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Bruzeguini MV, Corassa RB, Wang YP, Andrade LH, Sarti TD, Viana MC. The performance of K6 as a screening tool for mood disorders: A population-based study of the São Paulo metropolitan area. Early Interv Psychiatry 2024; 18:320-328. [PMID: 37655542 DOI: 10.1111/eip.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
AIM The use of screening instruments allows the detection of psychological and behavioural manifestations there are often not identified in users of health services. We evaluated the performance of the Kessler Psychological Distress Scale (K6) in identifying mood disorders (MD), using the Composite International Diagnostic Interview (CIDI) as gold-standard, in a population-based sample (n = 5037) of adult residents of metropolitan São Paulo. METHODS Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated to assess the performance of K6 in detecting 30-day CIDI MD. All cut-points for each disorder were analysed using the Youden index and the area under the receiver operating characteristic curve (AUC), and the best cut-points were identified. Cronbach's alpha was calculated to assess internal consistency. RESULTS In total, 5.5% respondents screened positive for any MD (95% IC 4.84-6.14). A good detection performance was observed for all MD, with AUC values for any MD of 0.91 (95% IC 0.89-0.92), ranging from 0.80 (95% CI 0.71-0.98) for minor depression to 0.93 (95% CI 0.87-0.98) for bipolar I disorder. Best cut-points for each MD were identified, with overall sensitivity and specificity of 88.8% and 80.2%, respectively. Cronbach's alpha was 0.83. CONCLUSIONS K6 is a good screening tool for MD in the Brazilian population. It is a brief and easy to use instrument that can promote the early identification and treatment of MD, reducing the burden of mental illness.
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Affiliation(s)
| | - Rafael Bello Corassa
- Postgraduate Program in Tropical Medicine and Public Health, Federal University of Goias, Goiania, Brazil
| | - Yuan-Pang Wang
- Núcleo de Epidemiologia Psiquiátrica, Departamento e Instituto de Psiquiatria, Hospital das Clinicas da faculdade de Medicina da Universidade de São Paulo - LIM 23, São Paulo, Brazil
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica, Departamento e Instituto de Psiquiatria, Hospital das Clinicas da faculdade de Medicina da Universidade de São Paulo - LIM 23, São Paulo, Brazil
| | - Thiago Dias Sarti
- Department of Social Medicine, Postgraduate Program in Collective Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Collective Health, Federal University of Espírito Santo, Vitória, Brazil
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Juan MA, Rosenfarb IF. Psychosocial Stress, Social Support, and the Escalation of Schizotypal Symptoms. J Nerv Ment Dis 2022; 210:61-67. [PMID: 34506351 DOI: 10.1097/nmd.0000000000001416] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Although research suggests that psychosocial stress is associated with an increase in schizotypal symptoms, the type of stressor associated with increased symptomatology is unclear, and no study has examined whether social support might mitigate the effects of stress on symptom change. In this study, 131 young adults completed measures of schizotypal symptoms, major life events, daily hassles, and perceptions of social support at baseline, and measures of stress and symptoms again 4 to 6 weeks later. Results indicated, after controlling for baseline measures, that for those scoring low on schizotypal measures at baseline, only low levels of social support were associated with increased symptoms. For those scoring high on the schizotypal scales at baseline, however, both major life events and daily hassles were associated with increased symptomatology, but only when perceptions of social support at baseline were low. The results suggest that it is important to assess both perceptions of social support and baseline symptomatology when examining whether major life events and daily stress are associated with increased psychotic symptoms. Both types of psychosocial stress are associated with an increase in symptoms, but only for those who are already showing above average symptoms and only when social support is low.
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Affiliation(s)
- Michael A Juan
- California School of Professional Psychology, Alliant International University, San Diego
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Abstract
ABSTRACT The most widely used measure to quantify dissociative symptoms is the Dissociative Experiences Scale (DES). However, little information is available concerning its temporal stability. The purpose of this study was to assess the stability of DES scores after 4 years. A total of 316 respondents recruited from a general population in Brazil took part in baseline and follow-up (70.57% were men; mean age = 32.97, SD = 10.95, minimum = 22, maximum = 74). Temporal stability was assessed through test-retest correlations and mean-level stability analyses. We found that the DES total and subscale scores revealed moderate test-retest correlations, with small variations among the DES factors. No significant difference (p > 0.05) was found between average scores for times 1 and 2. Overall, DES scores are significantly stable over time. Future studies would benefit from an investigation of the correlates and predictors of dissociation at different time points.
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Gildner TE, Uwizeye G, Milner RL, Alston GC, Thayer ZM. Associations between postpartum depression and assistance with household tasks and childcare during the COVID-19 pandemic: evidence from American mothers. BMC Pregnancy Childbirth 2021; 21:828. [PMID: 34903201 PMCID: PMC8666834 DOI: 10.1186/s12884-021-04300-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores. METHODS This study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 - November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey. RESULTS Participants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05). CONCLUSIONS The maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic.
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Affiliation(s)
- Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, USA.
| | - Glorieuse Uwizeye
- Department of Anthropology, Dartmouth College, Hanover, NH, USA
- Society of Fellows, Dartmouth College, Hanover, NH, USA
| | | | - Grace C Alston
- Department of Anthropology, Dartmouth College, Hanover, NH, USA
| | - Zaneta M Thayer
- Department of Anthropology, Dartmouth College, Hanover, NH, USA
- Ecology, Evolution, Environment & Society Program, Dartmouth College, Hanover, NH, USA
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Negeri ZF, Levis B, Sun Y, He C, Krishnan A, Wu Y, Bhandari PM, Neupane D, Brehaut E, Benedetti A, Thombs BD. Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis. BMJ 2021; 375:n2183. [PMID: 34610915 PMCID: PMC8491108 DOI: 10.1136/bmj.n2183] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression overall and by study or participant subgroups. DESIGN Systematic review and individual participant data meta-analysis. DATA SOURCES Medline, Medline In-Process, and Other Non-Indexed Citations via Ovid, PsycINFO, Web of Science searched through 9 May 2018. REVIEW METHODS Eligible studies administered the PHQ-9 and classified current major depression status using a validated semistructured diagnostic interview (designed for clinician administration), fully structured interview (designed for lay administration), or the Mini International Neuropsychiatric Interview (MINI; a brief interview designed for lay administration). A bivariate random effects meta-analytic model was used to obtain point and interval estimates of pooled PHQ-9 sensitivity and specificity at cut-off values 5-15, separately, among studies that used semistructured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual), fully structured interviews (eg, Composite International Diagnostic Interview), and the MINI. Meta-regression was used to investigate whether PHQ-9 accuracy correlated with reference standard categories and participant characteristics. RESULTS Data from 44 503 total participants (27 146 additional from the update) were obtained from 100 of 127 eligible studies (42 additional studies; 79% eligible studies; 86% eligible participants). Among studies with a semistructured interview reference standard, pooled PHQ-9 sensitivity and specificity (95% confidence interval) at the standard cut-off value of ≥10, which maximised combined sensitivity and specificity, were 0.85 (0.79 to 0.89) and 0.85 (0.82 to 0.87), respectively. Specificity was similar across reference standards, but sensitivity in studies with semistructured interviews was 7-24% (median 21%) higher than with fully structured reference standards and 2-14% (median 11%) higher than with the MINI across cut-off values. Across reference standards and cut-off values, specificity was 0-10% (median 3%) higher for men and 0-12 (median 5%) higher for people aged 60 or older. CONCLUSIONS Researchers and clinicians could use results to determine outcomes, such as total number of positive screens and false positive screens, at different PHQ-9 cut-off values for different clinical settings using the knowledge translation tool at www.depressionscreening100.com/phq. STUDY REGISTRATION PROSPERO CRD42014010673.
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Affiliation(s)
- Zelalem F Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, WC, Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, UK
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, WC, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, WC, Canada
| | - Eliana Brehaut
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, WC, Canada
- Department of Medicine, McGill University, Montréal, QC, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, WC, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Medicine, McGill University, Montréal, QC, Canada
- Department of Psychology, McGill University, Montréal, QC, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montréal, QC, Canada
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Orlas CP, Herrera-Escobar JP, Hau KM, Velmahos A, Patel N, Sanchez S, Kaafarani HMA, Salim A, Nehra D. Perceived social support is strongly associated with recovery after injury. J Trauma Acute Care Surg 2021; 91:552-558. [PMID: 34108418 DOI: 10.1097/ta.0000000000003230] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The strength of one's social support network is a potentially modifiable factor that may have a significant impact on recovery after injury. We sought to assess the association between one's perceived social support (PSS) and physical and mental health outcomes 6 months to 12 months postinjury. METHODS Moderate to severely injured patients admitted to one of three Level I trauma centers were asked to complete a phone-based survey assessing physical and mental health outcomes in addition to return to work and chronic pain 6 months to 12 months postinjury. Patients were also asked to rate the strength of their PSS on a 5-point Likert scale. Multivariate linear and logistic regression models were built to determine the association between PSS and postdischarge outcome metrics. RESULTS Of 907 patients included in this study, 653 (72.0%) identified themselves as having very strong/strong, 182 (20.1%) as average, and 72 (7.9%) as weak/nonexistent PSS. Patients who reported a weak/nonexistent PSS were younger and were more likely to be male, Black, and to have a lower level of education than those who reported a very strong/strong PSS. After adjusting for potential confounders, patients with a weak/nonexistent PSS were more likely to have new functional limitations and chronic pain in addition to being less likely to be back at work/school and being more likely to screen positive for symptoms of posttraumatic stress disorder, depression and anxiety at 6 months to 12 months postinjury than those with a strong/very strong PSS. CONCLUSION Lower PSS is strongly correlated with worse functional and mental health outcome metrics postdischarge. The strength of one's social support network should be considered when trying to identify patients who are at greatest risk for poor postdischarge outcomes after injury. Our data also lend support to creating a system wherein we strive to build a stronger support network for these high-risk individuals. LEVEL OF EVIDENCE Prognostic/epidemiologic, level III.
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Affiliation(s)
- Claudia P Orlas
- From the Center for Surgery and Public Health (C.P.O., J.P.H.-E., K.M.H.), Division of Trauma, Burn, and Surgical Critical Care (J.P.H.-E., N.P., A.S.), Brigham and Women's Hospital, Harvard Medical School; Division of Trauma, Emergency Surgery, and Surgical Critical Care (A.V., H.M.K.), Massachusetts General Hospital, Harvard Medical School; Division of Trauma, Acute Care Surgery & Surgical Critical Care (S.S.), Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; and Division of Trauma, Burn & Critical Care Surgery (D.N.), Harborview Medical Center, University of Washington, Seattle, Washington
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Abstract
BACKGROUND The frequencies of South Korean soldiers' depression and resulting suicide are increasing every year. Thus, this study aimed to develop and confirm the reliability and validity of a simple short form depression screening scale for soldiers. METHODS This study was conducted as part of a 2013 research project named 'The Epidemiological Study on the Prevalence of Depression in Military Service and a Search for High Risk Group Management.' Clinical depression was diagnosed using the Korean version of the Mini International Neuropsychiatric Interview and suicide risk was assessed through the Korean version of the Composite International Diagnostic Interview. Furthermore, the Center for Epidemiological Studies for Depression Scale (CES-D), the Stress Response Inventory, and the Barret Impulsiveness Scale were employed. Of the 20 CES-D items, three of the most correlated items with clinical diagnosis were derived to form the short form scale. Analyses for internal consistency, concurrent validity, and factor analysis were implemented for its validation. We performed a receiver operating curve (ROC) analysis using a clinical diagnosis of depression as a gold standard to calculate the area under the curve (AUC) value, cut-off score, and corresponding sensitivity and specificity to that cut-off score. RESULTS According to the results of the correlation analysis, 7, 18, and 4 were selected to be on our scale. The three-item scale was reliable with a Cronbach's alpha value of 0.720, and a factor was derived from the factor analysis. The ROC analysis showed a high discriminant validity, with an AUC value of 0.891. The sensitivity and specificity were 84.8% and 78.2%, and 71.7% and 91.6%, respectively, for each when the selected cut-off scores were 2 and 3, respectively. Depression screened through the scale when the cut-off score was 2 or 3 was significantly associated with suicidality, stress, and social support. CONCLUSION The depression screening questionnaire for Korean soldiers developed through this study demonstrated high reliability and validity. Since it comprises only three items, it can be utilized easily and frequently. It is expected to be employed in a large-scale suicide prevention project targeting military soldiers in the future; it will be beneficial in selecting high-risk groups for depression.
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Affiliation(s)
- Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea
| | - Sun Jin Jo
- Department of Prevention Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Woo Lee
- Department of Psychiatry, Seoul Medical Center, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Prevention Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Ik Park
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea.
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Abstract
Questionnaires are widely used in autism assessment. However, their psychometric properties are generally not evaluated in clinical practice, and the comparability and applicability of such research is limited because questionnaires are often not simultaneously evaluated. This certainly pertains to predictive values which are highly population and setting specific. This study evaluated the power of AQ and SRS-A in predicting an ASD diagnosis within the same clinical population. The patient records of 92 adults, referred for autism assessment, were analyzed. The AQ proved somewhat better than the SRS-A at discriminating and predicting autism. The predictive values of both questionnaires were lower than reported in general population studies. Psychometric results in core publications appear less representative for clinical practice.
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Affiliation(s)
- M L Bezemer
- INTER-PSY, Verlengde Meeuwerderweg 7, 9723 ZM, Groningen, The Netherlands
| | - E M A Blijd-Hoogewys
- INTER-PSY, Verlengde Meeuwerderweg 7, 9723 ZM, Groningen, The Netherlands.
- Department of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - M Meek-Heekelaar
- INTER-PSY, Verlengde Meeuwerderweg 7, 9723 ZM, Groningen, The Netherlands
- Private Practice PP-Noord and Psychology Academy Groningen, Vechtstraat 62, 9725 CW, Groningen, The Netherlands
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Jayawardena R, Sooriyaarachchi P, Kagawa M, Hills AP, King NA. Methods to develop figure rating scales (FRS): A systematic review. Diabetes Metab Syndr 2021; 15:687-693. [PMID: 33813243 DOI: 10.1016/j.dsx.2021.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS Figure Rating Scales (FRS) are psychometric instruments developed to measure individual's perception of physical appearance and subsequently, to determine the level of body dissatisfaction. The following systematic review summarizes existing FRSs and the techniques used to development them. METHODS A systematic search was conducted in the following databases; PubMed®, Web of Science®, Scopus® using key words "figure rating scale" AND "Stunkard". RESULTS From 466 potentially relevant articles, 24 publications were included, 22 publications reporting original FRSs with the other two scales being modifications of the original for children and babies. Fifteen were figural drawings or silhouettes and nine were developed by photographic techniques, video methods or using computer software. Most of the figural scales were applicable for adults and consisted of nine images. Ten of the 15 figural scales were without facial features and four scales had minimal facial features. Technological advancements including 3D modeling have played a pivotal role in the development of FRSs. CONCLUSIONS FRSs have been developed by a mix of traditional and modern techniques. The development and validation of ethnic specific FRSs using modern technology should be the priority for future studies.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka; Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia.
| | - Piumika Sooriyaarachchi
- Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia; Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka
| | - Masaharu Kagawa
- Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia; Institute of Nutrition Sciences, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado, Saitama, 350-0288, Japan
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham Drive, Newnham TAS, 7248, Australia
| | - Neil A King
- Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia
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Nasser A, Kosheleff AR, Hull JT, Liranso T, Qin P, Busse GD, O'Neal W, Fava M, Faraone SV, Rubin J. Translating Attention-Deficit/Hyperactivity Disorder Rating Scale-5 and Weiss Functional Impairment Rating Scale-Parent Effectiveness Scores into Clinical Global Impressions Clinical Significance Levels in Four Randomized Clinical Trials of SPN-812 (Viloxazine Extended-Release) in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2021; 31:214-226. [PMID: 33600233 PMCID: PMC8066343 DOI: 10.1089/cap.2020.0148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Indexed: 01/23/2023]
Abstract
Objectives: Clinical trials in psychiatry frequently report results from lengthy, comprehensive assessments to characterize a subject emotionally, cognitively, and behaviorally before and after treatment. However, the potential treatment implications of these results and how they translate into clinical practice remain unclear. Conversely, the Clinical Global Impressions (CGI) scales are quick, intuitive assessments used to assess the functional impact of a treatment in clinically relevant terms. The objectives of the present analyses are to translate scores from comprehensive assessments of symptom severity and functional impairment into clinically meaningful CGI levels. Methods: These post-hoc analyses use data integrated from four pivotal Phase 3 trials in attention-deficit/hyperactivity disorder (ADHD) in children and adolescents treated with the novel nonstimulant SPN-812 (Viloxazine Extended-Release). In this study, we evaluated the ADHD Rating Scale-5 (ADHD-RS-5) and Weiss Functional Impairment Rating Scale-Parent (WFIRS-P), assessments of symptom severity and functional impairment, respectively, by linking these scales with the CGI scales at baseline and end of study. Results: For participants that improved, a one-level change on the CGI-Improvement (CGI-I) was associated with a 10-15-point change on the ADHD-RS-5, and a 0.2-0.5-point change on the WFIRS-P. On the CGI-I, ratings of much improved and very much improved were associated with a percent score decrease (i.e., improvement) of ∼55% and 80% on the ADHD-RS-5 and ∼40% and 70% on the WFIRS-P, respectively. Differences between children and adolescents were minor and are unlikely to be clinically meaningful. Conclusion: These post-hoc analyses provide clinically meaningful benchmarks for the interpretation of scores on the ADHD-RS-5 and WFIRS-P in terms of CGI evaluations in subjects with ADHD. These results may be useful for physicians seeking to understand a treatment's potential impact on their ADHD patients or for researchers looking to define their study results within a clinically relevant context. Data are from clinical trials NCT03247530, NCT03247543, NCT03247517, and NCT03247556.
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Affiliation(s)
- Azmi Nasser
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | | | - Joseph T. Hull
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | | | - Peibing Qin
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | | | - Welton O'Neal
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Jonathan Rubin
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
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Gong P, Ma X, Gao L, Bi J. Simple acupuncture combined with fluoxetine in the treatment of poststroke depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24968. [PMID: 33725863 PMCID: PMC7969235 DOI: 10.1097/md.0000000000024968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Poststroke depression is a common secondary mental disorder after stroke, which increases the recurrence rate and mortality rate after stroke and hinders the recovery of function. As a combination therapy, simple acupuncture combined with fluoxetine has achieved good clinical effect, but there is a lack of evidence-based medicine. The purpose of this study is to evaluate the efficacy and safety of acupuncture combined with fluoxetine in the treatment of poststroke depression by meta-analysis. METHODS Search Chinese and English databases: China national knowledge infrastructure, VP information Chinese Journal Service Platform, Wanfang, the China Biomedical Database, PubMed, Embase, the Cochrane Library, and web of science. A randomized controlled trial of simple acupuncture combined with fluoxetine in the treatment of poststroke depression will be selected. The retrieval time is of the establishment of the database in January 2021. Selected literature is extracted and deleted by 2 researchers, and the quality of the included literature is evaluated. The included literature is analyzed by Meta with RevMan5.3 software. RESULTS In this study, the efficacy and safety of acupuncture combined with fluoxetine in the treatment of post-stroke depression are evaluated by Hamilton Depression scale (HAMD) and its reduction rate, Treatment Emergency Symptom Scale, Self-rating Depression Scale, and Activities of Daily living scale. CONCLUSION This study will provide reliable evidence-based evidence for the clinical application of acupuncture combined with fluoxetine in the treatment of post-stroke depression. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/5J896.
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Álvarez MJ, Masramom H, Foguet-Boreu Q, Tasa-Vinyals E, García-Eslava JS, Roura-Poch P, Escoté-Llobet S, Gonzalez A. Childhhood Trauma in Schizophrenia Spectrum Disorders: Dissociative, Psychotic Symptoms, and Suicide Behavior. J Nerv Ment Dis 2021; 209:40-48. [PMID: 33079796 DOI: 10.1097/nmd.0000000000001253] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Current evidence suggests a high prevalence of childhood trauma (CT) among adult patients diagnosed with schizophrenia spectrum disorders. Exposure to CT might lead to clinical differences eventually observed in these patients. We present a cross-sectional study with 54 patients with schizophrenia spectrum disorder (schizophrenia and schizoaffective disorder). We obtained sociodemographic data, as well as data on CT, dissociation, suicide history, and intensity of positive and negative psychotic symptoms. More than 75% of the patients reported a history of CT. We observed a link between CT and suicidal behavior. Patients showed high rates of dissociation. Dissociative experiences were related to CT, both in terms of intensity of trauma and number of traumas experienced. All CT forms except emotional neglect showed direct correlations with dissociative experiences. We found no correlation between intensity of CT and intensity of positive psychotic symptoms, yet we observed a moderate inverse correlation with negative psychotic symptoms.
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Affiliation(s)
| | | | | | - Elisabet Tasa-Vinyals
- Department of Psychiatry and Mental Health, Osona Salut Mental, Consorci Hospitalari de Vic
| | | | | | - Santiago Escoté-Llobet
- Department of Psychiatry and Mental Health, Osona Salut Mental, Consorci Hospitalari de Vic
| | - Anabel Gonzalez
- Mental Health Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
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Kołtuniuk A, Rosińczuk J. The Levels of Depression, Anxiety, Acceptance of Illness, and Medication Adherence in Patients with Multiple Sclerosis - Descriptive and Correlational Study. Int J Med Sci 2021; 18:216-225. [PMID: 33390790 PMCID: PMC7738975 DOI: 10.7150/ijms.51172] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/07/2020] [Indexed: 11/05/2022] Open
Abstract
Emotional functioning is one of the factors affecting medication adherence in patients with multiple sclerosis (MS). Adherence to treatment is a very important element in the therapy of patients with MS and requires from them cooperation, positive emotional status and acceptance of illness. This study evaluated the role of depression, anxiety, and the acceptance of illness on adherence to disease-modifying therapies (DMT) in MS. A group of 226 MS patients was included. The Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale-Modified Version (HADS-M), the Acceptance of Illness Scale (AIS) and the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) were used. It was shown that 41% of patients reported the symptoms of anxiety, 28% reported the symptoms of depression, and 63% were irritated and aggressive (HADS-M). Over 80% of patients accept their disease to varying degrees. There was a correlation between the results of HADS-M, BDI, and AIS and the domains of MS-TAQ. Analysis of the multiple-regression model showed that only being very satisfied with treatment positively affects adherence to DMT in MS patients. It has to be concluded that anxiety and depression have a significant negative impact on medication adherence in MS patients. However, MS patients with an increased acceptance of their illness have a higher rate of adherence to DMT. The emotional state of a patient is an important factor that can both positively and negatively affect their adherence and their resulting prognosis.
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Affiliation(s)
- Aleksandra Kołtuniuk
- Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
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14
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Aimagambetova G, Issanov A, Terzic S, Bapayeva G, Ukybassova T, Baikoshkarova S, Aldiyarova A, Shauyen F, Terzic M. The effect of psychological distress on IVF outcomes: Reality or speculations? PLoS One 2020; 15:e0242024. [PMID: 33315878 PMCID: PMC7735622 DOI: 10.1371/journal.pone.0242024] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/26/2020] [Indexed: 02/03/2023] Open
Abstract
Introduction Infertility is a problem that affects millions of people worldwide. The aim of this study was to assess the effect of stress, depression and anxiety on the IVF outcomes in Kazakhstan. Methods The prospective cohort study was performed using questionnaires to assess psychological distress in 304 infertile female in three different cities in Kazakhstan. Results The average age of participants was 33.7 years with infertility duration of 5.9 years. Regarding stress, depression and anxiety we found that more than 80% of all respondents had CES-D score higher than 16, indicating that they are at risk of developing clinical depression. On average, FPI subscales’ scores, global stress score and anxiety scale (STAI-S and STAI-T) scores were statistically significantly higher among not pregnant women than pregnant women. Similarly, in simple logistic regression analysis all FPI subscales scores, global stress scale score and anxiety scales’ scores were negatively associated with clinical pregnancy. Conclusion Rates of stress, anxiety and depression among IVF patients are higher than in general population. If the level of infertility-related stress is higher, IVF success rate is lower. Findings of our study indicate the need for the specific psychological interventions for all infertility women, to improve IVF success rate.
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Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- * E-mail:
| | - Alpamys Issanov
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Sanja Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Gauri Bapayeva
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Talshyn Ukybassova
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | | | - Aidana Aldiyarova
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Fariza Shauyen
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Milan Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
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Scott JG, Baker A, Lim CCW, Foley S, Dark F, Gordon A, Ward D, Richardson D, Bruxner G, Beckmann KM, Hatherill S, Stathis S, Dixon K, Ryan AE, McWhinney BC, Ungerer JPJ, Berk M, Dean OM, Saha S, McGrath J. Effect of Sodium Benzoate vs Placebo Among Individuals With Early Psychosis: A Randomized Clinical Trial. JAMA Netw Open 2020; 3:e2024335. [PMID: 33170261 PMCID: PMC7656289 DOI: 10.1001/jamanetworkopen.2020.24335] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
IMPORTANCE There is evidence that sodium benzoate (BZ) may be an effective adjunctive treatment for schizophrenia. The clinical efficacy of BZ has been investigated in chronic schizophrenia; however, the efficacy of this agent has not been studied in individuals with early psychosis. OBJECTIVE To examine the clinical efficacy of the adjunctive use of BZ for symptoms in people with early psychosis. DESIGN, SETTING, AND PARTICIPANTS Using a placebo-controlled double-masked parallel-group design, this randomized clinical trial was conducted from August 2015 to July 2018. Participants aged between 15 and 45 years experiencing early psychosis were enrolled from 5 major clinical sites in Queensland, Australia. Data analysis was conducted from October 2018 to February 2020. INTERVENTIONS Participants were randomized 1:1 (50 participants in each group) to receive 500 mg of sodium benzoate twice daily or placebo for 12 weeks. MAIN OUTCOMES AND MEASURES The primary efficacy outcome was the Positive and Negative Syndrome Scale (PANSS) total score at 12 weeks. The key secondary efficacy measures were (1) the Clinical Global Impression score, (2) the Hamilton Depression Rating Scale for depression, (3) functioning as assessed by the clinician-rated Global Assessment of Function, and (4) the Assessment of Quality of Life Scale. The PANSS subscale scores and impact on selected amino acid concentrations were also assessed. RESULTS The study comprised 100 participants with a mean (SD) age of 21.4 (4.1) years, of whom 73 (73%) were male individuals. The mean (SD) baseline PANSS score was 75.3 (15.4). We found no improvement in total PANSS score in the BZ group compared with the placebo group. The end result of least-squares mean difference (SE) for total PANSS was -1.2 (2.4) (P = .63). There were no differences in any subscales of the PANSS, any secondary measures, nor any amino acid concentrations. The dose of BZ was well tolerated without any clinically significant treatment-emergent adverse event differences between BZ and placebo groups. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, there was no evidence that adjunctive use of 500 mg of BZ twice daily is an effective treatment for individuals with early psychosis. TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12615000187549.
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Affiliation(s)
- James G. Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
- QIMR Berghofer Medical Research Institute, Herston, Australia
- Metro North Mental Health Service, Herston, Australia
| | - Andrea Baker
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
| | - Carmen C. W. Lim
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
- Queensland Brain Institute, University of Queensland, St Lucia, Australia
| | - Sharon Foley
- Emotional Health Unit, Mater Hospital, South Brisbane, Australia
| | | | - Anne Gordon
- Metro North Mental Health, Royal Brisbane and Women’s Hospital, Herston, Australia
| | - David Ward
- Metro North Mental Health, Royal Brisbane and Women’s Hospital, Herston, Australia
| | | | - George Bruxner
- Metro North Mental Health, Caboolture and Redcliffe Hospitals, Caboolture, Australia
| | - K. Martin Beckmann
- School of Medicine, Logan Hospital, Griffith University, Meadowbrook, Australia
- Child and Youth Mental Health Service, Metro South Mental Health, Logan Hospital, Meadowbrook, Australia
| | - Sean Hatherill
- Metro South Addiction and Mental Health Services, Logan Hospital, Meadowbrook, Australia
| | - Stephen Stathis
- Queensland Children’s Hospital, South Brisbane, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Krystal Dixon
- Mental Health and Addiction Services, Sunshine Coast Hospital and Health Service, Birtinya, Australia
- School of Medicine, Sunshine Coast University Hospital, Griffith University, Birtinya, Australia
| | - Alexander E. Ryan
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
- QIMR Berghofer Medical Research Institute, Herston, Australia
- University of Queensland Centre for Clinical Research, Herston, Australia
| | - Brett C. McWhinney
- Department of Chemical Pathology, Pathology Queensland, Royal Brisbane and Women’s Hospital, Herston, Australia
| | - Jacobus P. J. Ungerer
- Department of Chemical Pathology, Pathology Queensland, Brisbane, Australia
- School of Biomedical Sciences, University of Queensland, St Lucia, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Olivia M. Dean
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
- Queensland Brain Institute, University of Queensland, St Lucia, Australia
| | - John McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
- Queensland Brain Institute, University of Queensland, St Lucia, Australia
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
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16
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Peiper NC, Ridenour TA, Fishbein DH. Characterizing psychiatric symptoms and neurocognitive functioning among substance-naïve early adolescents: Associations with sleep problems. Early Interv Psychiatry 2020; 14:439-449. [PMID: 31468719 PMCID: PMC10576860 DOI: 10.1111/eip.12869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Received: 03/18/2019] [Revised: 07/09/2019] [Accepted: 08/06/2019] [Indexed: 11/30/2022]
Abstract
AIM Evidence consistently links psychiatric symptoms, reduced neurocognitive functioning (NCF) and sleep problems to the initiation of a wide range of risk behaviours. Less is known, however, about the associations between sleep problems with psychiatric symptoms and NCF among early adolescents yet to engage in substance use. METHODS The present study examined baseline data from an ongoing prospective study of 529 youth aged 10-12 years who completed a battery of instruments measuring symptom counts for four psychiatric disorders, performance on six tests of NCF and five types of sleep behaviour on week days. We used latent class analysis to classify the 473 substance-naïve youth into subtypes characterized by probabilistic patterns of psychiatric symptoms and poorer NCF. RESULTS Four subtypes emerged: normative (24% of the sample); nonspecific mental health symptoms (27%); lower neurocognitive function (24%) and comorbid psychiatric symptoms and lower neurocognitive function (25%). In a multivariable latent regression model, three or more sleep arousals per night, sleep phase of two or more hours and sleep latency of 20 minutes or more were significantly associated with the two classes having higher symptom counts. Lack of family support was significantly associated with the two classes having lower neurocognitive function and comorbid psychiatric symptoms. CONCLUSIONS The youth subtypes in this study provide an important baseline characterization to subsequently understand how these neuropsychiatric relationships may change when substance use and other risk behaviours develop during adolescence. Implications for preventing and treating sleep problems associated with psychiatric comorbidity and neurocognitive dysfunctions are discussed.
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Affiliation(s)
- Nicholas C. Peiper
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, Kentucky
- Department of Epidemiology and Population, Health, University of Louisville, Louisville, Kentucky
| | - Ty A. Ridenour
- Substance Use Prevention, Evaluation, and Research Program, RTI International, Research Triangle Park, North Carolina
- Center for Education and Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Diana H. Fishbein
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
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Poole L, Hackett RA, Panagi L, Steptoe A. Subjective wellbeing as a determinant of glycated hemoglobin in older adults: longitudinal findings from the English Longitudinal Study of Ageing. Psychol Med 2020; 50:1820-1828. [PMID: 31456532 PMCID: PMC7477365 DOI: 10.1017/s0033291719001879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/19/2019] [Revised: 06/25/2019] [Accepted: 07/08/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous research has shown an association between subjective wellbeing and incident diabetes. Less is known about the role of wellbeing for subclinical disease trajectories as captured via glycated hemoglobin (HbA1c). We aimed to explore the association between subjective wellbeing and future HbA1c levels, and the role of sociodemographic, behavioral and clinical factors in this association. METHODS We used data from the English Longitudinal Study of Ageing for this study (N = 2161). Subjective wellbeing (CASP-19) was measured at wave 2 and HbA1c was measured 8 years later at wave 6. Participants were free from diabetes at baseline. We conducted a series of analyses to examine the extent to which the association was accounted for by a range of sociodemographic, behavioral and clinical factors in linear regression models. RESULTS Models showed that subjective wellbeing (CASP-19 total score) was inversely associated with HbA1c 8 years later after controlling for depressive symptoms, age, sex, and baseline HbA1c (B = -0.035, 95% CI -0.060 to -0.011, p = 0.005). Inclusion of sociodemographic variables and behavioral factors in models accounted for a large proportion (17.0% and 24.5%, respectively) of the relationship between wellbeing and later HbA1c; clinical risk factors explained a smaller proportion of the relationship (3.4%). CONCLUSIONS Poorer subjective wellbeing is associated with greater HbA1c over 8 years of follow-up and this relationship can in part be explained by sociodemographic, behavioral and clinical factors among older adults.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Ruth A. Hackett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Laura Panagi
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
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Abstract
BACKGROUND Major depressive disorder (MDD) represents a leading cause of disability. This study examines the course of disability in patients with chronic, recurrent and remitting MDD compared to healthy controls and identifies predictors of disability in remitting MDD. METHODS We included 914 participants from the Netherlands Study of Depression and Anxiety (NESDA). DSM-IV MDD and WHO DAS II disability were assessed at baseline and at 2, 4 and 6 years. Six-year total and domain-specific disability were analysed and compared in participants with chronic (n = 57), recurrent (n = 120), remitting (n = 127) MDD and in healthy controls (n = 430). Predictors of residual disability were identified using linear regression analysis. RESULTS At baseline, most disability was found in chronic MDD, followed by recurrent MDD, remitting MDD and healthy controls. Across diagnostic groups, most disability was found in household activities, interpersonal functioning, participation in society and cognition. A chronic course was associated with chronic disability. Symptom remission was associated with a decrease in disability, but some disability remained. In remitting MDD, higher residual disability was predicted by older age, more severe avoidance symptoms, higher disability at baseline and late symptom remission. Severity of residual disability correlated with the severity of residual depressive symptoms. CONCLUSIONS Symptomatic remission is a prerequisite for improvements in disability. However, disability persists despite symptom remission. Therefore, treatment of MDD should include an explicit focus on disability, especially on the more complex domains. To this end, treatments should promote behavioural activation and address subthreshold depressive symptoms in patients with remitted MDD.
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Affiliation(s)
- Sorana C Iancu
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
| | - Yak Mee Wong
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Didi Rhebergen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and GGZ inGeest, Amsterdam, The Netherlands
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Frenkel TI, Donzella B, Frenn KA, Rousseau S, Fox NA, Gunnar MR. Moderating the Risk for Attention Deficits in Children with Pre-Adoptive Adversity: The Protective Role of Shorter Duration of out of Home Placement and Children's Enhanced Error Monitoring. J Abnorm Child Psychol 2020; 48:1115-1128. [PMID: 32607754 DOI: 10.1007/s10802-020-00671-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Early institutional-deprivation has been found to increase risk for inattention/hyperactivity (ADHD). Notably, studies suggest that children with a history of adversity evidencing an enhanced ERP (the error-related-negativity; ERN) may be protected against attention problems. However, such protective effects of the ERN have been studied in children whom typically experienced residential instability. It is unknown whether error-monitoring is similarly protective for children with stable post-deprivation placements. The present study examined the protective effect of the ERN in a sample of children who experienced at least 3-years of stable, relatively enriched caregiving after being internationally-adopted as infants/toddlers from institutional-care. We included two groups of children adopted internationally before age three, one group adopted from institutional-care (PI:n = 80) and one comparison group adopted from foster-care (FC;n = 44). A second comparison group consisted of non-adopted children (NA;n = 48) from demographically comparable families. At five-years of age, we assessed child ADHD symptoms (parent-report) and behavioral performance and neural correlates of error-monitoring (Go/No-Go task). PI children displayed lower Go/No-Go accuracy relative to FC children, and higher levels of ADHD symptoms relative to NA controls. In both FC and PI groups, longer duration of pre-adoptive out-of-home placement was associated with inattention, especially for children with deficits in error-monitoring. Enhancing cognitive control in the form of error monitoring might be a useful intervention target to protect children from some of the negative outcomes associated with adverse early care. Furthermore, results underscore that regardless of type of pre-adoptive care, we should aim to place children in stable/permanent homes as early as possible.
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Affiliation(s)
- Tahl I Frenkel
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Ziama Arkin Infancy Institute, Herzliya, Israel
| | - Bonny Donzella
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA
| | - Kristin A Frenn
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA
| | - Sofie Rousseau
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Ziama Arkin Infancy Institute, Herzliya, Israel
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742, USA
| | - Megan R Gunnar
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA.
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Lerthattasilp T, Tapanadechopone P, Butrdeewong P. Validity and Reliability of the Thai Version of the Short Mood and Feelings Questionnaire. East Asian Arch Psychiatry 2020; 30:48-51. [PMID: 32611827 DOI: 10.12809/eaap1875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the validity and reliability of a Thai version of the Short Mood and Feelings Questionnaire (SMFQ). METHODS The present study included 23 children with depressive disorders (diagnosis made by child psychiatrists) and 74 children with no depressive disorders. All children and their parents were asked to complete the Thai versions of the SMFQ, Children's Depression Inventory, and Mood and Feelings Questionnaire. Criterion validity, convergent validity, reliability, and parent-child agreement of the SMFQ were measured. RESULTS With a cut-off score of 9, the child-rated SMFQ yielded a sensitivity of 87.0% and specificity of 86.5%, whereas the parent-rated SMFQ yielded a sensitivity of 82.6% and a specificity of 89.2%. The correlation coefficient between the child-rated and parent-rated versions was 0.75, and the correlation coefficients between the Thai Children's Depression Inventory and the child-rated and parent-rated versions were 0.86 and 0.74, respectively. Respectively for the child-rated and parent-rated versions, the Cronbach's alpha was 0.90 and 0.923, and the intra-class correlation coefficient was 0.61 and 0.75. The Bland-Altman plot showed that 92.9% and 85.7% of the child and parent test-retest answers were within limits of agreement. CONCLUSION The Thai version of SMFQ has a high degree of psychometric validity and reliability.
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Affiliation(s)
- T Lerthattasilp
- Department of Psychiatry, Faculty of Medicine, Thammasat University, Thailand
| | - P Tapanadechopone
- Department of Psychiatry, Faculty of Medicine, Thammasat University, Thailand
| | - P Butrdeewong
- Thammasat University Hospital, Pathumthani, Thailand
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21
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Brailean A, Curtis J, Davis K, Dregan A, Hotopf M. Characteristics, comorbidities, and correlates of atypical depression: evidence from the UK Biobank Mental Health Survey. Psychol Med 2020; 50:1129-1138. [PMID: 31044683 DOI: 10.1017/s0033291719001004] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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] [Indexed: 12/30/2022]
Abstract
BACKGROUND Depression is a heterogeneous disorder with multiple aetiological pathways and multiple therapeutic targets. This study aims to determine whether atypical depression (AD) characterized by reversed neurovegetative symptoms is associated with a more pernicious course and a different sociodemographic, lifestyle, and comorbidity profile than nonatypical depression (nonAD). METHODS Among 157 366 adults who completed the UK Biobank Mental Health Questionnaire (MHQ), N = 37 434 (24%) met the DSM-5 criteria for probable lifetime major depressive disorder (MDD) based on the Composite International Diagnostic Interview Short Form. Participants reporting both hypersomnia and weight gain were classified as AD cases (N = 2305), and the others as nonAD cases (N = 35 129). Logistic regression analyses were conducted to examine differences between AD and nonAD in depression features, sociodemographic and lifestyle factors, lifetime adversities, psychiatric and physical comorbidities. RESULTS Persons with AD experienced an earlier age of depression onset, longer, more severe and recurrent episodes, and higher help-seeking rates than nonAD persons. AD was associated with female gender, unhealthy behaviours (smoking, social isolation, low physical activity), more lifetime deprivation and adversity, higher rates of comorbid psychiatric disorders, obesity, cardiovascular disease (CVD), and metabolic syndrome. Sensitivity analyses comparing AD persons with those having typical neurovegetative symptoms (hyposomnia and weight loss) revealed similar results. CONCLUSIONS These findings highlight the clinical and public health significance of AD as a chronic form of depression, associated with high comorbidity and lifetime adversity. Our findings have implications for predicting depression course and comorbidities, guiding research on aetiological mechanisms, planning service use and informing therapeutic approaches.
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Affiliation(s)
- Anamaria Brailean
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jessica Curtis
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Katrina Davis
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Alexandru Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Heinsch M, Sampson D, Huens V, Handley T, Hanstock T, Harris K, Kay-Lambkin F. Understanding ambivalence in help-seeking for suicidal people with comorbid depression and alcohol misuse. PLoS One 2020; 15:e0231647. [PMID: 32302340 PMCID: PMC7164619 DOI: 10.1371/journal.pone.0231647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 03/29/2020] [Indexed: 11/27/2022] Open
Abstract
Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.
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Affiliation(s)
- Milena Heinsch
- Priority Research Centre for Brain & Mental Health, University of Newcastle, Callaghan, NSW, Australia
- School of Social Work, Faculty of Arts and Humanities, University of Newcastle, Callaghan, NSW, Australia
| | - Dara Sampson
- Priority Research Centre for Brain & Mental Health, University of Newcastle, Callaghan, NSW, Australia
| | - Valerie Huens
- School of Psychology, Faulty of Science, University of Newcastle, Callaghan, NSW, Australia
| | - Tonelle Handley
- Priority Research Centre for Brain & Mental Health, University of Newcastle, Callaghan, NSW, Australia
- Centre for Rural and Remote Mental Health, Orange, NSW, Australia
| | - Tanya Hanstock
- School of Psychology, Faulty of Science, University of Newcastle, Callaghan, NSW, Australia
| | - Keith Harris
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Psychology, University of Queensland, Brisbane St Lucia, QLD, Australia
| | - Frances Kay-Lambkin
- Priority Research Centre for Brain & Mental Health, University of Newcastle, Callaghan, NSW, Australia
- National Drug and Alcohol Research Centre, UNSW, Randwick, NSW, Australia
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de Maat SM, Dekker J, Schoevers RA, de Jonghe F. Relative efficacy of psychotherapy and combined therapy in the treatment of depression: A meta-analysis. Eur Psychiatry 2020; 22:1-8. [PMID: 17194571 DOI: 10.1016/j.eurpsy.2006.10.008] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [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] [Received: 09/05/2006] [Revised: 10/27/2006] [Accepted: 10/29/2006] [Indexed: 12/16/2022] Open
Abstract
AbstractBackgroundReviews of the relative efficacy of psychotherapy and combined therapy (psychotherapy with pharmacotherapy) for depression have yielded contradicting conclusions. This may be explained by the clinical heterogeneity of the studies reviewed.AimsTo conduct a meta-analysis with an acceptable level of homogeneity in order to investigate the relative efficacy of psychotherapy and combined therapy in the acute treatment of depression.MethodA systematic search was performed for RCTs published between 1980 and 2005 comparing psychotherapy and combined therapy in adult psychiatric outpatients with non-psychotic unipolar major depressive disorder. The studies were classified according to the chronicity and severity of the depression. Data were pooled by means of meta-analysis and statistical tests were conducted to measure heterogeneity.ResultsThe meta-analysis included seven studies looking at a total of 903 patients. None of the heterogeneity tests established significance. This indicates a lack of evidence for the heterogeneity of the results. The dropout rates did not differ significantly between the two treatment modalities (25% in combined therapy and 24% in psychotherapy, p = 0.77). At treatment termination, the intention-to-treat remission rate for combined therapy (46%) was better than for psychotherapy (34%) (p = 0.0007); Relative Risk 1.32 (95% CI: 1.12–1.56), Odds Ratio 1.59 (95% CI: 1.22–2.09). In moderate depression, the difference between the remission rate for combined therapy and psychotherapy was statistically significant (47% compared to 34% respectively, p = 0.001). This was not the case in mild major depression (42% compared to 37% respectively, p = 0.29). The difference was also statistically significant in chronic major depression (48% compared to 32%, p < 0.001), but not in non-chronic major depression (43% compared to 37%, p = 0.22). On a more specific level, no differences were found in the remission rates for the treatment modalities in mild or moderate non-chronic depression. Combined therapy led to significantly better results than psychotherapy in moderate chronic depression only (48% compared to 32%, p < 0.001).ConclusionsIn the acute treatment of adult psychiatric outpatients with major depressive disorder, patient compliance with combined therapy matches compliance with psychotherapy alone. Combined therapy is more efficacious than psychotherapy alone. However, these results depend on severity and chronicity. Combined therapy outperformed psychotherapy in moderate chronic depression only. No differences were found in mild and moderate non-chronic depression. No data were found for mild chronic depression and for severe depression.
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Affiliation(s)
- Saskia M de Maat
- Mentrum Mental Health Institute Amsterdam, Klaprozenweg 111, P.O. Box 75848, 1070 AV Amsterdam, The Netherlands
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Bora E, Veznedaroglu B. Temperament and character dimensions of the relatives of schizophrenia patients and controls: The relationship between schizotypal features and personality. Eur Psychiatry 2020; 22:27-31. [PMID: 17129710 DOI: 10.1016/j.eurpsy.2006.07.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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] [Received: 02/11/2006] [Revised: 07/25/2006] [Accepted: 07/26/2006] [Indexed: 10/23/2022] Open
Abstract
AbstractPurposePrevious findings indicated that schizophrenia patients might have a different personality structure from the general population on several dimensions of temperament and character. Some authors proposed that HA might be a marker of underlying genetic vulnerability to schizophrenia. Studies on high-risk subjects and first degree relatives of patients is essential to test the value of a measure as a marker of genetic vulnerability to a disease. Few studies tested the biopsychosocial model of personality on unaffected relatives of schizophrenia.Subjects and methodsWe compared the Temperament and Character (TCI) profiles of 94 first degree relatives of schizophrenia and 75 controls. We also investigated the relationship between schizotypy and TCI dimensions in the study sample.ResultsThe harm avoidance scores of the relatives of schizoprenia patients with schizotypal features were significantly higher. Self transcendence scores were also significantly higher among relatives with schizotypal features. In contrast, the relatives of the patients with schizophrenia who did not have schizotypal features had higher SD and C scores than the control group.Discussion and conclusionThis finding is consistent with the previous findings which suggested harm avoidance as a vulnerability indicator of schizophrenia. Some character features like self transcendence might be also associated with schizotypal features.
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Affiliation(s)
- Emre Bora
- Medical School of Ege University, Psychiatry Department, 35100 Izmir, Turkey.
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Mainio A, Hakko H, Niemelä A, Koivukangas J, Räsänen P. Gender difference in relation to depression and quality of life among patients with a primary brain tumor. Eur Psychiatry 2020; 21:194-9. [PMID: 16140507 DOI: 10.1016/j.eurpsy.2005.05.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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] [Received: 10/11/2004] [Accepted: 05/26/2005] [Indexed: 11/13/2022] Open
Abstract
AbstractObjective. –We studied the relationship between depressive symptoms and quality of life (QOL) as well as functional status in primary brain tumor patients at recurrent measurements. Differences in QOL between depressive and non-depressive samples by gender were controlled for tumor characteristics and patients' psychosocial factors.Materials and methods. –The data consisted of 77 patients with a primary brain tumor, 30 males and 47 females. Depression of the patients was assessed by Beck Depression Inventory (BDI) and Crown-Crisp Experiential Index (CCEI), functional status by Karnofsky Performance scale (KPS) and QOL by Sintonen's 15D before tumor operation as well as at 3 months and at 1 year from surgical operation of the tumor.Results.The level of QOL in females was lower compared to that of males. Depression was the main predictor for worse QOL in the patients at all measurements. Depressive patients with a benign brain tumor had significantly worse QOL versus non-depressive ones.Discussion and conclusion. –Decreased QOL was strongly related to depression, especially among patients with a benign brain tumor. Further studies are needed to find whether sufficient depression therapy improves the QOL of patients.
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Affiliation(s)
- Arja Mainio
- Department of Psychiatry, University of Oulu, Box 5000, 90014 Oulu, Finland.
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Benazzi F. Reviewing the diagnostic validity and utility of mixed depression (depressive mixed states). Eur Psychiatry 2020; 23:40-8. [PMID: 17764909 DOI: 10.1016/j.eurpsy.2007.07.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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] [Received: 01/02/2007] [Revised: 07/15/2007] [Accepted: 07/15/2007] [Indexed: 12/01/2022] Open
Abstract
AbstractObjectiveTo review the diagnostic validity and utility of mixed depression, i.e. co-occurrence of depression and manic/hypomanic symptoms.MethodsPubMed search of all English-language papers published between January 1966 and December 2006 using and cross-listing key words: bipolar disorder, mixed states, criteria, utility, validation, gender, temperament, depression-mixed states, mixed depression, depressive mixed state/s, dysphoric hypomania, mixed hypomania, mixed/dysphoric mania, agitated depression, anxiety disorders, neuroimaging, pathophysiology, and genetics. A manual review of paper reference lists was also conducted.ResultsBy classic diagnostic validators, the diagnostic validity of categorically-defined mixed depression (i.e. at least 2–3 manic/hypomanic symptoms) is mainly supported by family history (the current strongest diagnostic validator). Its diagnostic utility is supported by treatment response (negative effects of antidepressants). A dimensionally-defined mixed depression is instead supported by a non-bi-modal distribution of its intradepression manic/hypomanic symptoms.DiscussionCategorically-defined mixed depression may have some diagnostic validity (family history is the current strongest validator). Its diagnostic utility seems supported by treatment response.
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Affiliation(s)
- Franco Benazzi
- Hecker Psychiatry Research Center, University of California at San Diego, San Diego, CA, USA.
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Haro G, Calabrese JR, Larsson C, Shirley ER, Martín E, Leal C, Delgado PL. The relationship of personality traits to substance abuse in patients with bipolar disorder. Eur Psychiatry 2020; 22:305-8. [PMID: 17521889 DOI: 10.1016/j.eurpsy.2007.03.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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] [Received: 01/28/2007] [Revised: 03/25/2007] [Accepted: 03/28/2007] [Indexed: 11/26/2022] Open
Abstract
AbstractPurposeThe aim of this study is to determine if personality traits contribute to the likelihood of substance abuse in Bipolar Disorder (BD).Subjects/materials and methodsFifty-nine patients meeting DSM-IV criteria for BD: 20 without any history of Substance Related Disorder (SRD), 21 with a lifetime history of SRD but without current SRD, and 18 with current SRD. Patients filled out the TCI, the differences were analyzed by ANOVA and the likelihood was obtained by Multinomial Logistic Regression.ResultsOnly Novelty Seeking (NS) is statistically different between the groups. Patients with BD with current SRD have higher rates in NS than those with past SRD, and those without a history of SRD. NS was confirmed as a predicting variable, both to current SRD (OR [CI 95%] = 1.039/1.351; p = 0.011) and past SRD (OR [CI 95%] = 1.004/1.277; p = 0.042) on patients with BD.DiscussionThe results shown would appear to confirm the relationship of NS with the SRD, so long as there is no clear evidence that indicates the association of NS with BD.ConclusionsThere appears a greater predisposition to develop SRD in those patients with a higher degree of NS. The use of the Cloninger's TCI could be used in BD to determine the risk of developing an SRD. Early detection might help improve prognosis.
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Affiliation(s)
- Gonzalo Haro
- Dual Pathology Unit, Psychiatry Department, Hospital de la Ribera, C/Onda s/n, 46600 Alzira, Valencia, Spain.
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Abstract
AbstractBackgroundA consistent amount of empirical research suggests that depression, besides interfering with quality of life and social functioning, may influence other symptom dimensions in schizophrenia, thus constituting an important domain for treatment strategies, outcome, and prognosis.Aim. –This study investigated the factorial structure of the Calgary depression scale for schizophrenia (CDSS) in a sample of schizophrenic patients and explored the relationships between such factors, major symptom dimensions and subjective experiences.MethodsOne hundred and sixty-one subjects were examined to assess the severity of schizophrenic symptoms (scored according to the five-dimensional model of Toomey et al. [28]), the distress due to the subjective experience of negative symptoms, and the degree of subjectively-felt cognitive-affective vulnerability (i.e. basic symptoms).ResultsPrincipal component analysis revealed CDSS to include three main factors, namely: “depression-hopelessness” (factor I), “guilty idea of reference-pathological guilt” (factor II) and “early wakening” (factor III).Whereas the last factor did not correlate with any of the other psychopathological domains, the first two factors revealed multiple correlations with both diagnostic symptoms and subjective experiences.ConclusionsThe results confirm the threefold factorial structure of the CDSS previously reported by the authors of the scale and could shed further light on the psychopathological nature of the components of depression in schizophrenia. The specific correlation patterns with diagnostic and subjective psychopatholgy substantiate the clinical distinction between a general depression factor (“depression-hopelessness”) and a cognitive-guilt factor (“guilty idea of reference-pathological guilt”).
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Affiliation(s)
- Carlo Maggini
- Psychiatry Section, Department of Neuroscience, University of Parma, Piazzale Matteotti, 43100 Parma, Italy.
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König HH, Roick C, Angermeyer MC. Validity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders. Eur Psychiatry 2020; 22:177-87. [PMID: 17142014 DOI: 10.1016/j.eurpsy.2006.08.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [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] [Received: 02/28/2006] [Revised: 08/01/2006] [Accepted: 08/11/2006] [Indexed: 12/12/2022] Open
Abstract
AbstractPurposeThe EQ-5D is a generic questionnaire generating a health profile and a single index score for health-related quality of life. This study aimed to analyse the discriminative ability and validity of the EQ-5D in patients with schizophrenic, schizotypal or delusional disorders.Subjects and methodsOne hundred sixty-six patients with schizophrenic, schizotypal or delusional disorders (ICD-10 F2) completed the EQ-5D. Measures of quality of life (WHOQOL-BREF), utility (TTO), subjective (SCL-90R) and objective (PANSS, CGI-S) psychopathology, and functioning (GAF, GARF, SOFAS, HoNOS) provided comparison. Discriminative ability was analysed by assessing frequency distributions of EQ-5D scores. Validity of the EQ-5D self-classifier was analysed by assessing differences in related other scores grouped by response levels of EQ-5D items. Validity of the visual analogue scale (EQ VAS) and the EQ-5D index (UK social tariff) was analysed by assessing their correlation with all other scores.ResultsSeventy-nine percent of respondents reported problems in at least one of the EQ-5D dimensions (anxiety/depression 57%, usual activities 45%, pain/discomfort 44%, self-care 29%, mobility 22%). The mean EQ VAS score/EQ-5D index was 65.7/0.71. The four most frequently reported EQ-5D health states covered 45% of all respondents. For almost all EQ-5D dimensions, different response levels were associated with significantly different scores of measures used for comparison. Correlation of EQ VAS score and EQ-5D index were largest with scores of subjective measures (SCL-90R: −0.50 and −0.73; WHOQOL mental subscore 0.62 and 0.58; always P < 0.001).Discussion and conclusionThe EQ-5D showed a moderate ceiling effect and seems to be reasonably valid in this patient group.
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Affiliation(s)
- Hans-Helmut König
- Health Economics Research Unit, Department of Psychiatry, University of Leipzig, 04317 Leipzig, Germany.
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Tiganov AS, Savenko YS. The necessity of developing a two-stage qualification in ICD-11. Psychiatriki 2020; 31:172-176. [PMID: 32840221 DOI: 10.22365/jpsych.2020.312.172] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In the International Classification of Diseases, 10th Revision (ICD-10) two opposing principles are combined and mixed: atheoreticity that is necessary for the natural classification and commitment to nosology. Implementation of these principles requires a two-stage qualification. The first stage should be narrative detailed syndromological qualifications with identification of psychotic level of disorders. As for the second stage, the qualification should be nosological, based on complete clinical analysis, which is far from being possible to realize at once. ICD-10, specifically brought to nosological certainty, may remain the natural foundation for nosological qualification. Implementation of the syndromic qualification at the first stage will allow to consider nosological features of each syndrome at the second stage and to expand the list of criteria in different clusters. Such a suggestion opens the prospect for subsequent revisions of the ICD and allows to direct our efforts and those of practitioners to the unified channel, where the statistical goals would not be implemented at the expense of the research ones.
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Affiliation(s)
- A S Tiganov
- The Mental Health Research Center of the Russian Academy of Sciences
| | - Yu S Savenko
- Independent Psychiatric Association of Russia, Russia
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Deshpande SK, Hasegawa RB, Weiss J, Small DS. The association between adolescent football participation and early adulthood depression. PLoS One 2020; 15:e0229978. [PMID: 32155206 PMCID: PMC7064245 DOI: 10.1371/journal.pone.0229978] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/18/2020] [Indexed: 12/31/2022] Open
Abstract
Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they either studied a much older cohort or, more seriously, failed to account for potential confounding. We leverage data from a nationally representative cohort of American men who were in grades 7–12 in the 1994–95 school year to estimate the effect of playing football in adolescent on depression in early adulthood. We control for several potential confounders related to subjects’ health, behavior, educational experience, family background, and family health history through matching and regression adjustment. We found no evidence of even a small harmful effect of football participation on scores on a version of the Center for Epidemiological Studies Depression scale (CES-D) nor did we find evidence of adverse associations with several secondary outcomes including anxiety disorder diagnosis or alcohol dependence in early adulthood. For men who were in grades 7–12 in the 1994–95 school year, participating or intending to participate in school football does not appear to be a major risk factor for early adulthood depression.
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Affiliation(s)
- Sameer K. Deshpande
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Raiden B. Hasegawa
- Department of Statistics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jordan Weiss
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Dylan S. Small
- Department of Statistics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Ng KC, Wu LH, Lam HY, Lam LK, Nip PY, Ng CM, Leung KC, Leung SF. The relationships between mobile phone use and depressive symptoms, bodily pain, and daytime sleepiness in Hong Kong secondary school students. Addict Behav 2020; 101:105975. [PMID: 31076240 DOI: 10.1016/j.addbeh.2019.04.033] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 10/30/2018] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Studies have found that increased mobile phone use (MPU) is associated with multiple health issues such as depression, disordered sleep and pain. However, the current situation and interrelationships of these problems remain unexplored in the Hong Kong population. OBJECTIVES This study aimed to understand the situation and problematic use of mobile phones by Hong Kong secondary school students and to investigate depressive symptoms, bodily pain and daytime sleepiness and the associations of these factors with MPU in Hong Kong secondary school students. METHODS This quantitative cross-sectional design study was based on self-administered questionnaires completed at five secondary schools. The questionnaire comprised five sections: MPU as measured by the Chinese version of the 10-Item Mobile Phone Problem Use Scale (CMPPUS-10); depressive symptoms according to the Depression Anxiety Stress Scale-21 Chinese Version (DASS-21); bodily pain according to the Brief Pain Inventory Short Form Chinese (BPISF-C); daytime sleepiness as measured using the Chinese version of the Epworth Sleepiness Scale (CESS) and socio-demographic questions. RESULTS A total of 686 students were recruited. The CMPPUS-10 score correlated positively with the average daily duration of MPU and the presence of depression, daytime sleepiness and bodily pain. Problematic mobile phone users received significantly higher scores for depression severity, bodily pain and daytime sleepiness. Health problems were significantly more severe in female than in male students. Bodily pain and daytime sleepiness mediated the relationship of MPU with depression. CONCLUSIONS Problematic MPU was associated with depression, bodily pain and daytime sleepiness. These findings will inform further studies of MPU-related health problems.
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Affiliation(s)
- Ka Chun Ng
- Master of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Lai Har Wu
- The School of Nursing at The Hong Kong Polytechnic University, Hong Kong.
| | - Hoi Yan Lam
- Master of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Lai Kuen Lam
- Master of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Po Yan Nip
- Master of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Cho Man Ng
- Master of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Ka Chun Leung
- Bachelor of Medicine and Bachelor of Surgery, The University of Hong Kong, Hong Kong.
| | - Sau Fong Leung
- The School of Nursing at The Hong Kong Polytechnic University, Hong Kong.
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Ishimaru D, Tanaka H, Nagata Y, Takabatake S, Nishikawa T. Physical Activity in Severe Dementia Is Associated With Agitation Rather Than Cognitive Function. Am J Alzheimers Dis Other Demen 2020; 35:1533317519871397. [PMID: 31533445 PMCID: PMC10624062 DOI: 10.1177/1533317519871397] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The authors examined associations between physical activity, cognitive function, activities of daily living, and behavioral and psychological dementia symptoms (BPSD) in severe and moderate dementia. METHODS A cross-sectional study was conducted to assess severe and moderate dementia groups according to the Clinical Dementia Rating. An actigraphy measured physical activity. Other measures included Mini-Mental State Examination, Cognitive Test for Severe Dementia, Hyogo Activities of Daily Living Scale, and Neuropsychiatric Inventory-Nursing Home. RESULTS Sixty-three participants were assessed (mean age = 89.3 ± 6.4). Physical activity was not associated with cognitive function among participants with severe dementia, although there was a trend-level association with cognitive function among those with moderate dementia. Physical activity was significantly associated with BPSD, specifically agitation/aggression symptoms, for participants with severe dementia, and there was a trend-level association with anxiety for participants with moderate dementia. CONCLUSIONS Physical activity appears to be associated with BPSD among individuals in the advanced stages of dementia.
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Affiliation(s)
- Daiki Ishimaru
- Course of Comprehensive Rehabilitation, Osaka Prefecture University Graduate School, Habikino-City, Osaka, Japan
- Department of Rehabilitation, Healthcare Corporation Seifuuen Imai Hospital, Kitataharaaza, Inagawacho, Kawabegun, Hyogo, Japan
| | - Hiroyuki Tanaka
- Course of Comprehensive Rehabilitation, Osaka Prefecture University Graduate School, Habikino-City, Osaka, Japan
| | - Yuma Nagata
- Course of Comprehensive Rehabilitation, Osaka Prefecture University Graduate School, Habikino-City, Osaka, Japan
- Department of Rehabilitation, Healthcare Corporation Seifuuen Imai Hospital, Kitataharaaza, Inagawacho, Kawabegun, Hyogo, Japan
| | - Shinichi Takabatake
- Course of Comprehensive Rehabilitation, Osaka Prefecture University Graduate School, Habikino-City, Osaka, Japan
| | - Takashi Nishikawa
- Course of Comprehensive Rehabilitation, Osaka Prefecture University Graduate School, Habikino-City, Osaka, Japan
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Abstract
BACKGROUND Traumatic injury is not only physically devastating, but also psychologically isolating, potentially leading to poor quality of life, depression and posttraumatic stress disorder (PTSD). Perceived social support (PSS) is associated with better outcomes in some populations. What is not known is if changes in PSS influence long-term outcomes following nonneurologic injury. We hypothesized that a single drop in PSS during recovery would be associated with worse quality of life. METHODS This is a post hoc analysis of a prospectively collected database that included patients 18 years or older admitted to a Level I trauma center with Injury Severity Score (ISS) of 10 or higher, and no traumatic brain or spinal cord injury. Demographic and injury data were collected at the initial hospital admission. Screening for depression, PTSD, and Medical Outcomes Study Short Form 36 Mental Composite Score (MCS) were obtained at the initial hospitalization, 1, 2, 4, and 12 months postinjury. The Multidimensional Scale of Perceived Social Support (MSPSS) was obtained at similar time points. Patients with high MSPSS (>5) at baseline were included and grouped by those that ever reported a score ≤5 (DROP), and those that remained high (STABLE). Outcomes were determined at 4 and 12 months. RESULTS Four hundred eleven patients were included with 96 meeting DROP criteria at 4 months, and 97 at 1 years. There were no differences in sex, race, or injury mechanism. The DROP patients were more likely to be single (p = 0.012 at 4 months, p = 0.0006 at 1 year) and unemployed (p = 0.016 at 4 months, and p = 0.026 at 1 year) compared with STABLE patients. At 4 months and 1 year, DROP patients were more likely to have PTSD, depression, and a lower MCS (p = 0.0006, p < 0.0001). CONCLUSION Patients who have a drop in PSS during the first year of recovery have significantly higher odds of poor psychological outcomes. Identifying these socially frail patients provides an opportunity for intervention to positively influence an otherwise poor quality of life. LEVEL OF EVIDENCE Therapeutic, Prognostic and Epidemiological, Level III.
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Affiliation(s)
- Bryan W Carr
- From the Indiana University School of Medicine (B.W.C., S.E.S., T.M.B.), Indianapolis, Indiana; and University of Wisconsin School of Medicine and Public Health (B.L.Z.), Madison, Wisconsin
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Tentorio T, Dentali S, Moioli C, Zuffi M, Marzullo R, Castiglioni S, Franceschi M. Anxiety and Depression Are Not Related to Increasing Levels of Burden and Stress in Caregivers of Patients With Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2020; 35:1533317519899544. [PMID: 32052659 PMCID: PMC10624007 DOI: 10.1177/1533317519899544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sixty-nine dyads of patients with Alzheimer's disease and primary caregivers have been followed up for 1 year to evaluate cognitive (Mini-Mental State Examination), functional (Instrumental Activities of Daily Living), and behavioral (Neuropsychiatric Inventory) decline of patient in relation to burden (Caregiver Burden Inventory), stress (Relative Stress Scale), anxiety (State-Trait Anxiety Inventory Y), and depression (Beck Depression Inventory) reported by the caregivers. After 1 year of observation, cognitive and functional scores worsened while behavioral problems remained unchanged and relatively mild in patients. After 1 year, caregivers' scores of scales of anxiety and depression decreased significantly, while stress scores remained unchanged and burden slightly increased. In our opinion, the unexpected improvement in psychological situation of caregivers may be mainly due to educational interventions focused on knowledge of the disease with a particular attention directed toward emotional support and individual needs.
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Affiliation(s)
| | - Sharon Dentali
- Neurology Department, Multimedica Hospital, Castellanza, Italy
| | - Camilla Moioli
- Neurology Department, Multimedica Hospital, Castellanza, Italy
| | - Marta Zuffi
- Neurology Department, Multimedica Hospital, Castellanza, Italy
| | - Rosy Marzullo
- Istituto Nazionale Riposo e Cura per Anziani (INRCA), Fermo, Italy
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Stasiewicz PR, Bradizza CM, Ruszczyk MU, Lucke JF, Zhao J, Linn B, Slosman KS, Dermen KH. The Identification of Pretreatment Trajectories of Alcohol Use and Their Relationship to Treatment Outcome in Men and Women With Alcohol Use Disorder. Alcohol Clin Exp Res 2019; 43:2637-2648. [PMID: 31688963 PMCID: PMC6904501 DOI: 10.1111/acer.14216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/08/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Few studies have focused on behavioral changes that occur prior to entering treatment for an alcohol use disorder (AUD). In 2 studies (Psychol Addict Behav, 27, 2013, 1159; J Stud Alcohol, 66, 2005, 369), pretreatment reductions in alcohol use were associated with better treatment outcomes. Identifying patterns of pretreatment change has the potential to inform clinical decision making. METHODS This study sought to identify pretreatment change trajectories in individuals seeking outpatient treatment for AUD (N = 205) using finite mixture modeling based on changes in number of days abstinent per week (NDA). RESULTS The analysis identified 3 pretreatment trajectory classes. Class 1 (High Abstinence-Minimal Increase; HA-MI) (n = 64; 31.2%) reported a high level of pretreatment NDA with minimal change during an 8-week pretreatment interval. Class 2 (Low Abstinence-Steady Increase; LA-SI) (n = 73; 35.6%) reported a low level of pretreatment NDA followed by a steady increase beginning 2 weeks prior to the phone screen. Class 3 (Nonabstinent-Accelerated Increase; NA-AI) (n = 68; 33.2%) reported no or very low levels of pretreatment NDA but demonstrated an increase following the phone screen. With regard to within-treatment change, Class 1 demonstrated the least and Class 3 demonstrated the most change in NDA. From baseline to 6-month follow-up, Class 3 added 2.31 abstinent days per week, Class 2 added 0.69 days, and Class 1 added 0.63 days. The increase in NDA for Class 3 was significantly different from the other 2 classes; however, Class 3 reported fewer overall days abstinent at 6-month follow-up. CONCLUSIONS Study results have clinical and research implications including recommended changes to treatment protocols and research designs. Understanding the impact of pretreatment trajectories of alcohol use on within-treatment and posttreatment outcomes may provide important information about adapting treatment to increase efficiency and effectiveness.
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Affiliation(s)
| | | | | | | | - Junru Zhao
- School of Social Work, University at Buffalo
| | - Braden Linn
- Clinical and Research Institute on Addictions, University at Buffalo
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Lee D. The convergent, discriminant, and nomological validity of the Depression Anxiety Stress Scales-21 (DASS-21). J Affect Disord 2019; 259:136-142. [PMID: 31445339 DOI: 10.1016/j.jad.2019.06.036] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [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] [Received: 01/18/2019] [Revised: 03/08/2019] [Accepted: 06/29/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous validity studies of Depression Anxiety Stress Scales-21 (DASS-21) through confirmatory factor analysis (CFA) were limited by yielding poor factor loading values and eventually skipping the critical process addressing convergent, discriminant, and nomological validity. Without the crucial process, it was risky that past studies insisted DASS-21 be ready for use. Therefore, the current study examined DASS-21 regarding the three kinds of validity to determine if DASS-21 can be further used in the future. METHODS The current study formulated a CFA model (i.e., modified one-factor model) of DASS-21, which yielded factor loading values over β = 0.70 and estimated a latent variable of Psychological Distress by employing indicators of Depression, Anxiety, and Stress. The data collection was conducted at two universities in the U.S. and South Korea in November 2016 (N = 255). The study participants completed an online survey developed with DASS-21. With the collected data, the present study investigated the convergent, discriminant, and nomological validity of the modified one-factor model of DASS-21 through CFA. RESULTS The model fit of the modified one-factor model was complete as saturated. The convergent validity coefficient of Psychological Distress was 0.87, and average variance extracted of the variable was 0.68. The three correlations among the measured variables (i.e., indicators) were 0.50 < r < 0.75. LIMITATIONS Application of the current study's findings to youth or older adults can be limited as the subjects were young adults. CONCLUSIONS The current study made substantial evidence regarding the convergent, discriminant, and nomological validity of DASS-21 through CFA.
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Affiliation(s)
- Dohyun Lee
- Department of Kinesiology and Recreation Administration, College of Behavioral & Social Sciences, North Carolina Central University, Durham, NC 27707, USA.
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Chen KH, Tam CWC, Chang K. Early Maladaptive Schemas, Depression Severity, and Risk Factors for Persistent Depressive Disorder: a Cross-sectional Study. East Asian Arch Psychiatry 2019; 29:112-117. [PMID: 31871307 DOI: 10.12809/eaap1821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate associations of the five early maladaptive schemas (EMS) domains with depression severity by comparing patients with persistent depressive disorder (PDD), patients with major depressive disorder (MDD), and controls with no psychiatric disorders. METHODS Patients with PDD (n = 30), patients with MDD (n = 24), and controls with no psychiatric disorders (n = 30) were recruited. Participants were assessed using the Mini-International Neuropsychiatric Interview 5.0 version (MINI), the Beck Depression Inventory-Second Edition (BDI-II), and the Young Schema Questionnaire-3rd Edition Short Form (YSQ-S3). RESULTS The five EMS domains (YSQ-S3 score) significantly correlated with depression severity (BDI-II score), with correlation coefficients ranging from 0.583 to 0.788. After controlling for age, education, and sex, the two best predictors of depression severity were domains 'over-vigilance and inhibition' and 'disconnection and rejection'. For domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition, the total YSQ-S3 score was significantly higher in the PDD group than both the MDD and control groups. For the domain of impaired limits, the total YSQ-S3 score was significantly higher in both the PDD and MDD groups than the control group. CONCLUSION All five EMS domains correlated significantly with depression severity. PDD and MDD differed in psychopathology. The EMS domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition may be specific risk factors for PDD.
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Affiliation(s)
- K H Chen
- Department of Clinical Psychology, Ten Chen Hospital (Chungli), Taoyuan City, Taiwan
| | - C W C Tam
- Department of Psychology, Chung Yuan Christian University, Chungli, Taoyuan City, Taiwan
| | - K Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan City, Taiwan
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Hamasha AAH, Kareem YM, Alghamdi MS, Algarni MS, Alahedib KS, Alharbi FA. Risk indicators of depression among medical, dental, nursing, pharmacology, and other medical science students in Saudi Arabia. Int Rev Psychiatry 2019; 31:646-652. [PMID: 31117837 DOI: 10.1080/09540261.2019.1584095] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of the study was to investigate the prevalence and risk indicators of depression in undergraduate students of health-related specialties. A systematic random sample of 398 students from seven health colleges was included. The assessment tool was a self-reported questionnaire based on Becks Depression Inventory (BDI). Participant status was categorized into Absence (BDI = 0-13) or Presence (BDI = 14-60) of depression. Data analyses included descriptive statistics, bivariate analysis, and stepwise logistic regression. About 45% of students reported having mild-to-severe depression. The significant risk indicators for depression were: gender, recent loss of family members, type of study, year of study, presence of psychological illnesses, social life, satisfaction with each of the following: the specialty, teaching staff, college facilities. The regression model showed the following factors to remain significantly related to depression: presence of psychological illness, social life style, recent loss of family member, and satisfaction with teaching staff. In conclusion, a significant number of undergraduate students have depression. This study indicates the need to support this group of students by the community and the university administration. Students' academic and social advisers' roles are recommended to be more effective. Teaching staff are recommended to have their teaching and communication skills enhanced.
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Affiliation(s)
- Abed Al-Hadi Hamasha
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef M Kareem
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed S Alghamdi
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed S Algarni
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid S Alahedib
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fahad A Alharbi
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Fredskild MU, Mintz J, Frye MA, McElroy SL, Nolen WA, Kupka R, Grunze H, Keck PE, Post RM, Kessing LV, Suppes T. Adding Increased Energy or Activity to Criterion (A) of the DSM-5 Definition of Hypomania and Mania: Effect on the Diagnoses of 907 Patients From the Bipolar Collaborative Network. J Clin Psychiatry 2019; 80. [PMID: 31665571 DOI: 10.4088/jcp.19m12834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/22/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE According to DSM-IV, criterion (A) for diagnosing a hypomanic/manic episode is mood change (ie, elevated, expansive, or irritable mood). Criterion (A) was redefined in DSM-5, adding increased energy or activity in addition to mood change. We sought to investigate the effect of adding increased energy or activity to criterion (A) for the diagnosis of hypomania/mania and, thus, bipolar disorder. METHODS This analysis of prospectively collected data from the Bipolar Collaborative Network (1995-2002) includes 907 DSM-IV-TR-diagnosed bipolar outpatients (14,306 visits). The Young Mania Rating Scale (YMRS) was administered monthly and used to define DSM-IV and DSM-5 criterion (A) fulfillment during a hypomanic/manic visit. RESULTS Patients were adults (median age = 40; IQR, 33-49), and over half (56%) were women. Median number of contributed visits was 10 (IQR, 4-23). Applying DSM-5 criterion (A) reduced the number of patients experiencing a hypomanic/manic visit by 34%, compared to DSM-IV. Visits fulfilling DSM-5 criterion (A) had higher odds of experiencing elevated levels of all other mania symptoms, compared to fulfilling DSM-IV criterion (A) only. Association between individual symptoms was strongest with mood elevation and energy or activity (OR [95% CL] = 8.65, [7.91, 9.47]). CONCLUSIONS The 34% reduction in the number of patients being diagnosed with a hypomanic/manic visit shows that the impact of applying DSM-5 criterion (A) is substantial. Fewer hypomanic/manic episodes may be diagnosed by the stricter DSM-5 criterion (A), but the episodes diagnosed are likely to be more severe. The DSM-5 criteria may in general prevent overdiagnosis of bipolar disorder but possibly at the cost of underdiagnosing hypomanic/manic episodes.
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Affiliation(s)
- Mette U Fredskild
- The Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, University Hospital Copenhagen, Copenhagen, Denmark
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jim Mintz
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, New York, USA
| | - Susan L McElroy
- The Lindner Center of HOPE, University of Cincinnati, Mason, Ohio, USA
| | - Willem A Nolen
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ralph Kupka
- Amsterdam University Medical Center, Vrije University, Amsterdam, the Netherlands
| | - Heinz Grunze
- Paracelsus Medical University, Nuremberg & Klinikum am Weissenhof, Weinsberg, Germany
| | - Paul E Keck
- The Lindner Center of HOPE, University of Cincinnati, Mason, Ohio, USA
| | - Robert M Post
- The School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA
| | - Lars V Kessing
- The Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, University Hospital Copenhagen, Copenhagen, Denmark
| | - Trisha Suppes
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, VA Palo Alto Health Care System, 3801 Miranda Ave (151 T), Palo Alto, CA 94304.
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
- VA Palo Alto Health Care System, Palo Alto, California, USA
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Fernandes GS, Parekh SM, Moses J, Fuller CW, Scammell B, Batt ME, Zhang W, Doherty M. Depressive symptoms and the general health of retired professional footballers compared with the general population in the UK: a case-control study. BMJ Open 2019; 9:e030056. [PMID: 31501119 PMCID: PMC6738669 DOI: 10.1136/bmjopen-2019-030056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To determine the prevalence of depressive symptoms and general health of male ex-professional footballers compared with general population controls. METHODS 572 retired professional footballers and 500 general population controls in the UK were assessed by postal questionnaire. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale and a threshold score of ≥11 was used to indicate probable caseness. General health was ascertained using the Short Form-12 Health Survey Questionnaire quality of life (QoL) tool; self-reported comorbidities, analgesic usage and body pain; and Index of Multiple Deprivation based on postcode data. Mood was assessed using the Positive and Negative Affect Scale and sleep using the Medical Outcome Survey. Linear regression analysis was used to determine adjusted relative risk with 95% CI and adjusted for age, body mass index, comorbidities, body pain and medication usage. RESULTS The prevalence of depressive symptoms in retired professional footballers was 5.66% compared with 5.76% in the general population and anxiety prevalence was also comparable (12.01% vs 10.29%; all p>0.05). However, footballers had lower physical and mental component scores compared with controls (p<0.01). They also reported significantly more sleep problems, more negative mood profiles and more widespread body pain (adjusted relative risk (aRR) 1.88, 95% CI 1.15 to 3.09). They also reported greater pain medication usage compared with controls (aRR 1.54, 95% CI 1.26 to 1.89). However, compared with controls, they were 26% (95% CI 15% to 37%) less likely to report comorbidities, especially heart attacks (aRR 57%, 95% CI 27% to 74%) and diabetes (aRR 61%, 95% CI 37% to 76%). CONCLUSIONS The prevalence of depressive symptoms and anxiety symptoms and probable caseness in ex-professional footballers is comparable with general population controls. However, ex-footballers reported lower health-related QoL, more widespread body pain and higher analgesic usage. Conversely, lower reporting of diabetes and heart attacks indicates potential long-term physical health benefits of professional football.
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Affiliation(s)
- Gwen S Fernandes
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sanjay M Parekh
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jonathan Moses
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Brigitte Scammell
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Mark Edward Batt
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Weiya Zhang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
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Contractor AA, Banducci AN, Dolan M, Keegan F, Weiss NH. Relation of positive memory recall count and accessibility with post-trauma mental health. Memory 2019; 27:1130-1143. [PMID: 31189410 PMCID: PMC6643998 DOI: 10.1080/09658211.2019.1628994] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
Positive memory encoding and retrieval deficits have an empirical relation with several post-trauma outcomes. Drawing from the Contractor et al. model, we examined relations between positive memory characteristics and post-trauma mental health indicators. A trauma-exposed community sample of 203 participants (Mage = 35.40 years; 61.10% female) was recruited via Amazon's Mechanical Turk. Participants completed measures of posttraumatic stress disorder (PTSD; PTSD Checklist for DSM-5), depression (Patient Health Questionnaire-9), posttraumatic cognitions (Posttraumatic Cognitions Inventory), affect (Positive and Negative Affect Schedule), count/number of recalled specific positive memories (Autobiographical Memory Test) and accessibility of a specific positive memory (i.e., subjective ease of recalling details of a memory; Memory Experiences Questionnaire-Short Form). Linear regression results indicated that PTSD intrusion severity, PTSD negative alterations in cognitions and mood (NACM) severity, PTSD alterations in arousal and reactivity (AAR) severity, self-blame, and positive affect significantly and negatively predicted the count of specific positive memories. Further, PTSD NACM severity, PTSD AAR severity, negative cognitions about the self, and negative affect significantly and negatively predicted accessibility of a specific positive memory. Thus, count/accessibility of specific positive memories was associated with several post-trauma mental health indicators; this highlights the relevance and potential impact of integrating positive memories into trauma treatment.
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Affiliation(s)
- Ateka A Contractor
- a Department of Psychology , University of North Texas , Denton , TX , USA
| | - Anne N Banducci
- b The National Center for PTSD at VA Boston Healthcare System , Boston , MA , USA
- c Boston University School of Medicine , Boston , MA , USA
| | - Megan Dolan
- a Department of Psychology , University of North Texas , Denton , TX , USA
| | - Fallon Keegan
- a Department of Psychology , University of North Texas , Denton , TX , USA
| | - Nicole H Weiss
- d Department of Psychology , University of Rhode Island , Kingston , RI , USA
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Reardon T, Creswell C, Lester KJ, Arendt K, Blatter-Meunier J, Bögels SM, Coleman JRI, Cooper PJ, Heiervang ER, Herren C, Hogendoorn SM, Hudson JL, Keers R, Lyneham HJ, Marin CE, Nauta M, Rapee RM, Roberts S, Schneider S, Silverman WK, Thastum M, Thirlwall K, Wergeland GJ, Eley TC. The utility of the SCAS-C/P to detect specific anxiety disorders among clinically anxious children. Psychol Assess 2019; 31:1006-1018. [PMID: 31070449 PMCID: PMC6671872 DOI: 10.1037/pas0000700] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/17/2018] [Accepted: 12/31/2018] [Indexed: 12/14/2022]
Abstract
Questionnaire measures offer a time and cost-effective alternative to full diagnostic assessments for identifying and differentiating between potential anxiety disorders and are commonly used in clinical practice. Little is known, however, about the capacity of questionnaire measures to detect specific anxiety disorders in clinically anxious preadolescent children. This study aimed to establish the ability of the Spence Children's Anxiety Scale (SCAS) subscales to identify children with specific anxiety disorders in a large clinic-referred sample (N = 1,438) of children aged 7 to 12 years. We examined the capacity of the Separation Anxiety, Social Phobia, Generalized Anxiety, and Physical Injury Fears (phobias) subscales to discriminate between children with and without the target disorder. We also identified optimal cutoff scores on subscales for accurate identification of children with the corresponding disorder, and examined the contribution of child, mother, and father reports. The Separation Anxiety subscale was able to accurately identify children with separation anxiety disorder, and this was replicated across all 3 reporters. Mother- and father-reported Social Phobia subscales also accurately identified children with social anxiety disorder, although child report was only able to accurately detect social anxiety disorder in girls. Using 2 or more reporters improved the sensitivity of the Separation Anxiety and Social Phobia subscales but reduced specificity. The Generalized Anxiety and Physical Injury Fears subscales failed to accurately identify children with the corresponding disorders. These findings have implications for the potential use of mother-, father-, and child-report SCAS subscales to detect specific disorders in preadolescent children in clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Kristian Arendt
- Department of Psychology and Behavioural Sciences, Aarhus University
| | | | - Susan M Bögels
- Research Institute Child Development and Education, University of Amsterdam
| | - Jonathan R I Coleman
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King's College London
| | - Peter J Cooper
- School of Psychology and Clinical Language Sciences, University of Reading
| | | | - Chantal Herren
- Department of Forensic Psychiatry, University of Basel Psychiatric Clinics
| | - Sanne M Hogendoorn
- Department of Child and Adolescent Psychiatry/De Bascule, Academic Medical Centre
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | - Robert Keers
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London
| | - Heidi J Lyneham
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | - Carla E Marin
- Child Study Center, Yale University School of Medicine
| | - Maaike Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | - Susanna Roberts
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London
| | - Silvia Schneider
- Mental Health Research and Treatment Center (MHRTC), Ruhr University Bochum
| | | | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University
| | - Kerstin Thirlwall
- School of Psychology and Clinical Language Sciences, University of Reading
| | - Gro Janne Wergeland
- Anxiety Disorders Research Network and Division of Psychiatry, Department of Child and Adolescent Psychiatry, Haukeland University Hospital
| | - Thalia C Eley
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London
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Dogansen SC, Cikrikcili U, Oruk G, Kutbay NO, Tanrikulu S, Hekimsoy Z, Hadzalic A, Gorar S, Omma T, Mert M, Akbaba G, Yalin GY, Bayram F, Ozkan M, Yarman S. Dopamine Agonist-Induced Impulse Control Disorders in Patients With Prolactinoma: A Cross-Sectional Multicenter Study. J Clin Endocrinol Metab 2019; 104:2527-2534. [PMID: 30848825 DOI: 10.1210/jc.2018-02202] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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] [Received: 10/12/2018] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Dopamine agonist (DA)-induced impulse control disorder (ICD) in patients with prolactinomas is not sufficiently known. OBJECTIVE To evaluate the prevalence of DA-induced ICDs and possible risk factors related to these disorders in patients with prolactinoma. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional multicenter study involving 308 patients with prolactinoma followed up in tertiary referral centers who received at least three months of DA therapy. DA-induced ICDs (pathological gambling, hypersexuality, compulsive shopping, and compulsive eating) and impulsivity were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease and the Barratt Impulsiveness Scale-11, respectively. Patients were evaluated in terms of parameters related to ICD development. RESULTS Any ICD prevalence was 17% (n = 51). Hypersexuality was most common (6.5%). Although any ICD and hypersexuality were more common in male patients (P = 0.009, P < 0.001, respectively), compulsive eating was more common in female patients (P = 0.046). Current smoking, alcohol use, and gambling history were more frequent (P = 0.033, P = 0.002, P = 0.008, respectively) in patients with any ICD. In Barratt Impulsiveness Scale-11 total, attentional, motor, and nonplanning scores were higher in patients with any ICD (P < 0.001). Current smoking and alcohol use were more frequent (P = 0.007, P = 0.003, respectively) and percentage increase of testosterone levels at last visit was higher (P = 0.021) in male patients with prolactinomas with hypersexuality. CONCLUSION Any ICD may be seen in one of six patients with prolactinoma who are receiving DA therapy. Endocrinology specialists should be aware of this side effect, particularly in male patients with a history of gambling, smoking, or alcohol use.
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Affiliation(s)
- Sema Ciftci Dogansen
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ugur Cikrikcili
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey
| | - Gonca Oruk
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nilufer Ozdemir Kutbay
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Seher Tanrikulu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Zeliha Hekimsoy
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Celal Bayar University Medicine Faculty, Manisa, Turkey
| | - Aysa Hadzalic
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Suheyla Gorar
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Antalya Training and Research Hospital, Antalya, Turkey
| | - Tulay Omma
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
| | - Meral Mert
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gulhan Akbaba
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Mugla Sıtkı Kocman University School of Medicine, Mugla, Turkey
| | - Gulsah Yenidunya Yalin
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
| | - Fahri Bayram
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mine Ozkan
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey
| | - Sema Yarman
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
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Abstract
BACKGROUND In mental health, outcomes are currently measured by changes of individual scores. However, such an analysis on individual scores does not take into account the interaction between symptoms, which could yield crucial information while investigating outcomes. Network analysis techniques can be used to routinely study these systems of interacting symptoms. The present study aimed at comparing outcomes using individual scores vs. symptom networks, after a 1 year intervention at a local community mental health centre. METHODS We used the Health of the Nation Outcomes Scales, which defines a set of 12 scales investigating mental health and social functioning. We first assessed how individual scores varied from baseline to end point and which items were associated to treatment response. Second, using network analysis techniques, we measured the overall connectivity of the networks and determined the most important symptoms. RESULTS The individual scores analysis revealed a significant improvement amongst most scales. No specific factors were related to treatment response at end point. At end point, network analysis revealed a very densely connected network while agitation and substance use were the most connected symptoms. CONCLUSIONS Individual scores and symptom network analysis resulted in very different outcomes, with network analysis toning down positive results gained from individual scores analysis. The strong connectivity of patients' network at end point may reflect their increased complexity. Allocating more resources to interventions tailored to symptoms that are the most connected would decrease network connectivity and improve patients' prognosis. When investigating outcomes, network analysis could give insights complementary to standard analysis on individual scores.
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Affiliation(s)
| | - Don van den Bergh
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Lyu D, Wu Z, Wang Y, Huang Q, Wu Z, Cao T, Zhao J, Cao Y, Hu Y, Chen J, Wang Y, Su Y, Zhang C, Peng D, Li Z, Cao L, Hong W, Fang Y. Disagreement and factors between symptom on self-report and clinician rating of major depressive disorder: A report of a national survey in China. J Affect Disord 2019; 253:141-146. [PMID: 31035214 DOI: 10.1016/j.jad.2019.04.073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/21/2019] [Accepted: 04/17/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Measurement-based care (MBC) is a popular strategy of clinical management for patients with major depressive disorder (MDD). The consistency of self-report and clinical measurements is of importance, but whether individual symptom severity is in agreement for both self-report and clinician rating in MDD has not been comprehensively tested. This study aimed to test whether individual symptom severity of MDD was in agreement between self-report and clinician rating, and to explore factors affecting the agreement. METHODS In the National Survey on Symptomatology of Depression (NSSD) of China, 3275 patients with a major depressive episode were evaluated by both self-report and a clinician-rated version of 62 questions. RESULTS On average, 59% of all patients reached absolute agreement with their research clinicians. Among all questions, 73% returned with moderate positive strength of correlation, followed by 27% with low positive correlation. In 77% of the total questions, there was a tendency to rate higher in the self-report version compared with the clinician-rated version. After classifying the symptoms by six major domains, it was found that patients and clinicians showed more consistent answers in history and somatic questions (81% and 65% reached agreement), and that there were more differences in mood, energy, and anxiety questions (up to 56% in full agreement). "Outpatient", "high financial status", "poor working condition", and "high education level" were found to be significant positive predictors for patients rating higher than clinicians or patients and clinicians reaching agreement as opposed to clinicians rating higher than patients. LIMITATIONS The cross-sectional nature of our study undermines the interpretation of the results across the MDD treatment course. CONCLUSIONS It is sufficient to use the self-report version of a questionnaire to screen, monitor, and detect remission for MDD symptoms. Complete assessment of depression severity should take both clinician-rated scales and self-reported measures into consideration. Factors other than source of admission, financial status, working condition, and education level should be further investigated for the discrepancy between self-report and clinician rating.
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Affiliation(s)
- Dongbin Lyu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhiguo Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qinte Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhenling Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Tongdan Cao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Huangpu District Mental Health Center, Shanghai, PR China
| | - Jie Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Huangpu District Mental Health Center, Shanghai, PR China
| | - Yonghua Cao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yingyan Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jun Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yong Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yousong Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zezhi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lan Cao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, PR China.
| | - Yiru Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, PR China; Chinese Academy of Sciences (CAS) Center for Excellence in Brain Science and Intelligence Technology, Shanghai, PR China.
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Zucca M, Rubino E, Vacca A, Govone F, Gai A, De Martino P, Boschi S, Gentile S, Giordana MT, Rainero I. High Risk of Suicide in Behavioral Variant Frontotemporal Dementia. Am J Alzheimers Dis Other Demen 2019; 34:265-271. [PMID: 30558441 PMCID: PMC10852495 DOI: 10.1177/1533317518817609] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 12/11/2022]
Abstract
AIM The purpose of the study was to determine the prevalence of suicidal ideation and attempts in patients with behavioral variant frontotemporal dementia (bvFTD), evaluating possible risk factors for suicidality. METHODS Risk of suicide was assessed using the Scale for Suicide Ideation (SSI) in 35 patients with bvFTD and 25 controls. RESULTS According to SSI, 40% of patients with bvFTD had suicidal ideation in comparison to 8% of controls ( P = .009). Four patients with bvFTD have attempted suicide versus none control ( P = .006). Patients with bvFTD with suicide risk showed higher levels of anxiety, depression, stress, and hopelessness than patients without suicide risk ( P < .001). Patients who attempted suicide were younger and had a longer disease duration than those with only suicide ideation. Intriguingly, 40% of patients with parkinsonism presented high level of suicide ideation. CONCLUSIONS Our findings show that patients with bvFTD have a high risk of suicide. Additional studies in larger populations are needed to confirm our results.
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Affiliation(s)
- Milena Zucca
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Elisa Rubino
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Alessandro Vacca
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Flora Govone
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Annalisa Gai
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Paola De Martino
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Silvia Boschi
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Salvatore Gentile
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Maria Teresa Giordana
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Innocenzo Rainero
- Department of Neuroscience “Rita Levi Montalcini,” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
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Prisciandaro JJ, Tolliver BK, DeSantis SM. Identification and initial validation of empirically derived bipolar symptom states from a large longitudinal dataset: an application of hidden Markov modeling to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. Psychol Med 2019; 49:1102-1108. [PMID: 30153871 PMCID: PMC7160825 DOI: 10.1017/s0033291718002143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/05/2022]
Abstract
BACKGROUND Although bipolar disorder (BD) is a fundamentally cyclical illness, a divided model of BD that emphasizes polarity over cyclicity has dominated modern psychiatric diagnostic systems since their advent in the 1980s. However, there has been a gradual return to conceptualizations of BD which focus on longitudinal course in the research community due to emerging supportive data. Advances in longitudinal statistical methods promise to further progress the field. METHODS The current study employed hidden Markov modeling to uncover empirically derived manic and depressive states from longitudinal data [i.e. Young Mania Rating Scale and Montgomery-Asberg Depression Rating Scale responses across five occasions from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study], estimate participants' probabilities of transitioning between these states over time (n = 3918), and evaluate whether clinical variables (e.g. rapid cycling and substance dependence) predict participants' state transitions (n = 3229). RESULTS Analyses identified three empirically derived mood states ('euthymic,' 'depressed,' and 'mixed'). Relative to the euthymic and depressed states, the mixed state was less commonly experienced, more temporally unstable, and uniquely associated with rapid cycling, substance use, and psychosis. Individuals assigned to the mixed state at baseline were relatively less likely to be diagnosed with BD-II (v. BD-I), more likely to present with a mixed or (hypo)manic episode, and reported experiencing irritable and elevated mood more frequently. CONCLUSIONS The results from the current study represent an important step in defining, and characterizing the longitudinal course of, empirically derived mood states that can be used to form the foundation of objective, empirical attempts to define meaningful subtypes of affective illness defined by clinical course.
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Affiliation(s)
- James J. Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of SC, Charleston, SC
| | - Bryan K. Tolliver
- Department of Psychiatry and Behavioral Sciences, Medical University of SC, Charleston, SC
| | - Stacia M. DeSantis
- School of Public Health, University of Texas Health Science Center, Houston, TX
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Lavallee K, Schuck K, Blatter-Meunier J, Schneider S. Transgenerational improvements following child anxiety treatment: An exploratory examination. PLoS One 2019; 14:e0212667. [PMID: 30817752 PMCID: PMC6394948 DOI: 10.1371/journal.pone.0212667] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 02/02/2019] [Indexed: 11/18/2022] Open
Abstract
Background The present study conducted secondary analyses of a randomized controlled trial to examine the transgenerational relationship between cognitive-behavioral therapy for child Separation Anxiety Disorder (SepAD) and the mental health of parents. Symptoms of anxiety and depression were compared before and after child treatment between parents of children treated for SepAD and parents of healthy children, who did not receive any treatment. Methods One hundred and seven children aged 4–14 years with SepAD received one of two cognitive behavioral treatment programs for SepAD (TAFF; TrennungsAngstprogramm Für Familien; English: Separation Anxiety Family Therapy or CC; Coping Cat). Their parents (N = 189; 101 mothers and 88 fathers) were assessed at baseline and post-treatment for symptoms of separation anxiety, general anxiety, and depression. A comparison group of parents (N = 74; 42 mothers and 32 fathers) of 45 children without SepAD, who did not receive any treatment, were also assessed. Results Results indicated a significant interaction effect between group and time on mothers’ depression and separation anxiety, indicating that maternal symptoms of depression and separation anxiety improved in the child treatment condition in comparison to mothers of healthy children. There was no significant improvement in parental pathology levels among fathers of children treated for SepAD. Conclusions Treatment for child SepAD may have subsequent positive effects on mothers’ own levels of separation anxiety and depression, though the mechanisms are yet unknown. Future studies are needed that test the transgenerational effect of child SepAD treatment on parental mental health as the primary research question.
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Parker G, Tavella G, Hadzi-Pavlovic D. Identifying and differentiating melancholic depression in a non-clinical sample. J Affect Disord 2019; 243:194-200. [PMID: 30245251 DOI: 10.1016/j.jad.2018.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Received: 04/26/2018] [Revised: 08/06/2018] [Accepted: 09/11/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Differentiating melancholic and non-melancholic depressive disorders and evaluating whether they differ categorically or dimensionally has had a lengthy history, but has not previously been evaluated in a non-clinical adolescent sample. METHODS We studied a sample of 1579 senior high school students and evaluated the capacity of the Sydney Melancholia Prototype Index (SMPI) to differentiate melancholic from non-melancholic depression, both using a 'top down' strategy of imposing a pre-established cut-off score and a 'bottom up' strategy of employing latent class analyses. RESULTS The two strategies respectively generated prevalence figures of 3.4% and 8.1% of the students having experienced a melancholic depressive episode and with the difference reflecting the LCA assigning some students who did not reach the pre-established cut-off score for the SMPI in the putative melancholic class. The principal latent class analysis failed to generate pristine melancholic and non-melancholic depressive classes, in that it also generated an 'intermediate' as well as a non-clinical depressive class. Both SMPI strategies identified similar symptoms-such as anhedonia and anergia-and several illness correlates that best differentiated those assigned melancholia status, and both strategies confirmed melancholia assignment being associated with factors indicative of more severe depressive disorders and of likely melancholic depression. LIMITATIONS Data were assessed by self-report only, only lifetime depression was assessed, and no other depressive diagnostic validating measure was administered. CONCLUSIONS The SMPI appears capable of identifying and differentiating melancholic from non-melancholic depression in a non-clinical adolescent sample.
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Affiliation(s)
- Gordon Parker
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia.
| | - Gabriela Tavella
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Dusan Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
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