center Aachen-Maastricht, Maastricht University Medical Centre, The Netherlands
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Arnoldussen CWKP, Strijkers RHW, Lambregts DMJ, Lahaye MJ, de Graaf R, Wittens CHA. Feasibility of identifying deep vein thrombosis characteristics with contrast enhanced MR-Venography. Phlebology 2014; 29:119-124. [DOI: 10.1177/0268355514529697] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To assess the feasibility of identifying deep vein thrombosis characteristics with contrast enhanced magnetic resonance venography. Materials and Methods A total of 53 cases of deep vein thrombosis extending in and/or above the common femoral vein were evaluated by 4 independent observers (2 expert, 2 novice) using pre-determined characteristics to determine the thrombosis present to be acute, sub-acute or old. If present, chronic remnants of a previous deep vein thrombosis were reported. Additionally these image qualifications were compared to the reported duration of complaints. Results In all cases all observers were able to qualify the thrombosis. The interobserver agreement between the experts was excellent (kappa 0.97) and good between expert and novice (kappa 0.82). Thrombosis identified as acute had an average duration of complaints of 6,5 (2–13) days, sub‐acute 13 (8–18) days and old 22 (15–32) days. Conclusion Qualification of thrombosis as acute, sub-acute or old and identification of chronic remnants of DVT with CE-MRV using routinely identifiable characteristics is feasible and reproducible with good to excellent interobserver agreement.
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Affiliation(s)
- CWKP Arnoldussen
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
- Department of Diagnostic and Interventional Radiology, Viecuri Medical Centre, Venlo, The Netherlands
| | - RHW Strijkers
- Department of Vascular Surgery, Maastricht University Medical Centre, The Netherlands
| | - DMJ Lambregts
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - MJ Lahaye
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - R de Graaf
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - CHA Wittens
- Department of Vascular Surgery, Maastricht University Medical Centre, The Netherlands
- European Vascular Center Aachen-Maastricht, Uniklinik, Aachen, Germany
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Abstract
Background Iliofemoral venous obstruction, caused by post-thrombotic disease, can be treated by percutaneous angioplasty and additional stenting with good results. However, no hemodynamic parameter determining the need for treatment has been defined. This article describes the preliminary results of a study investigating the pressure changes occurring in post-thrombotic deep venous obstruction. Methodology Four patients with post-thrombotic deep venous obstruction of the iliofemoral tract were identified. Intravenous pressure was pre-operatively measured in the common femoral vein and in a dorsal foot vein bilaterally. During these pressure measurements patients were asked to walk on a treadmill with a speed of 3.2 km/h and a zero per cent slope, with the slope increasing two per cent every two minutes. Results Four patients (two male, two female) with age varying from 23 to 40 were identified. In two patients, disease extended below the femoral confluence. Pressure in the dorsal foot vein was not notably different between the affected and the control side. Pressure in the common femoral vein was markedly higher in post-thrombotic limbs compared to the control limb, with ambulatory pressure increasing more in post-thrombotic limbs. Conclusions These preliminary results are highly illustrative for the hemodynamic effect of iliofemoral deep venous obstruction due to post-thrombotic disease, even though sample size is admittedly limited. Furthermore, these results suggest that pressure measurements of the common femoral vein, and not the dorsal foot vein, might be able to identify a significant outflow obstruction due to post-thrombotic disease, though further inclusion of patients is necessary.
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Affiliation(s)
- RLM Kurstjens
- Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- CARIM, School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - MAF de Wolf
- Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- CARIM, School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - R de Graaf
- Department of radiology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of vascular surgery, University Hospital Aachen, Aachen, Germany
| | - CHA Wittens
- Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- CARIM, School for Cardiovascular Diseases, Maastricht, The Netherlands
- Department of vascular surgery, University Hospital Aachen, Aachen, Germany
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Ten Have M, de Graaf R, van Weeghel J, van Dorsselaer S. The association between common mental disorders and violence: to what extent is it influenced by prior victimization, negative life events and low levels of social support? Psychol Med 2014; 44:1485-1498. [PMID: 24001369 DOI: 10.1017/s0033291713002262] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Few studies have been published on the association between mental disorders and violence based on general population studies. Here we focus on different types of violence, adjusting for violent victimization and taking account of the limitations of previous population studies. METHOD Data were used from the first two waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 18-64 years (n = 6646). Violence was differentiated into physical and psychological violence against intimate partner(s), children or any person(s) in general. DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0). RESULTS Psychological violence occurs considerably more frequently than physical violence, but both showed almost identical associations with mental disorders. After adjustment for sociodemographic characteristics, most of the main categories of common mental disorders were associated with violence. The strongest associations were found for externalizing disorders (substance use, impulse-control, antisocial personality disorder). After additional adjustment for violent victimization, negative life events and social support, most diagnostic correlates lost their significance whereas substance use (in particular alcohol) disorders were still associated with most types of violence. CONCLUSIONS The increased risk of violent offending among people with common mental disorders, other than substance use disorders, can be attributed to factors other than their mental illness.
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Affiliation(s)
- M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | | | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G, Bromet E, Bruffaerts R, de Girolamo G, de Graaf R, Florescu S, Gureje O, Hinkov HR, Hu C, Huang Y, Hwang I, Jin R, Karam EG, Kovess-Masfety V, Levinson D, Matschinger H, O'Neill S, Posada-Villa J, Sagar R, Sampson NA, Sasu C, Stein DJ, Takeshima T, Viana MC, Xavier M, Kessler RC. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med 2014; 44:1303-1317. [PMID: 23931656 DOI: 10.1017/s003329171300194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. METHOD Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity. RESULTS Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). CONCLUSIONS Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.
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Affiliation(s)
- L H Andrade
- Section of Psychiatric Epidemiology-LIM 23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - J Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Z Mneimneh
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon
| | - J E Wells
- Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
| | - A Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - G Borges
- Instituto Nacional de Psiquatria Ramon de la Fuente and Universidad Autonoma Metropolitana, Mexico DF, Mexico
| | - E Bromet
- Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - R Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - G de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - R de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - H R Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - C Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, P. R. China
| | - Y Huang
- Institute of Mental Health, Peking University, Beijing, P. R. China
| | - I Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R Jin
- Harvard Pilgrim Health Care, Boston, MA, USA
| | - E G Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon
| | - V Kovess-Masfety
- EA 4069 Université Paris Descartes and Department of Epidemiology, EHESP School for Public Health, Paris, France
| | - D Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - H Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Germany
| | - S O'Neill
- Psychology Research Institute, University of Ulster, Londonderry, UK
| | - J Posada-Villa
- Pontificia Universidad Javeriana, Instituto Colombiano del Sistema Nervioso, Bogota, Colombia
| | - R Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - N A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - C Sasu
- Scoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar (SNSPMPDSB), Bucharest, Romania
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Cape Town, South Africa
| | - T Takeshima
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - M C Viana
- Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - M Xavier
- Mental Health Department, Faculdade Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - R C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G, Bromet E, Bruffaerts R, de Girolamo G, de Graaf R, Florescu S, Gureje O, Hinkov HR, Hu C, Huang Y, Hwang I, Jin R, Karam EG, Kovess-Masfety V, Levinson D, Matschinger H, O’Neill S, Posada-Villa J, Sagar R, Sampson NA, Sasu C, Stein D, Takeshima T, Viana MC, Xavier M, Kessler RC. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med 2014; 44:1303-1317. [PMID: 23931656 PMCID: PMC4100460 DOI: 10.1017/s0033291713001943] [Citation(s) in RCA: 603] [Impact Index Per Article: 60.3] [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: 12/18/2022]
Abstract
BACKGROUND To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. METHOD Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity. RESULTS Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). CONCLUSIONS Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.
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Affiliation(s)
- L. H. Andrade
- Section of Psychiatric Epidemiology-LIM 23, Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - J. Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Z. Mneimneh
- Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Survey Methodology Program, Institute for Social Research, University of Michigan, USA
| | - J. E. Wells
- Department of Public Health and General Practice, University of Otago, Christchurch. Christchurch, New Zealand
| | - A. Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - G. Borges
- Instituto Nacional de Psiquatria Ramon de la Fuente & Universidad Autonoma Metropolitana, Mexico DF, Mexico
| | - E. Bromet
- State University of New York at Stony Brook Department of Psychiatry, Stony Brook, NY
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum –Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - G. de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - R. de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S. Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - H. R. Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, People’s Republic of China
| | - Y. Huang
- Institute of Mental Health, Peking University, Beijing, P. R. China
| | - I. Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - R. Jin
- Harvard Pilgrim Health Care, Boston, MA
| | - E. G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon
| | - V. Kovess-Masfety
- EA 4069 Université Paris Descartes & EHESP School for Public Health, Department of Epidemiology, Paris, France
| | - D. Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - H. Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Germany
| | - S. O’Neill
- Psychology Research Institute, University of Ulster, Londonderry, UK
| | - J. Posada-Villa
- Pontificia Universidad Javeriana, Instituto Colombiano del Sistema Nervioso, Bogota, Colombia
| | - R. Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - C. Sasu
- Scoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar (SNSPMPDSB), Bucharest, Romania
| | - D. Stein
- University of Cape Town, Department of Psychiatry and Mental Health, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - T. Takeshima
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - M. Xavier
- Mental Health Department, Faculdade Ciências Médicas - Universidade Nova de Lisboa Lisbon, Portugal
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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McDowell RD, Ryan A, Bunting BP, O'Neill SM, Alonso J, Bruffaerts R, de Graaf R, Florescu S, Vilagut G, de Almeida JMC, de Girolamo G, Haro JM, Hinkov H, Kovess-Masfety V, Matschinger H, Tomov T. Mood and anxiety disorders across the adult lifespan: a European perspective. Psychol Med 2014; 44:707-722. [PMID: 23721650 DOI: 10.1017/s0033291713001116] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The World Mental Health Survey Initiative (WMHSI) has advanced our understanding of mental disorders by providing data suitable for analysis across many countries. However, these data have not yet been fully explored from a cross-national lifespan perspective. In particular, there is a shortage of research on the relationship between mood and anxiety disorders and age across countries. In this study we used multigroup methods to model the distribution of 12-month DSM-IV/CIDI mood and anxiety disorders across the adult lifespan in relation to determinants of mental health in 10 European Union (EU) countries. METHOD Logistic regression was used to model the odds of any mood or any anxiety disorder as a function of age, gender, marital status, urbanicity and employment using a multigroup approach (n = 35500). This allowed for the testing of specific lifespan hypotheses across participating countries. RESULTS No simple geographical pattern exists with which to describe the relationship between 12-month prevalence of mood and anxiety disorders and age. Of the adults sampled, very few aged ≥ 80 years met DSM-IV diagnostic criteria for these disorders. The associations between these disorders and key sociodemographic variables were relatively homogeneous across countries after adjusting for age. CONCLUSIONS Further research is required to confirm that there are indeed stages in the lifespan where the reported prevalence of mental disorders is low, such as among younger adults in the East and older adults in the West. This project illustrates the difficulties in conducting research among different age groups simultaneously.
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Affiliation(s)
- R D McDowell
- Institute of Nursing & Health Research, University of Ulster, Coleraine, N. Ireland
| | - A Ryan
- Institute of Nursing & Health Research, University of Ulster, Coleraine, N. Ireland
| | - B P Bunting
- Psychology Research Institute, University of Ulster, Londonderry, N. Ireland
| | - S M O'Neill
- Psychology Research Institute, University of Ulster, Londonderry, N. Ireland
| | - J Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - R Bruffaerts
- Universitair Psychiatrisch Centrum - KU Leuven (UPC-KUL), KU Leuven, Leuven, Belgium
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - S Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - G Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - J M C de Almeida
- Departamento de Saúde Mental, Faculdade de Ciências Médicas, Portugal
| | - G de Girolamo
- IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Italy
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, CIBER en Salud Mental, Spain
| | - H Hinkov
- National Center for Public Health Protection, Bulgaria
| | | | | | - T Tomov
- Department of Psychiatry, Alexandrovsaka Hospital, Bulgaria
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40
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Kessler R, Shahly V, Hudson J, Supina D, Berglund P, Chiu W, Gruber M, Aguilar-Gaxiola S, Alonso J, Andrade L, Benjet C, Bruffaerts R, de Girolamo G, de Graaf R, Florescu S, Haro J, Murphy S, Posada-Villa J, Scott K, Xavier M. A comparative analysis of role attainment and impairment in binge-eating disorder and bulimia nervosa: results from the WHO World Mental Health Surveys. Epidemiol Psychiatr Sci 2014; 23:27-41. [PMID: 24054053 PMCID: PMC4100465 DOI: 10.1017/s2045796013000516] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 08/28/2013] [Accepted: 08/28/2013] [Indexed: 02/05/2023] Open
Abstract
Background. Cross-national population data from the WHO World Mental Health surveys are used to compare role attainments and role impairments associated with binge-eating disorder (BED) and bulimia nervosa (BN). Methods. Community surveys assessed 23 000 adults across 12 countries for BED, BN and ten other DSM-IV mental disorders using the WHO Composite International Diagnostic Interview. Age-of-onset was assessed retrospectively. Ten physical disorders were assessed using standard conditions checklists. Analyses examined reciprocal time-lagged associations of eating disorders (EDs) with education, associations of early-onset (i.e., prior to completing education) EDs with subsequent adult role attainments and cross-sectional associations of current EDs with days of role impairment. Results. BED and BN predicted significantly increased education (females). Student status predicted increased risk of subsequent BED and BN (females). Early-onset BED predicted reduced odds of current (at time of interview) marriage (females) and reduced odds of current employment (males). Early-onset BN predicted increased odds of current work disability (females and males). Current BED and BN were both associated with significantly increased days of role impairment (females and males). Significant BED and BN effects on adult role attainments and impairments were explained by controls for comorbid disorders. Conclusions. Effects of BED on role attainments and impairments are comparable with those of BN. The most plausible interpretation of the fact that these associations are explained by comorbid disorders is that causal effects of EDs are mediated through secondary disorders. Controlled treatment effectiveness studies are needed to trace out long-term effects of BED-BN on secondary disorders.
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Affiliation(s)
- R.C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - V. Shahly
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - J.I. Hudson
- Psychiatric Epidemiology Research Program, McLean Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - D. Supina
- Health Economics, Outcomes Research and Epidemiology, Shire Pharmaceuticals, Wayne, Pennsylvania
| | - P.A. Berglund
- University of Michigan, Institute for Social Research, Ann Arbor, Michigan, USA
| | - W.T. Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - M. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - S. Aguilar-Gaxiola
- University of California, Davis, Center for Reducing Health Disparities, School of Medicine, CTSC Building, Sacramento, California, USA
| | - J. Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L.H. Andrade
- Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - C. Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), campus Gasthuisberg, Leuven, Belgium
| | - G. de Girolamo
- IRCCS Centro S. Giovanni di Dio Fatebenefratelli Brescia, Bologna, Italy
| | - R. de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S.E. Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - J.M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - S.D. Murphy
- School of Psychology, University of Ulster, Londonderry, Northern Ireland
| | | | - K. Scott
- Department of Psychological Medicine, Otago University, Dunedin, New Zealand
| | - M. Xavier
- Department of Mental Health – CEDOC and Faculdade Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal
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de Wolf MAF, de Graaf R, Kurstjens R, Penninx S, Arnoldussen CWKP, Jalaie H, Wittens CHA. Short-Term Clinical Experience with a Dedicated Venous Stent. J Vasc Surg Venous Lymphat Disord 2014; 2:116. [PMID: 26993016 DOI: 10.1016/j.jvsv.2013.10.038] [Citation(s) in RCA: 2] [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: 11/27/2022]
Affiliation(s)
- M A F de Wolf
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - R de Graaf
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - R Kurstjens
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - S Penninx
- Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - H Jalaie
- Universitats Klinikum Aachen, Aachen, Germany
| | - C H A Wittens
- Maastricht University Medical Center, Maastricht, The Netherlands; Universitats Klinikum Aachen, Aachen, Germany
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Gevonden MJ, Selten JP, Myin-Germeys I, de Graaf R, ten Have M, van Dorsselaer S, van Os J, Veling W. Sexual minority status and psychotic symptoms: findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS). Psychol Med 2014; 44:421-433. [PMID: 23710972 DOI: 10.1017/s0033291713000718] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased risk for psychotic symptoms and to explore mediating pathways. METHOD A cross-sectional survey was performed assessing cumulative incidence of psychotic symptoms with the Composite International Diagnostic Interview in two separate random general population samples (NEMESIS-1 and NEMESIS-2). Participants were sexually active and aged 18-64 years (n = 5927, n = 5308). Being lesbian, gay or bisexual (LGB) was defined as having sexual relations with at least one same-sex partner during the past year. Lifetime experience of any psychotic symptom was analysed using logistic regression, adjusted for gender, educational level, urbanicity, foreign-born parents, living without a partner, cannabis use and other drug use. RESULTS The rate of any psychotic symptom was elevated in the LGB population as compared with the heterosexual population both in NEMESIS-1 [odds ratio (OR) 2.56, 95% confidence interval (CI) 1.71-3.84] and NEMESIS-2 (OR 2.30, 95% CI 1.42-3.71). Childhood trauma, bullying and experience of discrimination partly mediated the association. CONCLUSIONS The finding that LGB orientation is associated with psychotic symptoms adds to the growing body of literature linking minority status with psychosis and other mental health problems, and suggests that exposure to minority stress represents an important mechanism.
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Affiliation(s)
- M J Gevonden
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
| | - J P Selten
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
| | - I Myin-Germeys
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - J van Os
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
| | - W Veling
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
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43
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Tuithof M, Ten Have M, van Dorsselaer S, de Graaf R. [Prevalence, persistency and consequences of ADHD in the Dutch adult population]. Tijdschr Psychiatr 2014; 56:10-19. [PMID: 24446222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Little is known about the prevalence and the consequences of attention-deficit hyperactivity disorder (ADHD) among adults in the general Dutch population. AIM To ascertain the prevalence of ADHD in childhood and adulthood, to investigate characteristics associated with the prevalence and persistency of ADHD and to draw a number of comparisons: to compare the functioning of adults with ADHD with that of people with a different mental disorder and to compare the extent to which these groups make use of treatment facilities. METHOD Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), in which the occurrence of ADHD was determined in a representative sample of the Dutch population (n = 3,309; aged 18-44). RESULTS 2.9% of the respondents had had ADHD in childhood, 70.0% of them still had the disorder in adulthood. An anxiety disorder before the age of 16 increased the risk of ADHD persistency, whereas an impulse-control disorder decreased this risk. ADHD in adulthood was associated with lower socio-economic status, mental disorders, poor functioning and increased use of treatment facilities. ADHD adults and adults with an anxiety or substance use disorder showed very similar functional limitations and used treatment facilities to approximately the same extent. CONCLUSION More than two-thirds of the adults who had had childhood ADHD still had the disorder in adulthood. The consequences of this in terms of functioning and use of treatment facilities are substantial.
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Arnoldussen C, Kurstjens R, de Wolf M, de Graaf R, Das M, Wittens C. Assessment of Postoperative and Postintervention Remodeling with Dynamic CT Venography After Treatment of Chronic Venous Obstructions: Important Observations. J Vasc Surg Venous Lymphat Disord 2014; 2:106-7. [DOI: 10.1016/j.jvsv.2013.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tijssen MPM, Hofman PAM, Stadler AAR, van Zwam W, de Graaf R, van Oostenbrugge RJ, Klotz E, Wildberger JE, Postma AA. The role of dual energy CT in differentiating between brain haemorrhage and contrast medium after mechanical revascularisation in acute ischaemic stroke. Eur Radiol 2013; 24:834-40. [PMID: 24258277 DOI: 10.1007/s00330-013-3073-x] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 10/19/2013] [Accepted: 11/01/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess the feasibility of dual energy computed tomography (DE-CT) in intra-arterially treated acute ischaemic stroke patients to discriminate between contrast extravasation and intracerebral haemorrhage. METHODS Thirty consecutive acute ischaemic stroke patients following intra-arterial treatment were examined with DE-CT. Simultaneous imaging at 80 kV and 140 kV was employed with calculation of mixed images. Virtual unenhanced non-contrast (VNC) images and iodine overlay maps (IOM) were calculated using a dedicated brain haemorrhage algorithm. Mixed images alone, as "conventional CT", and DE-CT interpretations were evaluated and compared with follow-up CT. RESULTS Eight patients were excluded owing to a lack of follow-up or loss of data. Mixed images showed intracerebral hyperdense areas in 19/22 patients. Both haemorrhage and residual contrast material were present in 1/22. IOM suggested contrast extravasation in 18/22 patients; in 16/18 patients this was confirmed at follow-up. The positive predictive value (PPV) of mixed imaging alone was 25 %, with a negative predictive value (NPV) of 91 % and accuracy of 63 %. The PPV for detection of haemorrhage with DE-CT was 100 %, with an NPV of 89 % and accuracy improved to 89 %. CONCLUSIONS Dual energy computed tomography improves accuracy and diagnostic confidence in early differentiation between intracranial haemorrhage and contrast medium extravasation in acute stroke patients following intra-arterial revascularisation. KEY POINTS • Contrast material and haemorrhage have similar density on conventional 120-kV CT. • Contrast material hinders interpretation of CT in stroke patients after recanalisation. • Iodine and haemorrhage have different attenuation at lower kVs. • Dual energy CT improves accuracy in early differentiation of haemorrhage and contrast extravasation. • Early differentiation between iodine and haemorrhage helps to initiate therapy promptly.
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Affiliation(s)
- M P M Tijssen
- Department of Radiology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
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Ahmedani BK, Kubiak SP, Kessler RC, de Graaf R, Alonso J, Bruffaerts R, Zarkov Z, Viana MC, Huang YQ, Hu C, Posada-Villa JA, Lepine JP, Angermeyer MC, de Girolamo G, Karam AN, Medina-Mora ME, Gureje O, Ferry F, Sagar R, Anthony JC. Embarrassment when illness strikes a close relative: a World Mental Health Survey Consortium Multi-Site Study. Psychol Med 2013; 43:2191-2202. [PMID: 23298443 PMCID: PMC4013530 DOI: 10.1017/s003329171200298x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 11/06/2022]
Abstract
BACKGROUND In this global study we sought to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) versus a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual but have not assessed family embarrassment in a large-scale study. METHOD In 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, a GMC, or both conditions. RESULTS There was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed compared to subgroups with a relative affected by a GMC (p<0.001), even with covariate adjustments for age and sex. CONCLUSIONS . The pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as possible obstacles to effective early intervention and treatment for an ADMC. Macro-level interventions are under way but micro-level interventions may also be required among family members, along with care for each person with an ADMC.
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Affiliation(s)
- B K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI 48202, USA.
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Ten Have M, Nuyen J, Beekman A, de Graaf R. Common mental disorder severity and its association with treatment contact and treatment intensity for mental health problems. Psychol Med 2013; 43:2203-2213. [PMID: 23388154 DOI: 10.1017/s0033291713000135] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Detailed population-based survey information on the relationship between the severity of common mental disorders (CMDs) and treatment for mental health problems is heavily based on North American research. The aim of this study was to replicate and expand existing knowledge by studying CMD severity and its association with treatment contact and treatment intensity in The Netherlands. METHOD Data were obtained from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 18–64 years (n=6646, response rate=65.1%). DSM-IV diagnoses and disorder severity were assessed with the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0). Treatment contact refers to at least one contact for mental health problems made in the general medical care (GMC) or mental health care (MHC) sector. Four levels of treatment intensity were assessed, based on type and duration of therapy received. RESULTS Although CMD severity was related to treatment contact, only 39.0% of severe cases received MHC. At the same time, 40.3% of MHC users did not have a 12-month disorder. Increasing levels of treatment intensity ranged from 51.6% to 13.0% in GMC and from 81.4% to 51.1% in MHC. CMD severity was related to treatment intensity in MHC but not in GMC. Sociodemographic characteristics were not significantly related to having experienced the highest level of treatment intensity in MHC. CONCLUSIONS. Mental health treatment in the GMC sector should be improved, especially when policy is aimed at increasing the role of primary care in the management of mental health problems.
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Affiliation(s)
- M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
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Arnoldussen CWKP, de Graaf R, Wittens CHA, de Haan MW. Value of magnetic resonance venography and computed tomographic venography in lower extremity chronic venous disease. Phlebology 2013; 28 Suppl 1:169-75. [PMID: 23482555 DOI: 10.1177/0268355513477785] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
For the treatment of chronic venous disease (CVD) of the lower extremity, identification of the underlying venous pathologies is essential. Traditionally, the pathologies to detect with imaging have been centred on insufficiency and reflux of the superficial, perforator and deep veins of the leg. More recently, stenosis and obstruction of the deep veins of the pelvis and abdomen (i.e. inferior vena cava, common and external iliac veins) have been identified as significant underlying pathologies in CVD. Accurate detection of stenotic and/or occlusive venous disease expands the treatment options for patients with CVD. In most cases, imaging of venous disease is performed with duplex ultrasound. In this article we discuss the existing evidence and potential value of computed tomographic venography and magnetic resonance venography to contribute in accurately identifying chronic venous disease, in particular chronic venous obstruction.
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Affiliation(s)
- C W K P Arnoldussen
- Department of Radiology and Interventional Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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de Graaf R, Tijhuis A, Janssen T, Damen E, van Vliet-Vroegindeweij C. EP-1227: Increasing the dose inhomogeneity in the prostate PTV reduces dose delivered to the adjacent OARs. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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de Wolf M, Grommes J, Arnoldussen C, de Haan M, de Graaf R, Wittens C. Surgical Desobstruction of the Common Femoral Vein in Deep Venous Occlusive Disease. J Vasc Surg Venous Lymphat Disord 2013; 1:115. [DOI: 10.1016/j.jvsv.2012.10.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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