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Zhang Z, Xu H, Liping C, Wang Y. Renewable energy reduces domestic depression but increases depression for neighboring countries: evidence of spatial effects from 181 countries worldwide. BMC Public Health 2025; 25:1676. [PMID: 40329252 PMCID: PMC12056998 DOI: 10.1186/s12889-025-22323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 03/13/2025] [Indexed: 05/08/2025] Open
Abstract
BACKGROUND Depression poses a significant global public health challenge, affecting millions of people worldwide. The utilization of renewable energy holds potential for improving mental health by reducing air pollution and promoting green spaces. PURPOSE This study aims to investigate the impact of renewable energy use on depression, with a focus on its spatial effects and the mediating roles of air pollution reduction and green space expansion. METHODS Data from 181 countries were analyzed using a two-way fixed effects model and the Spatial Durbin Model (SDM). Depression-related metrics, including Disability-Adjusted Life Years (DALYs), Age-Standardized Disability-Adjusted Life Years Rate (ASDR), prevalence, and Age-Standardized Prevalence Rate (ASPR), were evaluated. RESULTS Renewable energy use significantly reduces DALYs, ASDR, prevalence, and ASPR within a country, but it also significantly increases the risk of depression in neighboring countries. The impact of renewable energy on depression varies by gender, age, and SDI level, being more pronounced for males and the 50-74 age group. The effect is significant in high and low SDI countries but not in middle SDI countries, indicating a "middle-income trap." CONCLUSION Renewable energy can improve mental health by reducing air pollution and promoting green spaces. However, policymakers need to consider spatial effects and tailor policies accordingly to maximize health benefits.
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Affiliation(s)
- Zheng Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Huijie Xu
- School of Education, Huazhong University of Science and Technology, Wuhan, China
| | - Cui Liping
- Human Resources Department, Hebei Vocational University of Technology and Engineering, Hebei, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Zhang G, Yang Z, Luo N, Busschbach J. Comparing the Measurement Properties of the Preliminary Version of the EuroQol Health and Well-Being and EQ-5D-5L in Patients, Healthy General Public, and Caregivers. Value Health Reg Issues 2025; 47:101081. [PMID: 39965310 DOI: 10.1016/j.vhri.2025.101081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 11/16/2024] [Accepted: 12/19/2024] [Indexed: 02/20/2025]
Abstract
OBJECTIVES The EuroQol Health and Well-Being (EQ-HWB) is a new generic quality of life (QOL) questionnaire to capture broader aspects of health and well-being than EQ-5D-5L. This study examined the measurement properties of the preliminary EQ-HWB version in patients, healthy individuals, and healthy caregivers. METHODS Respondents (1) with or without caregiver tasks, (2) with different diseases, or (3) in full health were recruited online. Ceiling effects, convergent and divergent validity, known disease, and caregiver group differences were explored, and an exploratory factor analysis was used. RESULTS A total of 500 respondents were recruited, including 100 healthy individuals (excluding 40 healthy caregivers), 122 with chronic hepatitis B, 101 with HIV/AIDS, 107 with depression, and 90 with generalized anxiety disorder. The EQ-HWB activities dimension correlated most highly with the EQ-5D-5L mobility, self-care, and usual activities dimensions, whereas EQ-HWB physical sensation dimension was strongly related to the EQ-5D-5L pain/discomfort dimension. Additional EQ-HWB dimensions (self-identity, cognition, autonomy, feelings and emotions, and relationships) aligned most closely with the EQ-5D-5L anxiety/depression dimension. Both instruments differentiated disease burden across healthy individuals and patients and identified caregiving roles. The EQ-5D-5L revealed 3 factors in exploratory factor analysis, whereas the EQ-HWB included 2 additional factors (F1 cognition, F2 physical activity, F3 feelings and emotions, F4 positive items, and F5 physical sensation). CONCLUSIONS EQ-HWB is able to measure health-related QOL in healthy people, patients, and caregivers given that it shares the same conceptual structure with EQ-5D. EQ-HWB is more sensitive in patients with mental health conditions than the EQ-5D. These results support that EQ-HWB captures well-being alongside health-related QOL.
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Affiliation(s)
- Guangjie Zhang
- Department of Psychiatry, Section Medical Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Zhihao Yang
- Department of Psychiatry, Section Medical Psychology, Erasmus MC, Rotterdam, The Netherlands; Health Services Management Department, Guizhou Medical University, Guiyang, China.
| | - Nan Luo
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jan Busschbach
- Department of Psychiatry, Section Medical Psychology, Erasmus MC, Rotterdam, The Netherlands
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Selinheimo S, Vuokko A, Lappalainen P, Keinonen K, Sainio M, Lappalainen R, Paunio T. The association between quality of life and psychological flexibility, depressive, anxiety or insomnia symptoms in patients with persistent indoor environment-related symptoms or chronic fatigue. BMC Psychol 2025; 13:229. [PMID: 40069901 PMCID: PMC11900652 DOI: 10.1186/s40359-025-02549-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/26/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND Persistent physical symptoms (PPS) can significantly impair health-related quality of life (HRQoL) and are often accompanied by psychiatric comorbidity. Psychological flexibility (PF), characterized by the ability to adapt functionally and congruently to diverse situations based on personal values, may play a crucial role in determining HRQoL. This study aims to examine the associations between symptoms of depression, anxiety or insomnia or PF and HRQoL among individuals with PPS associated with (i) the indoor environment (IE), (ii) chronic fatigue, or (iii) both. METHODS We utilized the baseline data (n = 103) from a randomized controlled trial focused on improving the HRQoL of individuals (mean age 46.1, SD 7.8, 86% women) experiencing PPS associated with IE or chronic fatigue. Self-report questionnaires were administered to evaluate symptoms of depression, anxiety, insomnia, and dimensions of PF, including acceptance, cognitive fusion, and thought suppression. The primary outcome was HRQoL, assessed using a 15D questionnaire. The association between symptoms, PF dimensions, and HRQoL was examined using Pearson's correlation and ANCOVA. RESULTS Symptoms of depression, anxiety, and insomnia were negatively associated with HRQoL (p <.001) across all participants. Among individuals with PPS associated with IE, higher PF was significantly associated with higher HRQoL. No association was found between PF and HRQoL in those with chronic fatigue-associated PPS or both conditions. CONCLUSIONS PF associated with positive outcomes in HRQoL in individuals with PPS associated with the indoor environment, but not in those with chronic fatigue. Further research on the differences between these groups is warranted to enhance treatment targeting. TRIAL REGISTRATION Clinicaltrials.gov NCT04532827 (registered 26.08.2020).
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Affiliation(s)
| | - Aki Vuokko
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Päivi Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Markku Sainio
- Outpatient Clinic for Functional Disorders, HUS Helsinki University Hospital, Helsinki, Finland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Paunio
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
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Shah HA, Jutlla G, Herrera-Restrepo O, Graham J, Hicks KA, Carrico J, Grace M, Clements DE, Burman C, Sohn WY, Kuylen E, Begum S, Kocaata Z. Public Health Impact of Introducing a Pentavalent Vaccine Against Invasive Meningococcal Disease in the United States. PHARMACOECONOMICS 2025; 43:311-329. [PMID: 39585581 PMCID: PMC11825582 DOI: 10.1007/s40273-024-01439-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/22/2024] [Indexed: 11/26/2024]
Abstract
BACKGROUND Invasive meningococcal disease (IMD) is primarily associated with five Neisseria meningitidis serogroups: A, B, C, W, or Y. In the United States (US), available vaccines protect against serogroups B (MenB), A, C, W, and Y (MenACWY), and A, B, C, W, and Y (MenABCWY). The Advisory Committee on Immunization Practices is re-evaluating the adolescent meningococcal vaccination schedule with varying recommendation formats. This analysis aimed to predict which schedule could avert the most IMD cases and have the most positive public health impact (PHI). METHODS An epidemiological model compared the 15-year PHI of vaccination schedules using MenB, MenACWY, and/or MenABCWY vaccines versus current US standard of care (SoC). Varying coverage rates reflected routine, shared clinical decision making, and risk-based recommendations. Sensitivity analyses assessed robustness of the results to different inputs/assumptions. RESULTS The most positive PHI compared with SoC was observed with one dose of MenACWY at 11 years of age and two doses of MenABCWY (6 months apart) at 16 years of age, assuming routine recommendation and coverage reflecting real-world uptake of MenACWY. This strategy resulted in 123 IMD cases averted (MenB: 59, MenACWY: 64), 17 deaths prevented, 574 life-years saved, and 757 quality-adjusted life-years gained versus SoC. Eliminating MenACWY vaccination at 11 years was found to result in an additional IMD burden. CONCLUSION A routinely recommended two-dose pentavalent vaccine, with doses administered 6 months apart at 16 years of age, alongside the routinely recommended MenACWY vaccine at 11 years of age, would improve the PHI and benefits of IMD vaccination to society.
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Affiliation(s)
- Hiral Anil Shah
- GSK, London, UK.
- Neisseria Portfolio, Value Evidence & Outcomes Team, 90 Great West Road, Brentford, TW8 9GS, UK.
| | | | | | | | | | | | - Mei Grace
- RTI Health Solutions, Research Triangle Park, NC, USA
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Terhorst Y, Knauer J, Philippi P, Baumeister H. The Relation Between Passively Collected GPS Mobility Metrics and Depressive Symptoms: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e51875. [PMID: 39486026 PMCID: PMC11568401 DOI: 10.2196/51875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 07/02/2024] [Accepted: 07/26/2024] [Indexed: 11/03/2024] Open
Abstract
BACKGROUND The objective, unobtrusively collected GPS features (eg, homestay and distance) from everyday devices like smartphones may offer a promising augmentation to current assessment tools for depression. However, to date, there is no systematic and meta-analytical evidence on the associations between GPS features and depression. OBJECTIVE This study aimed to investigate the between-person and within-person correlations between GPS mobility and activity features and depressive symptoms, and to critically review the quality and potential publication bias in the field. METHODS We searched MEDLINE, PsycINFO, Embase, CENTRAL, ACM, IEEE Xplore, PubMed, and Web of Science to identify eligible articles focusing on the correlations between GPS features and depression from December 6, 2022, to March 24, 2023. Inclusion and exclusion criteria were applied in a 2-stage inclusion process conducted by 2 independent reviewers (YT and JK). To be eligible, studies needed to report correlations between wearable-based GPS variables (eg, total distance) and depression symptoms measured with a validated questionnaire. Studies with underage persons and other mental health disorders were excluded. Between- and within-person correlations were analyzed using random effects models. Study quality was determined by comparing studies against the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. Publication bias was investigated using Egger test and funnel plots. RESULTS A total of k=19 studies involving N=2930 participants were included in the analysis. The mean age was 38.42 (SD 18.96) years with 59.64% (SD 22.99%) of participants being female. Significant between-person correlations between GPS features and depression were identified: distance (r=-0.25, 95% CI -0.29 to -0.21), normalized entropy (r-0.17, 95% CI -0.29 to -0.04), location variance (r-0.17, 95% CI -0.26 to -0.04), entropy (r=-0.13, 95% CI -0.23 to -0.04), number of clusters (r=-0.11, 95% CI -0.18 to -0.03), and homestay (r=0.10, 95% CI 0.00 to 0.19). Studies reporting within-correlations (k=3) were too heterogeneous to conduct meta-analysis. A deficiency in study quality and research standards was identified: all studies followed exploratory observational designs, but no study referenced or fully adhered to the international guidelines for reporting observational studies (STROBE). A total of 79% (k=15) of the studies were underpowered to detect a small correlation (r=.20). Results showed evidence for potential publication bias. CONCLUSIONS Our results provide meta-analytical evidence for between-person correlations of GPS mobility and activity features and depression. Hence, depression diagnostics may benefit from adding GPS mobility and activity features as an integral part of future assessment and expert tools. However, confirmatory studies for between-person correlations and further research on within-person correlations are needed. In addition, the methodological quality of the evidence needs to improve. TRIAL REGISTRATION OSF Registeries cwder; https://osf.io/cwder.
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Affiliation(s)
- Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
- German Center for Mental Health (DZPG), Partner Site Munich-Augsburg, Munich, Germany
| | - Johannes Knauer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Paula Philippi
- Department of Clinical Child and Adolescent Psychology and Psychotherapy, Institute of Psychology, University of Wuppertal, Wuppertal, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
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Havnen A, Lindberg MS, Lundqvist J, Brattmyr M, Hjemdal O, Solem S. Health-related quality of life in psychiatric outpatients: a cross-sectional study of associations with symptoms, diagnoses, and employment status. Qual Life Res 2024; 33:3093-3105. [PMID: 39110377 PMCID: PMC11541330 DOI: 10.1007/s11136-024-03748-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 11/07/2024]
Abstract
BACKGROUND This cross-sectional study aimed to explore health-related quality of life (HRQoL) in a large heterogeneous patient sample seeking outpatient treatment at a specialist mental health clinic. METHOD A sample of 1947 patients with common mental disorders, including depressive-, anxiety-, personality-, hyperkinetic- and trauma-related disorders, completed the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) to assess HRQoL. We investigated clinical and sociodemographic factors associated with the EQ-5D index and the EQ Visual Analogue Scale (VAS) using regression analyses. RESULTS The sample reported lower HRQoL compared with the general population and primary mental health care patients. Sick leave, disability pension, work assessment allowance, and more symptoms of anxiety and depression were associated with lower EQ-5D index and EQ VAS scores. Furthermore, being male, use of pain medication and having disorders related to trauma were associated with reduced EQ-5D index scores, while hyperkinetic disorders were associated with higher EQ-5D index scores. CONCLUSION HRQoL of psychiatric outpatients is clearly impaired. This study indicated a significant association between employment status, symptom severity, and HRQoL in treatment-seeking outpatients. The findings highlight the importance of assessing HRQoL as part of routine clinical assessment.
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Affiliation(s)
- Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway.
- Division of Psychiatry, Nidaros Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway.
| | - Martin Schevik Lindberg
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
- Health and welfare, Trondheim Municipality, Norway
| | - Jakob Lundqvist
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Martin Brattmyr
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
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Tan YB, Tay EH, Shahwan S, Zhang Y, Sambasivam R, Subramaniam M. Associations between parental bonding and health-related quality of life in a clinical sample of youths aged 14-35 years in Singapore. Singapore Med J 2024; 65:579-585. [PMID: 38993101 PMCID: PMC11575725 DOI: 10.4103/singaporemedj.smj-2023-223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/15/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Individuals with psychiatric disorders tend to report having poorer bonds with their parents during their early years. These individuals often experience lower quality of life as well. This study investigated the associations between aspects of parental bonding and health-related quality of life (HRQOL) in a clinical sample of youths. It was hypothesised that high parental care and low parental overprotectiveness would be associated with higher levels of HRQOL. METHODS Data were obtained from a larger cross-sectional study. The sample consisted of 400 psychiatric outpatients: 191 patients aged 14-21 (mean ± standard deviation 18.1 ± 2.22) years and 209 patients aged 22-35 (28.0 ± 4.33) years. The Parental Bonding Instrument was used to measure parental care and overprotectiveness. Short Form-12 measured physical health (physical component summary [PCS]) and mental health (mental component summary [MCS]) components of HRQOL, and the 8-item Patient Health Questionnaire assessed depressive symptoms. These scales and a sociodemographic form were self-administered. Multivariable linear regression was used for analysis. RESULTS About half of the sample reported affectionless control for mothers (46.6%) and fathers (45.9%). After controlling for sociodemographic variables, no significant relationship was found between aspects of parental bonding and PCS scores. Maternal care was associated with MCS scores (β = 0.32, P < 0.01) and PHQ-8 scores (β = -0.12, P < 0.05). CONCLUSION Our results suggest that youths who experienced quality care from their mothers exhibit better mental health functioning despite their clinical diagnoses, which suggests that early maternal care exerts an overall long-term protective effect. Early parental education that promotes positive parenting practices could improve the overall HRQOL of individuals in adulthood despite their clinical diagnoses.
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Affiliation(s)
- Yoke Boon Tan
- Research Division, Institute of Mental Health, Singapore
| | - Eng Hong Tay
- Research Division, Institute of Mental Health, Singapore
| | | | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore
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Aucoin M, LaChance L, van der Wurff I, McLaren M, Monteiro S, Miller S, Jenkins A, Sabri E, Cooley K. Dietary counseling plus omega-3 supplementation in the treatment of generalized anxiety disorder: results of a randomized wait-list controlled pilot trial (the 'EASe-GAD Trial'). Nutr Neurosci 2024:1-14. [PMID: 39316026 DOI: 10.1080/1028415x.2024.2403901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
OBJECTIVES Clinical evidence suggests that nutrition interventions can significantly improve symptoms of major depressive disorder; however, the effect on clinical anxiety symptoms in individuals with anxiety disorders has not been studied. The primary objective of the present study was to assess the feasibility and acceptability of a nutrition intervention. The secondary objectives included assessing changes in anxiety symptom severity, diet quality, self-efficacy, mindful eating, quality of life, and biomarkers. METHODS This study was a randomized, wait-list controlled pilot trial delivering a 12-week, biweekly dietary counseling intervention and omega-3 supplementation to 50 adult women with generalized anxiety disorder. Questionnaires and blood work were completed at baseline, after the waiting period, and after the intervention. RESULTS 443 individuals expressed interest within eight months; 50 met the criteria for enrollment. The mean number of sessions attended was 6.4. Final questionnaires were completed by 46 participants. Eighty-four percent of participants strongly agreed with the statement 'My experience during this study was positive'. The mean anxiety symptom severity score in the intervention group was 26.2 (95% CI 22.94-29.48) at baseline and 11.0 (95% CI 8.05-13.87) at week 12. The mean diet quality score was 7.2 (95% CI 6.32-8.10) and 10.5 (95% CI 9.55-11.49) at baseline and week 12, respectively. Among the waitlist participants, the mean baseline anxiety score was 29.3 (95% CI 24.73-33.91) and 26.8 (95% CI 22.09-31.56) at week 12. DISCUSSION This study was feasible and acceptable. Participation in the intervention was associated with a decrease in anxiety symptoms. These findings lay the foundation for large-scale studies. Trial registration: ClinicalTrials.gov NCT05573672.
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Affiliation(s)
- Monique Aucoin
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Laura LaChance
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Psychiatry, St. Mary's Hospital, Montreal, Canada
| | - Inge van der Wurff
- Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Meagan McLaren
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
| | - Sasha Monteiro
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
| | | | | | - Elham Sabri
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kieran Cooley
- Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada
- Southern Cross University, Lismore, Australia
- University of Technology Sydney, Sydney, Australia
- Human Biology, University of Toronto, Toronto, Canada
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Sevilla JP, Tortorice D, Kantor D, Regan J, Meszaros KH, Beck EC, Begum N, Bloom DE. Lifecycle model-based evaluation of infant 4CMenB vaccination in the UK. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:1133-1146. [PMID: 38182698 PMCID: PMC11377635 DOI: 10.1007/s10198-023-01654-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/22/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVES Invasive meningococcal disease, an uncommon but severe disease, imposes catastrophic health and economic burdens. Cost-utility analysis (CUA) assumes separability in lifetime health and economic variables and cannot capture the full value of preventing such burdens. We overcome these limitations with a retrospective societal perspective cost-benefit analysis (CBA) of meningococcal serogroup B vaccination (4CMenB) of one infant cohort in the United Kingdom using a health-augmented lifecycle model (HALM) incorporating health's interactions with consumption, earnings, non-market time and financial risk. METHODS We used a static Markov model of vaccination's health impact and an HALM to estimate the private willingness to pay (PWTP) for the intrinsic and instrumental value of health under perfect capital markets, financial risk protection in the absence of insurance against permanent disability, parental spillovers, and acute phase disability. We estimated social WTP (SWTP) incorporating social severity preferences. We estimated rates of return that inform health payer reimbursement decisions, finance ministry budgeting decisions, and legislature taxation decisions. An expert Advisory Board investigated the validity of applying the HALM to infant 4CMenB. RESULTS The PWTP for a 2 + 1 vaccination schedule is £395, comprising £166 of disability insurance value, £79 of positive parental spillover value, £28 in the value of averting acute phase disability, and £122 in residual intrinsic and instrumental value of health. SWTP is £969. CONCLUSIONS HALM-based CBA provides an empirically richer, more utility-theoretically grounded approach to vaccine evaluation than CUA, demonstrating good value for money for legislatures (based on private values) and for all decision-makers (based on social values).
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Affiliation(s)
- J P Sevilla
- Data for Decisions (DfD) LLC, 681 Main Street, Suite 3-37, Waltham, MA, 02457, USA.
| | - Daniel Tortorice
- Data for Decisions (DfD) LLC, 681 Main Street, Suite 3-37, Waltham, MA, 02457, USA
| | - David Kantor
- Data for Decisions (DfD) LLC, 681 Main Street, Suite 3-37, Waltham, MA, 02457, USA
| | - John Regan
- Data for Decisions (DfD) LLC, 681 Main Street, Suite 3-37, Waltham, MA, 02457, USA
| | | | | | | | - David E Bloom
- Data for Decisions (DfD) LLC, 681 Main Street, Suite 3-37, Waltham, MA, 02457, USA
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Remmerswaal KCP, Ten Have M, de Graaf R, van Balkom AJLM, Penninx BWJH, Batelaan NM. Risk factors of chronic course of anxiety and depressive disorders: a 3-year longitudinal study in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1607-1615. [PMID: 38015237 DOI: 10.1007/s00127-023-02591-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Risk factors of a chronic course of anxiety and depressive disorders were previously studied using a limited definition of recovery, i.e. remission of the index disorder. However, frequently, other mental disorders are present at follow-up. Thus, the course of anxiety and depressive disorders was represented too rosy and the identified determinants may not apply when using a broader, more realistic definition. Additionally, physical health risk factors have often been ignored. METHODS Data were used from two waves of the Netherlands Mental Health Survey and Incidence Study-2 including 509 respondents with 12-month anxiety disorder (panic disorder, social phobia, agoraphobia or generalized anxiety disorder) or/and major depressive disorder at baseline. Chronic course was defined as (1) presence of index disorder; and (2) presence of any anxiety, mood or substance use disorder (overall course) during the subsequent three years. Regression models were built with sociodemographic, clinical, and lifestyle/physical health indicators. Predictive accuracy was evaluated with area under the curve (AUC). RESULTS Chronic course of the index disorder was present among 24.8% of cases, whereas 38.7% had a chronic overall course. The accuracy of prediction of chronic course of the index disorder was suboptimal (AUC = 0.68) compared to prediction of overall course (AUC = 0.75). The main risk factors were baseline number of mental disorders, neuroticism, childhood abuse, parental psychopathology and alcohol use. Lifestyle and physical health indicators were marginally relevant. CONCLUSION Transdiagnostic risk factors are important in predicting overall course of anxiety and depressive disorders but cannot accurately predict chronic course of the index disorder.
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Affiliation(s)
- Karin C P Remmerswaal
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Anton J L M van Balkom
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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Sextl-Plötz T, Steinhoff M, Baumeister H, Cuijpers P, Ebert DD, Zarski AC. A systematic review of predictors and moderators of treatment outcomes in internet- and mobile-based interventions for depression. Internet Interv 2024; 37:100760. [PMID: 39139716 PMCID: PMC11320424 DOI: 10.1016/j.invent.2024.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/08/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024] Open
Abstract
This systematic review aimed to synthesize evidence on predictors and moderators of treatment outcomes in internet- and mobile-based interventions (IMIs) for depression, informing personalized care. A systematic search across PubMed, PsycInfo, and Cochrane yielded 33,002 results. Two reviewers independently performed screening, data extraction, risk of bias assessment, and methodological quality evaluation. Fifty-eight single studies (m = 466 analyses) focusing on baseline-predictors (59.7 %, m = 278), process-predictors (16.5 %, m = 77), and moderators (21.9 %, m = 102), and six individual patient data meta-analyses (m = 93) were included. Only 24.0 % (m = 112/466) of analyses in single studies and 15.1 % (m = 14/93) in individual patient data meta-analyses were significant. Evidence from single studies was rated as insufficient for all variable categories with only 2 out of 40 categories showing >50 % significant results. Baseline depression severity had the strongest predictive value with higher scores linked to better outcomes followed by variables indicative for the course-of-change. Other frequently analyzed and potentially relevant variables with significant results were adherence, age, educational level, ethnicity, relationship status, treatment history, and behavioral variables. More high quality quantitative studies with sufficient power are essential to validate and expand findings, identifying predictors and moderators specifically relevant in IMIs to explain differential treatment effects.
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Affiliation(s)
- Theresa Sextl-Plötz
- Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Germany
- Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany
| | - Maria Steinhoff
- Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute and World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Netherlands
- Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - David D. Ebert
- Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany
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12
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Mostafa IM, Mohamed AA, Alahmadi Y, Shehata AM, Almikhlafi MA, Omar MA. Facile, eco-friendly and sensitive fluorimetric approach for detection of chlorpromazine: Application in biological fluids and tablet formulations as well as greenness evaluation of the analytical method. LUMINESCENCE 2024; 39:e4897. [PMID: 39252443 DOI: 10.1002/bio.4897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/30/2024] [Accepted: 09/01/2024] [Indexed: 09/11/2024]
Abstract
Monitoring antipsychotic drugs in biological fluids, such as human serum and urine, is important for ensuring the safety and efficacy of psychiatric treatments. This process helps maintain therapeutic drug levels, minimize side effects, and optimize patient well-being. Chlorpromazine (CZ) is a widely prescribed antipsychotic drug used for conditions like schizophrenia, bipolar disorder, and acute psychosis. Almost all existing sensing techniques for CZ are either insensitive spectrophotometric methods or involve long and complex chromatographic procedures, limiting their routine use. In this work, we introduce a facile, green, and sensitive fluorimetric strategy with high reproducibility for detecting CZ in its pure form, tablet formulation, and spiked human plasma and urine without the need for derivatization reactions. The proposed method relies on the inhibition of the intramolecular photoinduced electron transfer (PET) effect by using 2.0 M acetic acid. This approach enables the linear detection of CZ from 3.0 to 600 ng/mL with remarkably low quantitation and detection limits of 1.51 and 0.49 ng/mL, respectively. Moreover, the developed method's greenness was evaluated.
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Affiliation(s)
- Islam M Mostafa
- Analytical Chemistry Department, Faculty of Pharmacy, Minia University, Minia, Egypt
| | - Abobakr A Mohamed
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Fayoum University, Faiyum, Egypt
| | - Yaser Alahmadi
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ahmed M Shehata
- Departement of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
- Departement of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Mohannad A Almikhlafi
- Departement of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Mahmoud A Omar
- Analytical Chemistry Department, Faculty of Pharmacy, Minia University, Minia, Egypt
- Pharmacognosy and Pharmaceutical Chemistry, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
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13
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Lawrence JM, Foote IF, Breunig S, Schaffer LS, Mallard TT, Grotzinger AD. Shared Genetic Liability across Systems of Psychiatric and Physical Illness. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.02.24311427. [PMID: 39132481 PMCID: PMC11312649 DOI: 10.1101/2024.08.02.24311427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Epidemiological literature has shown that there are extensive comorbidity patterns between psychiatric and physical illness. However, our understanding of the multivariate systems of relationships underlying these patterns is poorly understood. Using Genomic SEM and Genomic E-SEM, an extension for genomic exploratory factor analysis that we introduce and validate, we evaluate the extent to which latent genomic factors from eight domains, encompassing 76 physical outcomes across 1.9 million cases, evince genetic overlap with previously identified psychiatric factors. We find that internalizing, neurodevelopmental, and substance use factors are broadly associated with increased genetic risk sharing across all physical illness domains. Conversely, we find that a compulsive factor is protective against circulatory and metabolic illness, whereas genetic risk sharing between physical illness factors and psychotic/thought disorders was limited. Our results reveal pervasive risk sharing between specific groups of psychiatric and physical conditions and call into question the bifurcation of psychiatric and physical conditions.
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Affiliation(s)
- Jeremy M. Lawrence
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
| | - Isabelle F. Foote
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
| | - Sophie Breunig
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
| | - Lukas S. Schaffer
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
| | - Travis T. Mallard
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Andrew D. Grotzinger
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
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14
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de Pouvourville G, Breau-Brunel M, Loncle-Provot V, Beck E, Gaugain L, Nachbaur G, Pribil C. Public Health Impact and Cost-Effectiveness Analysis of 4-Component Meningococcal Serotype B Vaccination for Infants in France. PHARMACOECONOMICS - OPEN 2024; 8:539-557. [PMID: 38780884 PMCID: PMC11252096 DOI: 10.1007/s41669-024-00488-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND AND OBJECTIVES In France, meningococcal serogroup B (MenB) is the most common serogroup causing invasive meningococcal disease (IMD) in infants and young children. Our objective was to illustrate the impact of model choices on health outcomes and the cost-effectiveness of infant vaccination with the multicomponent meningococcal serogroup B vaccine (4CMenB) versus no vaccine in France. METHODS A previously published dynamic transmission-based cost-effectiveness model was adapted for the French context using updated, French-specific demographic, epidemiological, and cost data. IMD incidence and long-term sequelae were derived through analysis of French healthcare and surveillance databases. A collective perspective over a 100-year time horizon was adopted, with a discount rate of 2.5%, reduced to 1.5% after the first 30 years. Deterministic and probabilistic sensitivity and scenario analyses were performed. RESULTS In the base case analysis, infant vaccination with 4CMenB avoided 3101 MenB IMD cases in infants aged < 1 year (- 54%) and 6845 cases in all age groups (- 21%). The estimated incremental cost-effectiveness ratio was €316,272/quality-adjusted life-year (QALY) but was highly sensitive to the types of sequelae included, MenB incidence, vaccine effectiveness parameters, and consideration of life-expectancy in IMD survivors (range: €65,272/QALY to €493,218/QALY). CONCLUSIONS Using economic models compliant with French methodology guidelines, 4CMenB does not seem cost-effective; however, results are sensitive to model choices and 4CMenB immunization is an effective strategy to prevent MenB IMD cases and to improve quality of life and economic burden associated with MenB IMD treatment, especially with regard to long-term sequelae.
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Affiliation(s)
| | | | | | | | | | | | - Céline Pribil
- GSK, 23, rue François Jacob, 92500, Rueil-Malmaison, France.
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15
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Mihić L, Knežević G, Lazarević LB, Marić NP. Screening for depression in the Serbian general population sample: an alternative to the traditional patient health questionnaire-9 cut-off score. J Public Health (Oxf) 2024; 46:e15-e22. [PMID: 37934963 DOI: 10.1093/pubmed/fdad204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/14/2023] [Accepted: 10/11/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND The Patient Health Questionnaire (PHQ-9) score ≥ 10 balances best sensitivity and specificity when detecting probable depression in patients. In the general population, different cut-offs are suggested. European studies on general populations validating the PHQ-9 against a diagnostic interview to detect depression are rare. METHODS This was a cross-sectional observational epidemiological survey using multistage household probabilistic sampling to recruit a representative adult sample (N = 1203; age = 43.7 ± 13.6; 48.7% male). Mental disorders including current major depressive episode (MDE) were observer-rated (Mini International Neuropsychiatric Interview). The PHQ-9, quality of life (QoL), and loneliness were self-assessed. We performed validity and reliability tests of the PHQ-9 and receiver operating curve (ROC) analysis. RESULTS The Serbian PHQ-9 was internally consistent and correlated in the expected directions with QoL and loneliness. At the cut-off score ≥ 8, sensitivity was .85 and specificity was .91. ROC analysis showed that the area under the curve was .95, indicating that the Serbian PHQ-9 can discriminate very well between persons with/without MDE. CONCLUSIONS When the PHQ-9 is assessed against the structured diagnostic interview in the general population to detect depression, the cut-off of ≥8 balances best sensitivity and specificity.
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Affiliation(s)
- Ljiljana Mihić
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Novi Sad 21 000, Serbia
| | - Goran Knežević
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade 11 000, Serbia
| | - Ljiljana B Lazarević
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade 11 000, Serbia
| | - Nadja P Marić
- Department of Psychiatry, Faculty of Medicine, University of Belgarde, Belgrade 11 000, Serbia
- Department for Research and Education in Psychiatry, Institute of Mental Health, Belgrade 11 000, Serbia
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16
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Low F, Earleywine M. Educational Materials and Image Induction Increase Treatment Credibility. J Psychoactive Drugs 2024; 56:56-65. [PMID: 36682063 DOI: 10.1080/02791072.2022.2154722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/02/2022] [Accepted: 10/19/2022] [Indexed: 01/23/2023]
Abstract
Patient-perceived treatment credibility is linked to important outcome measures including symptom reduction, therapeutic alliance, patient satisfaction, and attrition rates. However, few studies have tested strategies to enhance treatment credibility. The present study investigates the effect of brief, written educational materials and the use of an image induction prime on perceptions of credibility for cognitive behavioral therapy and psilocybin-assisted therapy for depression. Participants (N = 493) rated the perceived credibility of depression treatments before and after reading brief educational materials. Half of the participants were asked an image induction question containing the construct of open-mindedness. Results indicate that brief educational materials of about 300 words significantly increased perceived treatment credibility for both therapies, with a large effect size (Cohen's d = .91). The use of an image induction prime further increased perceived credibility for psilocybin-assisted therapy for depression (Cohen's d = .38). These strategies offer an efficient and cost-effective way to enhance treatment credibility. Future studies testing variations of the image induction prime might prove fruitful for optimizing the technique.
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Affiliation(s)
- Fiona Low
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
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17
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Aucoin M, LaChance L, van der Wurff I, Miller S, Naidoo U, Jenkins A, Cooley K. Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the "EASe-GAD Trial"). Pilot Feasibility Stud 2023; 9:186. [PMID: 37950301 PMCID: PMC10636887 DOI: 10.1186/s40814-023-01414-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Anxiety disorders are prevalent and disabling conditions involving excessive worry and tension. Generalized anxiety disorder (GAD), the most common anxiety disorder, affects 5% of individuals from high-income countries and many individuals report that treatment options are not accessible, effective, or tolerable. Clinical evidence suggests that nutrition interventions, based on the Mediterranean diet and supplementation of omega-3 fatty acids, can significantly improve symptoms of depression; however, the effect of nutrition interventions on anxiety symptoms has not been studied in a clinical population. The primary objective of the present study is to assess the feasibility and acceptability of a dietary counselling and omega-3 fatty acid supplementation intervention delivered to adult women with GAD. The secondary objectives include assessing changes in anxiety symptom severity, assessing changes in quality of life, assessing changes in biomarkers, and evaluating the components of the program. METHODS This study is a randomized, wait-list controlled pilot trial delivering a 12-week, dietary counselling intervention and omega-3 supplementation to 50 adult women with GAD. Participants will complete seven individual counselling sessions which include education, personalized recommendations, mindful eating techniques, motivational interviewing, and goal setting. They will be provided with recipes, instructional videos, and food items. The intervention is designed based on the Social Cognitive Theory and previous research that has been done by the author team to identify dietary constituents with the most evidence to support their use in the treatment of anxiety disorders. Questionnaires and blood work will be completed at baseline, after the waiting period (for those in the waitlist group), and after the intervention. DISCUSSION Results from this study will lay the foundation for future large-scale studies in this area and may provide preliminary evidence of the role of diet counselling and omega-3 supplementation in the management of GAD. Research on the role of nutrition in psychiatric care has been identified as a priority by a number of international organizations. The present trial directly addresses the call for the research that is most needed to advance the field. TRIAL REGISTRATION This protocol was registered at ClinicalTrials.gov on October 10, 2022; NCT05573672 . Trial sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416-498-1255. Steering committee: Composed of MA, LL, KC, IvdW, SM, UN, AJ. The committee meets monthly to oversee the trial. Protocol identifier: CCNM_EASe-GADCT_2201v4.
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Affiliation(s)
- Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, Canada.
- University of Guelph, Guelph, Canada.
| | - Laura LaChance
- McGill University, Montreal, Canada
- St. Mary's Hospital, Montreal, Canada
| | - Inge van der Wurff
- Health Psychology, Faculty of Psychology, Open University of the Netherlands, Utrecht, Netherlands
| | | | - Umadevi Naidoo
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | | | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, Canada
- Southern Cross University, Lismore, Australia
- University of Technology Sydney, Ultimo, Australia
- Pacific College of Health and Science, San Diego, USA
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18
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Maj A, Michalak N, Graczykowska A, Andersson G. The effect of internet-delivered cognitive behavioral therapy for depression and anxiety on quality of life: A meta-analysis of randomized controlled trials. Internet Interv 2023; 33:100654. [PMID: 37555075 PMCID: PMC10404731 DOI: 10.1016/j.invent.2023.100654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023] Open
Abstract
Although numerous studies have examined the effects of internet-delivered cognitive behavioral therapy (iCBT) for depression and anxiety on quality of life, no meta-analysis has yet been conducted to integrate the results of these studies. We conducted systematic searches in PubMed, Cochrane, and PsycInfo, which included terms for treatment type, modality of delivery, condition, and main outcome. We included studies that met the following inclusion criteria: (a) randomized controlled trials, (b) patients allocated to some form of the control condition, (c) patients receiving some type of treatment of anxiety and/or depression involving Internet-delivered Cognitive Behavioral Therapy, (d) use of a validated outcome measure assessing the level of quality of life, (e) conducted with adult participants diagnosed with anxiety disorder and/or unipolar depression, (f) papers written in English. We analyzed 40 randomized controlled trials with a total of 4289 participants that met inclusion criteria. The pooled between-group effect size for the quality of life overall score was small (g = 0.35, 95 % CI: 0.26-0.44, p = .0001), favoring iCBT over the control conditions. Regarding the distinct quality of life domains measured by the World Health Organization Quality of Life Assessment, a statistically significant difference between iCBT and control conditions was found only for the physical health domain (g = 0.56, 95 % CI: 0.06-1.07, p = .029), in favor of iCBT. In both cases, heterogeneity was moderate. While the effect on the quality of life is small (the overall quality of life score) to moderate (the physical health domain score), we conclude that iCBT for depression and anxiety may be a promising approach for improving the quality of life of patients.
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Affiliation(s)
- Anna Maj
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Natalia Michalak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Agata Graczykowska
- Faculty of Design, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning; Department of Biomedical and Clinical Sciences, Linköping University, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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19
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Karpov B, Lipsanen JO, Ritola V, Rosenström T, Saarni S, Pihlaja S, Stenberg JH, Laizane P, Joffe G. The Overall Anxiety Severity and Impairment Scale as an Outcome Measure in Internet-Delivered Cognitive Behavioral Therapy for Anxiety Disorders: Observational Study. J Med Internet Res 2023; 25:e45362. [PMID: 37590055 PMCID: PMC10472172 DOI: 10.2196/45362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Internet-delivered cognitive behavioral therapy (iCBT) is effective in the treatment of anxiety disorders. iCBT clinical trials use relatively long and time-consuming disorder-specific rather than transdiagnostic anxiety measurements. Overall Anxiety Severity and Impairment Scale (OASIS) is a brief self-report scale that could offer a universal, easy-to-use anxiety measurement option in disorder-specific and transdiagnostic iCBT programs. OBJECTIVE We aimed to investigate relationships between OASIS and disorder-specific instruments in iCBT. We expected these relationships to be positive. METHODS We investigated patients in original nationwide iCBT programs for generalized anxiety disorder (GAD), obsessive-compulsive disorder, panic disorder, and social anxiety disorder, which were administered by Helsinki University Hospital, Finland. In each program, anxiety symptoms were measured using both disorder-specific scales (the 7-item Generalized Anxiety Disorder scale, Penn State Worry Questionnaire, revised Obsessive-Compulsive Inventory, Panic Disorder Severity Scale, and Social Phobia Inventory) and by OASIS. A general linear model for repeated measures (mixed models) and interaction analysis were used for investigating the changes and relationships in the mean scores of OASIS and disorder-specific scales from the first session to the last one. RESULTS The main effect of linear mixed models indicated a distinct positive association between OASIS and disorder-specific scale scores. Interaction analysis demonstrated relatively stable associations between OASIS and the revised Obsessive-Compulsive Inventory (F822.9=0.09; 95% CI 0.090-0.277; P=.32), and OASIS and the Panic Disorder Severity Scale (F596.6=-0.02; 95% CI -0.108 to -0.065; P=.63) from first the session to the last one, while the 7-item Generalized Anxiety Disorder scale (F4345.8=-0.06; 95% CI -0.109 to -0.017; P=.007), Penn State Worry Questionnaire (F4270.8=-0.52; 95% CI -0.620 to -0.437; P<.001), and Social Phobia Inventory (F862.1=-0.39; 95% CI -0.596 to -0.187; P<.001) interrelated with OASIS more strongly at the last session than at the first one. CONCLUSIONS OASIS demonstrates clear and relatively stable associations with disorder-specific symptom measures. Thus, OASIS might serve as an outcome measurement instrument for disorder-specific and plausibly transdiagnostic iCBT programs for anxiety disorders in regular clinical practice.
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Affiliation(s)
- Boris Karpov
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | | | - Ville Ritola
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Suoma Saarni
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Satu Pihlaja
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jan-Henry Stenberg
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Grigori Joffe
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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20
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Quang Dao P, Dat PT, Khoa NN. Anxiety as a mediator in the relationship between the socioeconomic impact of COVID-19 and quality of life: a cross-sectional study in Vietnam. PSYCHOL HEALTH MED 2023; 28:2526-2536. [PMID: 36878882 DOI: 10.1080/13548506.2023.2188231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Previous studies have investigated the effects of the pandemic on quality of life; both economical and psychosocial effects were explored. Some studies also mentioned mediating factors as mechanisms in this relationship; however, the mediating role of anxiety has not been examined. The present study examined the mediating effects of anxiety on the relationship between socioeconomic impact of COVID-19 and quality of life. An online survey of 280 Vietnamese residents was conducted in the context of the pandemic outbreak. Anxiety was found to be a completely mediating variable in the association between the socioeconomic impact of the pandemic and quality of life during the lockdown period. This finding contributes to a better understanding of how the pandemic affects people's quality of life and serves as the foundation for lessening the negative effects of the epidemic on people's lives.
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Affiliation(s)
- Pham Quang Dao
- Faculty of Psychology, Ural Federal University, Yekaterinburg, Sverdlovsk Oblast, Russia
| | - Pham Tien Dat
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh, Vietnam
| | - Nguyen Ngoc Khoa
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh, Vietnam
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21
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Kogias N, Geurts DEM, Krause F, Speckens AEM, Hermans EJ. Study protocol for a randomised controlled trial investigating the effects of Mindfulness Based Stress Reduction on stress regulation and associated neurocognitive mechanisms in stressed university students: the MindRest study. BMC Psychol 2023; 11:194. [PMID: 37393359 PMCID: PMC10315027 DOI: 10.1186/s40359-023-01220-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Stress-related disorders are a growing public health concern. While stress is a natural and adaptive process, chronic exposure to stressors can lead to dysregulation and take a cumulative toll on physical and mental well-being. One approach to coping with stress and building resilience is through Mindfulness-Based Stress Reduction (MBSR). By understanding the neural mechanisms of MBSR, we can gain insight into how it reduces stress and what drives individual differences in treatment outcomes. This study aims to establish the clinical effects of MBSR on stress regulation in a population that is susceptible to develop stress-related disorders (i.e., university students with mild to high self-reported stress), to assess the role of large-scale brain networks in stress regulation changes induced by MBSR, and to identify who may benefit most from MBSR. METHODS This study is a longitudinal two-arm randomised, wait-list controlled trial to investigate the effects of MBSR on a preselected, Dutch university student population with elevated stress levels. Clinical symptoms are measured at baseline, post-treatment, and three months after training. Our primary clinical symptom is perceived stress, with additional measures of depressive and anxiety symptoms, alcohol use, stress resilience, positive mental health, and stress reactivity in daily life. We investigate the effects of MBSR on stress regulation in terms of behaviour, self-report measures, physiology, and brain activity. Repetitive negative thinking, cognitive reactivity, emotional allowance, mindfulness skills, and self-compassion will be tested as potential mediating factors for the clinical effects of MBSR. Childhood trauma, personality traits and baseline brain activity patterns will be tested as potential moderators of the clinical outcomes. DISCUSSION This study aims to provide valuable insights into the effectiveness of MBSR in reducing stress-related symptoms in a susceptible student population and crucially, to investigate its effects on stress regulation, and to identify who may benefit most from the intervention. TRIAL REGISTRATION Registered on September 15, 2022, at clinicaltrials.gov, NCT05541263 .
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Affiliation(s)
- Nikos Kogias
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Dirk E M Geurts
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Centre for Mindfulness, Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Florian Krause
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne E M Speckens
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Centre for Mindfulness, Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erno J Hermans
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Avery M, LaVoice J. The effect of "failed" community mental health centers on non-white mortality. HEALTH ECONOMICS 2023; 32:1362-1393. [PMID: 36864606 DOI: 10.1002/hec.4671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 05/04/2023]
Abstract
The Community Mental Health Act of 1963 established Community Mental Health Centers (CMHCs) across the country with the goal of providing continuous, comprehensive, community-oriented care to people suffering from mental illness. Despite this program being considered a failure by most contemporary accounts, the World Health Organization advocates for a transition from the institutionalization of the mentally ill to a system of community-centered care. In this paper, we construct a novel dataset documenting the rollout of CMHCs from 1971 to 1981 to identify the effect of establishing a CMHC on county level mortality rates, focusing on causes of death related to mental illness. Though we find little evidence that access to a CMHC impacted mortality rates in the white population, we find large and robust effects for the non-white population, with CMHCs reducing suicide and homicide rates by 8% and 14%, respectively. CMHCs also reduced deaths from alcohol in the female non-white population by 18%. These results suggest the historical narrative surrounding the failure of this program does not represent the non-white experience and that community care can be effective at reducing mental health related mortality in populations with the least access to alternative treatment options.
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Affiliation(s)
- Mallory Avery
- Department of Economics, Monash University, Clayton, Australia
| | - Jessica LaVoice
- Department of Economics, Bowdoin College, University of Pittsburgh, Brunswick, Maine, USA
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23
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Finze A, Deleanu L, Weiss C, Ratliff M, Seiz-Rosenhagen M. Depression in brain tumor patients-early detection and screening. Support Care Cancer 2023; 31:339. [PMID: 37191815 DOI: 10.1007/s00520-023-07785-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/27/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Depres sion is reported in up to 90% of cancer patients but to this date, a standardized screening tool for depression specifically modified for patients diagnosed with brain tumors is lacking. Thus, this study aims to develop an adapted screening tool and identify a suitable time slot for screening. METHODS Sixty-one patients with brain lesions were interviewed prior to neurosurgical resection. For screening purposes, established depression scores were used. A study-specific questionnaire (SSQ) was developed based on patient interviews prior to the trial. Two subgroups were analyzed: patients with benign and patients with malignant tumors (including brain metastases). As a subgroup within malignant lesions, patients with glioblastoma (GBM) were also analyzed separately. RESULTS Of patients, 87.5% with GBM presented with results > 16 points on the Center for Epidemiologic Studies Depression Scale (CES-D) after surgery. A decline in patients with benign brain tumors (p = 0.0058) and an increase in patients with malignant tumors (p = 0.0491) could be shown over time for CES-D scores. In this study, we established a new prototype screening tool for depression. In patients diagnosed with GBM, the number of patients needed to screen for identification of symptoms of depression was 1.59. Best time for screening was 35 days after surgery. CONCLUSIONS Considering the high prevalence and low number needed to screen of depression in patients diagnosed with GBM, we strongly encourage their routine screening during follow-up appointments (35 days after surgery). We encourage a plan to further establish the questionnaire developed in this pilot study.
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Affiliation(s)
- Alida Finze
- Department of Surgery, University Hospital Mannheim, Medical Faculty of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany.
| | - Laura Deleanu
- Department of Surgery, University Hospital Mannheim, Medical Faculty of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Miriam Ratliff
- Department of Neurosurgery, Municipal Hospital Memmingen, Memmingen, Germany
| | - Marcel Seiz-Rosenhagen
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty of Heidelberg, Mannheim, Germany
- Department of Neurosurgery, Municipal Hospital Memmingen, Memmingen, Germany
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24
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Schley K, Kowalik JC, Sullivan SM, Vyse A, Czudek C, Tichy E, Findlow J. Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection? Vaccines (Basel) 2023; 11:vaccines11050940. [PMID: 37243043 DOI: 10.3390/vaccines11050940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
A combined Haemophilus influenzae type b (Hib)/meningococcal serogroup C (MenC) vaccine will soon be unavailable in the UK immunisation schedule due to discontinuation by the manufacturer. An interim statement by the Joint Committee on Vaccination and Immunisation (JCVI) advises stopping MenC immunisation at 12 months of age when this occurs. We undertook an analysis of the public health impact of various potential meningococcal vaccination strategies in the UK in the absence of the Hib/MenC vaccine. A static population-cohort model was developed evaluating the burden of IMD (using 2005-2015 epidemiological data) and related health outcomes (e.g., cases, cases with long-term sequelae, deaths), which allows for the comparison of any two meningococcal immunisation strategies. We compared potential strategies that included different combinations of infant and/or toddler MenACWY immunisations with the anticipated future situation in which a 12-month MenC vaccine is not used, but the MenACWY vaccine is routinely given in adolescents. The most effective strategy is combining MenACWY immunisation at 2, 4, and 12 months of age with the incumbent adolescent MenACWY immunisation programme, resulting in the prevention of an additional 269 IMD cases and 13 fatalities over the modelling period; of these cases, 87 would be associated with long-term sequelae. Among the different vaccination strategies, it was observed that those with multiple doses and earlier doses provided the greatest protection. Our study provides evidence suggesting that the removal of the MenC toddler immunisation from the UK schedule would potentially increase the risk of unnecessary IMD cases and have a detrimental public health impact if not replaced by an alternate infant and/or toddler programme. This analysis supports that infant and toddler MenACWY immunisation can provide maximal protection while complementing both infant/toddler MenB and adolescent MenACWY immunisation programmes in the UK.
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Affiliation(s)
| | - Jack C Kowalik
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
| | | | - Andrew Vyse
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
| | - Carole Czudek
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
| | - Eszter Tichy
- Evidera/PPD, Bocskai ut 134-144, Dorottya Udvar, Building E, Floor 2, H-1113 Budapest, Hungary
| | - Jamie Findlow
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
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25
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Shi Y, Franke B, Mota NR, Sprooten E. Genetic liability to major psychiatric disorders contributes to multi-faceted quality of life outcomes in children and adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.17.23284645. [PMID: 36711661 PMCID: PMC9882403 DOI: 10.1101/2023.01.17.23284645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Importance Psychiatric disorders can have an immense impact on socioeconomic, physical, and social-psychological facets of life. Psychiatric disorders are also highly heritable. Under a liability threshold model, an important question arises as to what extent genetic liability for psychiatric disorders relates to, and possibly impacts on, different aspects of quality of life in the general population. Objective To characterize the link between psychiatric genetic liability and diverse aspects of quality of life in childhood and adulthood. Design setting and participants We used data from two multi-site, population-based cohorts, i.e. preadolescent children in the USA enrolled at age 9-10 years from the Adolescent Brain Cognitive Development (ABCD) study (N=4,645) and white British adults between age 40-69 years from the UK Biobank (UKB) study (N=377,664). Due to the current limitations of our genetic methods, only data from unrelated individuals of European descent could be included. Main outcomes and measures To derive robust measures capturing multiple domains of quality of life in each of the cohorts, we integrated an array of measurements of academic, economic, and physical status, as well as social well-being, in a second-level three-factor confirmatory factor analysis. The genetic liabilities to seven major psychiatric disorders were quantified by a set of polygenic scores (PGSs) derived from the largest genome-wide association studies to date, independent of the target cohorts, of major depressive disorder (MDD, N=142k-173k), anxiety disorders (ANX, N=22k-144k), attention-deficit/hyperactivity disorder (ADHD, N=226k), autism spectrum disorder (ASD, N=55k), schizophrenia (SCZ, N=130k), bipolar disorder (BIP, N=353k-414k), and cannabis use disorder (CUD, N=384k). Using general linear models we assessed associations between PGSs and the estimated latent factors, controlling for age, sex, site, genotyping batch, plate, and genetic ancestry. Results In each cohort, three latent factors indexing distinct but correlated quality of life domains, (1) educational performance and cognition (Edu, in ABCD) / social economic status (SES, in UKB), (2) physical health (Hea), (3) adverse social experience (Adv, in ABCD) / social well-being (Soc, in UKB), were estimated with excellent model fit indices. In addition, a general factor was derived that captured the covariances between the three latent factors (QoL). In the ABCD cohort, ADHD-PGS was significantly associated with Edu (β = -0.13, t = -8.29, p = 1.53e-16), Adv (β = -0.09, t = -5.79, p = 7.81e-09), and general QoL (β = -0.14, t = -8.74, p = 3.37e-18) factors. In the UKB cohort, all examined disorder PGSs were significantly associated with the general QoL latent factor and at least one first-order subdomain, with ADHD-PGS (β = -0.06 ~ -0.10, t = -29.1 ~ -52.5, p < 5.91e-186) and MDD-PGS (β = -0.04 ~ -0.07, t = -23.8 ~ -36.3, p < 3.63e-125) showing the largest effects. Conclusions and relevance The present study reveals an inverse relationship between psychiatric genetic liabilities and multiple quality of life metrics, with ADHD-associated genetic risk being the main contributor in both children and adults, and MDD additionally showing effects in adults. All effect sizes observed were small, as expected. Understanding potential real-world outcomes of quantitative measures of disorder-related genetic risks in the general population can provide a scientific foundation for societal intervention and policy-making processes, with profound implications for promoting a flourishing society.
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Affiliation(s)
- Yingjie Shi
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nina Roth Mota
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Emma Sprooten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
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26
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Riihimäki K, Sintonen H, Vuorilehto M, Isometsä E. Health-related quality of life-based definition of remission from depression among primary care patients. Front Psychiatry 2023; 14:926410. [PMID: 37051167 PMCID: PMC10084667 DOI: 10.3389/fpsyt.2023.926410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
Background Depression undermines health-related quality of life (HRQoL). Remission is the central aim of all treatments for depression, but the degree of remission necessary for depressive patients' HRQoL to correspond to the normal range of the general population remains unknown. Methods The Vantaa Primary Care Depression Study prospectively followed-up a screening-based cohort of depressive primary care patients for 5 years. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to diagnose major depressive disorder. HRQoL was measured by the generic 15D instrument at baseline and at 5 years (N = 106, 77% of baseline patients), and compared with the 15D results of an age-standardized general population sample from the Finnish Health 2011 Survey (N = 4,157). Receiver operating characteristic analyses determined the optimal Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) cut-offs for remission, using the 15D score as the construct validator. Remission was defined as the score at which HRQoL reached the general population range (minimum mean - 1 SD). As age may influence HRQoL, patients older and younger than the median 52 years were investigated separately. Results For HAMD, the optimal cut-off point score was 8.5, for BDI 10.5, and for BAI 11.5. The differences between the findings of the younger and older patients were small. Limitations Cross-sectional analysis, small number of patients in the cohort. Conclusion Depressive primary care patients' HRQoL reaches the normal variation range of the general population when their depression and anxiety scores reach the conventional clinical cut-offs for remission.
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Affiliation(s)
- Kirsi Riihimäki
- Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Maria Vuorilehto
- Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Erkki Isometsä,
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27
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Kishimoto T, Nakamura H, Kano Y, Eguchi Y, Kitazawa M, Liang KC, Kudo K, Sento A, Takamiya A, Horigome T, Yamasaki T, Sunami Y, Kikuchi T, Nakajima K, Tomita M, Bun S, Momota Y, Sawada K, Murakami J, Takahashi H, Mimura M. Understanding psychiatric illness through natural language processing (UNDERPIN): Rationale, design, and methodology. Front Psychiatry 2022; 13:954703. [PMID: 36532181 PMCID: PMC9752868 DOI: 10.3389/fpsyt.2022.954703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Psychiatric disorders are diagnosed through observations of psychiatrists according to diagnostic criteria such as the DSM-5. Such observations, however, are mainly based on each psychiatrist's level of experience and often lack objectivity, potentially leading to disagreements among psychiatrists. In contrast, specific linguistic features can be observed in some psychiatric disorders, such as a loosening of associations in schizophrenia. Some studies explored biomarkers, but biomarkers have yet to be used in clinical practice. Aim The purposes of this study are to create a large dataset of Japanese speech data labeled with detailed information on psychiatric disorders and neurocognitive disorders to quantify the linguistic features of those disorders using natural language processing and, finally, to develop objective and easy-to-use biomarkers for diagnosing and assessing the severity of them. Methods This study will have a multi-center prospective design. The DSM-5 or ICD-11 criteria for major depressive disorder, bipolar disorder, schizophrenia, and anxiety disorder and for major and minor neurocognitive disorders will be regarded as the inclusion criteria for the psychiatric disorder samples. For the healthy subjects, the absence of a history of psychiatric disorders will be confirmed using the Mini-International Neuropsychiatric Interview (M.I.N.I.). The absence of current cognitive decline will be confirmed using the Mini-Mental State Examination (MMSE). A psychiatrist or psychologist will conduct 30-to-60-min interviews with each participant; these interviews will include free conversation, picture-description task, and story-telling task, all of which will be recorded using a microphone headset. In addition, the severity of disorders will be assessed using clinical rating scales. Data will be collected from each participant at least twice during the study period and up to a maximum of five times at an interval of at least one month. Discussion This study is unique in its large sample size and the novelty of its method, and has potential for applications in many fields. We have some challenges regarding inter-rater reliability and the linguistic peculiarities of Japanese. As of September 2022, we have collected a total of >1000 records from >400 participants. To the best of our knowledge, this data sample is one of the largest in this field. Clinical Trial Registration Identifier: UMIN000032141.
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Affiliation(s)
- Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| | - Hironobu Nakamura
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinobu Kano
- Faculty of Informatics, Shizuoka University, Shizuoka, Japan
| | - Yoko Eguchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Momoko Kitazawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kuo-ching Liang
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Koki Kudo
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Neuropsychiatry, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Ayako Sento
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Akihiro Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshiro Horigome
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshihiko Yamasaki
- Computer Vision and Media Lab (Yamasaki Lab), Department of Information and Communication Engineering, Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yuki Sunami
- Keio University School of Medicine, Tokyo, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kazuki Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, Koutokukai Sato Hospital, Yamagata, Japan
| | - Yuki Momota
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kyosuke Sawada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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28
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Trait Versus State Predictors of Emotional Distress Symptoms: The Role of the Big-5 Personality Traits, Metacognitive Beliefs, and Strategies. J Nerv Ment Dis 2022; 210:943-950. [PMID: 35764593 PMCID: PMC9742004 DOI: 10.1097/nmd.0000000000001557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To enhance formulation and interventions for emotional distress symptoms, research should aim to identify factors that contribute to distress and disorder. One way to formulate emotional distress symptoms is to view them as state manifestations of underlying personality traits. However, the metacognitive model suggests that emotional distress is maintained by metacognitive strategies directed by underlying metacognitive beliefs. The aim of the present study was therefore to evaluate the role of these factors as predictors of anxiety and depression symptoms in a cross-sectional sample of 4936 participants collected during the COVID-19 pandemic. Personality traits (especially neuroticism) were linked to anxiety and depression, but metacognitive beliefs and strategies accounted for additional variance. Among the predictors, metacognitive strategies accounted for the most variance in symptoms. Furthermore, we evaluated two statistical models based on personality traits versus metacognitions and found that the latter provided the best fit. Thus, these findings indicate that emotional distress symptoms are maintained by metacognitive strategies that are better accounted for by metacognitions compared with personality traits. Theoretical and clinical implications of these findings are discussed.
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Krause K, Guertler D, Moehring A, Batra A, Eck S, Rumpf HJ, Bischof G, Buchholz M, John U, Meyer C. Association between Alcohol Consumption and Health-Related Quality of Life among Hospital and Ambulatory Care Patients with Past Year Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14664. [PMID: 36429382 PMCID: PMC9690263 DOI: 10.3390/ijerph192214664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Little is known about how substance use affects health-related quality of life (HRQOL) in depressed individuals. Here, associations between alcohol consumption and HRQOL in hospital and ambulatory care patients with past-year depressive symptoms are analyzed. METHOD The sample consisted of 590 participants (26.8% non-drinkers) recruited via consecutive screenings. Individuals with alcohol use disorders were excluded. HRQOL was assessed with the Veterans Rand 12-item health survey (VR-12). Multivariable fractional polynomials (MFP) regression analyses were conducted (1) to test for non-linear associations between average daily consumption and HRQOL and (2) to analyze associations between alcohol consumption and the physical and mental health component summaries of the VR-12 and their subdomains. RESULTS Alcohol consumption was positively associated with the physical health component summary of the VR-12 (p = 0.001) and its subdomains general health (p = 0.006), physical functioning (p < 0.001), and bodily pain (p = 0.017), but not with the mental health component summary (p = 0.941) or any of its subdomains. Average daily alcohol consumption was not associated with HRQOL. CONCLUSION Alcohol consumption was associated with better physical HRQOL. Findings do not justify ascribing alcohol positive effects on HRQOL. Data indicate that non-drinkers may suffer from serious health disorders. The results of this study can inform the development of future alcohol- and depression-related interventions.
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Affiliation(s)
- Kristian Krause
- Evangelic Hospital Bethania, Gützkower Landstraße 69, 17489 Greifswald, Germany
| | - Diana Guertler
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
| | - Anne Moehring
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Geissweg 3, 72076 Tübingen, Germany
| | - Sandra Eck
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Geissweg 3, 72076 Tübingen, Germany
| | - Hans-Jürgen Rumpf
- Research Group S:TEP, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23583 Lübeck, Germany
| | - Gallus Bischof
- Research Group S:TEP, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23583 Lübeck, Germany
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Ulrich John
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
| | - Christian Meyer
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
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30
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Shortell DD, Rubin LH, Murphy AJ, Cohen RA, Porges EC. The Association Between Peripheral Oxytocin Levels and Depressive Symptoms in People With HIV. Psychosom Med 2022; 84:885-892. [PMID: 35980773 PMCID: PMC9553265 DOI: 10.1097/psy.0000000000001122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 05/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Depression is common in people with HIV (PWH), yet little is known about the mechanisms contributing to depressive symptoms in PWH. Previous research across a range of populations has suggested a relationship between the neuropeptide oxytocin and depressive symptoms, with variable directionality. This article investigated the association between peripheral oxytocin levels and depressive symptoms in PWH. METHODS Unextracted oxytocin serum concentrations were assayed in 79 PWH (44% female, mean age = 34.35 [8.5], mean body mass index = 25.69 [5.46], mean CD4 = 516.60 [271.15]) who also completed the Center for Epidemiologic Studies Depression Scale (CES-D). CES-D items were evaluated in an exploratory factor analysis (EFA), and the relationships between oxytocin, total CES-D score, and the resulting EFA factors were analyzed with multivariate linear regressions conducted in R. Multiple regression models were used to adjust for age, sex, body mass index, CD4, and education. RESULTS Contrary to hypothesized, higher peripheral oxytocin levels were associated with higher CES-D total scores with a small-to-moderate effect size ( β = 0.26, p = .009). Following Bonferroni correction, oxytocin was not significantly associated with any of the five factors identified from the EFA: depressed affect, positive affect, appetite, cognitive symptoms, or perceived failure ( p values > .042). Small effect sizes were found for the depressed affect ( β = 0.22) and perceived failure ( β = 0.21) factors ( p values > .042). CONCLUSIONS In a sample of predominately Black or African American individuals with HIV, higher oxytocin was associated with higher total depressive symptoms. In addition, this relationship was slightly stronger than those of specific depressive symptoms. These findings warrant further study into the role of oxytocin in mood symptoms within PWH.
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Preliminary Study of Efficacy and Safety of Self-Administered Virtual Exposure Therapy for Social Anxiety Disorder vs. Cognitive-Behavioral Therapy. Brain Sci 2022; 12:brainsci12091236. [PMID: 36138972 PMCID: PMC9496986 DOI: 10.3390/brainsci12091236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022] Open
Abstract
Social anxiety disorder (SAD) is one of the most frequent mental disorders. Exposure to virtual reality can be a solution complementing standard CBT (cognitive-behavioral therapy) or can be used as an independent therapeutic tool. The study’s objective was to assess the safety and efficacy of using self-administered virtual reality exposure vs. CBT and CBT with virtual exposure. We assessed the efficacy of the applied intervention with the Leibowitz Social Anxiety Scale (LSAS). We compared three groups: CBT (n = 25), CBT + VR (n = 29), and self-administered therapy without aid of a therapist (n = 19). The results indicated that all three groups showed changes on the LSAS. The simple effect analysis showed that there were no differences between experimental conditions at T0 (session 1) and T1 (session 9) and that the only significant difference occurred at T2 (session 14). The pairwise comparisons showed that the participants in the VR condition scored higher on the LSAS score during the measurement at T2 than participants in CBT condition. Our study has several limitations. The presented initial study shows that the methods of CBT for social anxiety used so far are also effective, while the VR tool for self-therapy requires further research.
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Health-related quality of life in hoarding: A comparison to chronic conditions with high disease burden. J Psychiatr Res 2022; 149:68-75. [PMID: 35255385 DOI: 10.1016/j.jpsychires.2022.02.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/28/2022] [Accepted: 02/28/2022] [Indexed: 12/21/2022]
Abstract
Hoarding disorder often results in debilitating functional impairment and may also compromise health-related quality of life (QoL). This study investigated the association between hoarding behavior and QoL relative to six highly impairing medical and psychiatric disorders in a sample of 20,722 participants enrolled in the internet-based Brain Health Registry. Nearly 1 in 8 participants (12.2%) endorsed clinically relevant hoarding symptoms (CHS). In separate multivariable linear regression models, hoarding was more strongly associated with mental QoL than diabetes (Standardizedβ = -0.21, 95% CI: [-0.22, -0.20] vs. -0.01 [-0.02, 0.0]), heart disease (-0.22 [-0.23, -0.20] vs. 0.00 [-0.02, 0.01]), chronic pain (-0.18 [-0.19, -0.16] vs. -0.12 [-0.13, -0.10]), post-traumatic stress disorder (PTSD; -0.20 [-0.22, -0.19] vs. -0.07 [-0.09, -0.06]), and substance use disorder (SUD; -0.21 [-0.23, -0.20] vs. -0.04 [-0.05, -0.03]). Similarly, CHS was more strongly negatively associated with physical QoL than diabetes (-0.11 [-0.10, -0.12] vs. -0.08 [-0.06, -0.09]), major depressive disorder (-0.09 [-0.10, -0.08] vs. -0.05 [-0.06, 0.03]), PTSD (-0.11 [-0.12, -0.10] vs. -0.08 [-0.09, -0.07]), and SUD (-0.12 [-0.13, -0.09] vs. -0.01 [-0.02, 0.00]). Higher hoarding severity was associated with reductions in both mental (Standardizedβ = -0.28, ΔR2 = 0.08, p < 0.0001) and physical (β = -0.12, ΔR2 = 0.02, p < 0.0001) QoL, though the strength of the relationship between hoarding symptoms and QoL varied with depression severity. Efforts to improve the overall QoL and well-being of those with CHS are needed.
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Wilke SA, Johnson CL, Corlier J, Marder KG, Wilson AC, Pleman CM, Leuchter AF. Psychostimulant use and clinical outcome of repetitive transcranial magnetic stimulation treatment of major depressive disorder. Depress Anxiety 2022; 39:397-406. [PMID: 35389536 DOI: 10.1002/da.23255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 01/24/2022] [Accepted: 03/16/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). Psychostimulant medication use may be associated with improved rTMS outcomes, but a detailed understanding of these relationships is lacking. METHODS We compared MDD subjects taking psychostimulants (n = 37) with those not taking one of these medications (n = 53) during a course of 30 rTMS treatments. Changes in the 30-item Inventory of Depressive Symptomatology Self Report (IDS-SR30) subscale scores were examined at treatment 30. We also subdivided subjects into three categories based on drug mechanism and looked at IDS-SR30 total score after treatments 10, 20, and 30. RESULTS Subjects taking psychostimulants had a significantly greater overall clinical improvement than those not taking these medications at treatment 30. The psychostimulant group also improved significantly more than the control group in "sleep" and "mood/cognition," but not "anxiety/arousal" IDS-SR30 subscales. No differences were detected among individual drug categories, which may reflect the limited sample size for individual medications. There was a negative dose-response relationship for the lisdexamfetamine/dextroamphetamine group, in which lower doses were associated with better clinical outcome. CONCLUSIONS Psychostimulant medications may enhance clinical efficacy of rTMS for MDD by preferentially impacting specific symptom domains. For some psychostimulants, these effects may be dose-dependent. Prospective clinical trials are needed to guide psychostimulant augmentation of brain stimulation therapies.
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Affiliation(s)
- Scott A Wilke
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Crystal L Johnson
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Juliana Corlier
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Katharine G Marder
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Andrew C Wilson
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Christopher M Pleman
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Andrew F Leuchter
- Neuromodulation Division, TMS Clinical and Research Service, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
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Physical activity and health-related quality of life among high-risk women for type 2 diabetes in the early years after pregnancy. BMC Womens Health 2022; 22:84. [PMID: 35313870 PMCID: PMC8939162 DOI: 10.1186/s12905-022-01664-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Previous studies have shown that physical activity (PA) correlates positively with health-related quality of life (HRQoL) in the general population. Few studies have investigated associations between device-measured PA and HRQoL among premenopausal women at risk for type 2 diabetes (T2D). In addition to physical well-being, general well-being improved by PA has been suggested to strengthen PA’s benefits in reducing metabolic diseases. The aim of this study was to examine the associations between PA and HRQoL (general and dimensions) among high-risk women in the early post-pregnancy years when T2D risk is highest and to estimate whether current obesity or prior gestational diabetes (GDM) modified these associations. Methods This cross-sectional study of high-risk women [body mass index (BMI) ≥ 30 kg/m2 and/or prior GDM)]4–6 years after delivery measured sleep, sedentary time, daily steps, and light (LPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) with the SenseWear ArmbandTM accelerometer for seven days and HRQoL with the 15D instrument. Results The analyses included 204 women with a median (IQR) age of 39 (6.0) years and a median BMI of 31.1 kg/m2 (10.9). 54% were currently obese (BMI ≥ 30 kg/m2), and 70% had prior gestational diabetes (GDM+). Women with obesity had lower PA levels than women with normal weight or overweight (p < 0.001) but there was no difference between the GDM+ or GDM− women. Women with both current obesity and GDM+ had highest sedentary time and lowest PA levels. The whole sample’s median 15D score was 0.934 (IQR 0.092), lower among women with obesity compared to the others (p < 0.001), but not different between GDM+ or GDM−. There was a positive correlation between VPA (adjusted rs = 0.262 p = 0.001) and the 15D score. After grouping according to BMI (< and ≥ 30 kg/m2), the associations remained significant only in women without obesity. Among them, sleep, total steps, MVPA, and VPA were positively associated with 15D. Conclusions Higher PA levels are associated with better HRQoL among high-risk women with normal weight and overweight but no differences were found among women affected by obesity in the early years after pregnancy. Trial registration Ethics committees of Helsinki University Hospital (Dnro 300/e9/06) and South Karelian Central Hospital (Dnro 06/08).
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Heady N, Watkins A, John A, Hutchings H. Prevalence of neurodevelopmental disorders and their impact on the health and social well-being among looked after children (LAC): a systematic review protocol. Syst Rev 2022; 11:49. [PMID: 35305681 PMCID: PMC8934470 DOI: 10.1186/s13643-022-01923-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Looked after children (LAC) that are placed in either a foster, kinship, residential care setting or transition to adoption continue to develop debilitating disorders that significantly impact their overall health and social well-being. The prevalence of these disorders is often depicted under broad categories such as mental, behavioural or neurodevelopmental disorders (NDDs). Limited in research is the prevalence of what specific disorders fall under these broad categories. NDDs such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) which fall under an umbrella group in the expert field of genetics and neuropsychiatry will be explored. Unsupported, these disorders can lead to suboptimal health and social outcomes for both the child and family. In the general population, the prevalence of these NDDs and impacts on health and social well-being are relatively well documented, but for minority groups such as LAC, research is extremely limited. This review aims to estimate the prevalence of NDDs among LAC and explore how they might impact the health and social well-being of these vulnerable children. If feasible, the review will compare the prevalence rates to those children who are not looked after, to illuminate any differences or similarities between populations. METHODS PubMed, ASSIA, IBSS, Web of Science, PsychINFO, Scopus, Psych articles, Social Care Online, secondary, grey literature and government publications will be searched to identify any eligible studies. No restrictions will be placed on country, design or year of publication. Studies must provide primary data on the prevalence or incidence of NDDs for individuals < 25 years of age, supported by either a diagnostic code, standardised diagnostic assessment tool or survey response. The Joanna Briggs Institute (JBI) critical appraisal tools will be utilised to assess the quality and bias and the random-effects model used to estimate a pooled prevalence of NDDs. DISCUSSION Attaining an estimated prevalence of these NDDs and identifying any impacts on health and social well-being might inform key stakeholders in health, educational and social sectors with important information that might aid in the early identification and intervention to safeguard and meet the unique needs of these children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD4201913103 .
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Affiliation(s)
- Nicola Heady
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| | - Alan Watkins
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| | - Ann John
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| | - Hayley Hutchings
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
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Natale A, Concerto C, Rodolico A, Birgillito A, Bonelli M, Martinez M, Signorelli MS, Petralia A, Infortuna C, Battaglia F, Aguglia E. Risk Perception among Psychiatric Patients during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052620. [PMID: 35270313 PMCID: PMC8909657 DOI: 10.3390/ijerph19052620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 01/06/2023]
Abstract
The fear of the new coronavirus infection has driven many non-COVID-19 patients away from essential healthcare. Our study aimed to investigate the perception of risk and feelings of danger for the contagion in a sample of Italian psychiatric patients. We conducted a cross-sectional observational study during the second wave of the COVID-19 pandemic and the lockdown in Italy. The risk perception and risk-related variables were assessed in a sample of 150 consecutive patients with a previous diagnosis of major depression (50), bipolar I disorder (50), and schizophrenia seeking ambulatory care using a questionnaire previously administered to the general Italian population. Our results showed that patients were more concerned about economic, psychological, and interpersonal consequences of COVID-19 pandemic, rather than about their own health. At the multiple regression analysis, the likelihood of COVID-19 resolution was positively influenced by the diagnosis of schizophrenia, the increased perceived effectiveness, and the presence of positive emotions. Indeed, positive emotions and uncertainty positively influenced interpersonal risk. Our study highlights the need to provide more support to psychiatric patients during emergency events to prevent them from engaging in risky behaviors.
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Affiliation(s)
- Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Andrea Birgillito
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Marina Bonelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Miriam Martinez
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Antonino Petralia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Carmenrita Infortuna
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy;
| | - Fortunato Battaglia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
- Correspondence:
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
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Plessen CY, Karyotaki E, Cuijpers P. Exploring the efficacy of psychological treatments for depression: a multiverse meta-analysis protocol. BMJ Open 2022; 12:e050197. [PMID: 35078836 PMCID: PMC8796219 DOI: 10.1136/bmjopen-2021-050197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION In the past four decades, over 700 randomised controlled trials (RCTs) and 80 meta-analyses have examined the efficacy of psychological treatments for depression. Overwhelming evidence suggests that all types of psychological treatments are effective. Yet, many aspects are still unexplored. Meta-analysts could perform hundreds of potential meta-analyses with the current literature, and a comprehensive bird's-eye view of all published studies is missing. This protocol outlines how a multiverse meta-analysis can evaluate the entire body of the literature on psychological treatments of depression in a single analysis. Thereby, gaps of evidence and areas of robustness are highlighted. METHODS AND ANALYSIS We will conduct systematic literature searches in bibliographical databases (PubMed, Embase, PsycINFO and Cochrane Register of Controlled Trials) up until 1 January 2021. We will include all RCTs comparing a psychological treatment with a control condition. We will include studies published in English, German, Spanish or Dutch, and exclude trials on maintenance and relapse prevention as well as dissertations. Two independent researchers will check all records. All self-reported and clinician-rated instruments measuring depression are included. We will extract information on recruitment settings, target groups, age groups, comorbidity, intervention formats, psychotherapy types, number of sessions, control conditions and country. Two independent researchers will assess risk of bias using the Cochrane Risk of Bias assessment tool. As part of the multiverse meta-analysis, unweighted, fixed effect and random effects models will be calculated. ETHICS AND DISSEMINATION As we will not collect any primary data, an ethical approval of this protocol is not required. We will publish the results in a peer-review journal and present them at international conferences. We will follow open science practices and provide our code and data.
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Affiliation(s)
- Constantin Yves Plessen
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, Netherlands
- Department of Psychosomatic Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eirini Karyotaki
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, Netherlands
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Broekharst DSE, Bloem S, Groenland EAG, van Raaij WF, van Agthoven M. Differences between expert reported and patient reported burden of disease rankings. Sci Rep 2022; 12:895. [PMID: 35042859 PMCID: PMC8766519 DOI: 10.1038/s41598-021-04070-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/13/2021] [Indexed: 11/08/2022] Open
Abstract
Many attempted to develop burden of disease rankings for the purpose of resource allocation, priority setting, cost-effectiveness evaluation, and service development in healthcare. As this proved difficult the World Health Organization commissioned expert panels to develop internally consistent burden of disease rankings. Although these rankings provide valuable insight in the biomedical burden of different diseases, they do not yet provide insight in the psychological burden of different diseases experienced and reported by patients on a daily basis. Since expert reported and patient reported burden of disease could differ, deviations between expert reported and patient reported burden of disease rankings are likely. To explore how these rankings differ, it is important to develop patient reported burden of disease rankings and compare these to expert reported burden of disease rankings. In this study patient reported burden of disease rankings were developed by ranking the subjective health experience of patients. To measure subjective health experience an online questionnaire was administered to a large panel of Dutch citizens. The final sample consisted of 58,490 panel members. This final sample contained 36 diseases and was largely representative of the Dutch population. The data were analysed by using reliability tests, descriptive statistics and Spearman rank-order correlation coefficients. This study shows that expert reported and patient reported burden of disease rankings could differ. Burden of cardiovascular diseases ranks low on patient reported burden of disease rankings, while it ranks higher on expert reported burden of disease rankings. Burden of psychiatric diseases and gastrointestinal diseases ranks high on patient reported burden of disease rankings, while it ranks lower on expert reported burden of disease rankings. Burden of pain diseases ranks high on patient reported burden of disease rankings, while it is still overlooked in expert reported burden of disease rankings. This study suggests that it can be beneficial to develop and utilize patient reported burden of disease rankings in addition to the already existing expert reported burden of disease rankings in order to establish a more comprehensive perspective on burden of disease. This could improve decision-making on resource allocation, priority setting, cost-effectiveness evaluation, and service development in healthcare.
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Affiliation(s)
- Damien S E Broekharst
- Center for Marketing and Supply Chain Management, Nyenrode Business University, Breukelen, The Netherlands.
| | - Sjaak Bloem
- Center for Marketing and Supply Chain Management, Nyenrode Business University, Breukelen, The Netherlands
- Janssen-Cilag B.V., Johnson and Johnson, Breda, The Netherlands
| | - Edward A G Groenland
- Center for Marketing and Supply Chain Management, Nyenrode Business University, Breukelen, The Netherlands
| | - W Fred van Raaij
- Department of Social Psychology, Tilburg University, Tilburg, The Netherlands
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Monteiro S, Nejad YS, Aucoin M. Perinatal diet and offspring anxiety: A scoping review. Transl Neurosci 2022; 13:275-290. [PMID: 36128579 PMCID: PMC9449687 DOI: 10.1515/tnsci-2022-0242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/04/2022] [Accepted: 08/12/2022] [Indexed: 11/15/2022] Open
Abstract
Health behaviors during pregnancy have an impact on the developing offspring. Dietary factors play a role in the development of mental illness: however, less is known about the impact of diet factors during pre-conception, gestation, and lactation on anxiety levels in offspring. This scoping review sought to systematically map the available research involving human and animal subjects to identify nutritional interventions which may have a harmful or protective effect, as well as identify gaps. Studies investigating an association between any perinatal diet pattern or diet constituent and offspring anxiety were included. The number of studies reporting an association with increased or decreased levels of anxiety were counted and presented in figures. A total of 55,914 results were identified as part of a larger scoping review, and 120 articles met the criteria for inclusion. A greater intake of phytochemicals and vitamins were associated with decreased offspring anxiety whereas maternal caloric restriction, protein restriction, reduced omega-3 consumption, and exposure to a high fat diet were associated with higher levels of offspring anxiety. Results were limited by a very large proportion of animal studies. High quality intervention studies involving human subjects are warranted to elucidate the precise dietary factors or constituents that modulate the risk of anxiety in offspring.
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Affiliation(s)
- Sasha Monteiro
- Department of Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON, M2K 1E2, Canada
| | - Yousef Sadat Nejad
- Department of Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON, M2K 1E2, Canada
| | - Monique Aucoin
- Department of Research and Clinical Epidemiology, Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON, M2K 1E2, Canada
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Indirect prevention and treatment of depression: An emerging paradigm? CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e6847. [PMID: 36398290 PMCID: PMC9667226 DOI: 10.32872/cpe.6847] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/18/2021] [Indexed: 12/16/2022] Open
Abstract
Background Although depression is one of the main public health challenges of our time, the uptake of interventions aimed at the prevention and treatment is low to modest. New approaches are needed to reduce the disease burden of depression. Method Indirect prevention and treatment may be one method to increase uptake of services. Indirect interventions aim at problems related to depression but with lower stigma and prevent or treat depression indirectly. This paper describes the approach, the empirical support and limitations. Results A growing number of studies focus on indirect prevention and treatment. Several studies have examining the possibilities to prevent and treat depression through interventions aimed at insomnia. Several other studies focus on indirect interventions aimed at for example stress and perfectionism. Digital ‘suites’ of interventions may focus on daily problems of for example students or the workplace and offer a broad range of indirect interventions in specific settings. Conclusion Indirect prevention and treatment may be a new approach to increase uptake and reduce the disease burden of depression.
Effective treatments and preventive interventions are available for depression but uptake is low. Indirect prevention and treatment focus on problems related to depression. Uptake of indirect interventions is higher because they focus on daily problems. Indirect interventions may provide a new paradigm for prevention and treatment.
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Aucoin M, LaChance L, Naidoo U, Remy D, Shekdar T, Sayar N, Cardozo V, Rawana T, Chan I, Cooley K. Diet and Anxiety: A Scoping Review. Nutrients 2021; 13:4418. [PMID: 34959972 PMCID: PMC8706568 DOI: 10.3390/nu13124418] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/23/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022] Open
Abstract
Anxiety disorders are the most common group of mental disorders. There is mounting evidence demonstrating the importance of nutrition in the development and progression of mental disorders such as depression; however, less is known about the role of nutrition in anxiety disorders. This scoping review sought to systematically map the existing literature on anxiety disorders and nutrition in order to identify associations between dietary factors and anxiety symptoms or disorder prevalence as well as identify gaps and opportunities for further research. The review followed established methodological approaches for scoping reviews. Due to the large volume of results, an online program (Abstrackr) with artificial intelligence features was used. Studies reporting an association between a dietary constituent and anxiety symptoms or disorders were counted and presented in figures. A total of 55,914 unique results were identified. After a full-text review, 1541 articles met criteria for inclusion. Analysis revealed an association between less anxiety and more fruits and vegetables, omega-3 fatty acids, "healthy" dietary patterns, caloric restriction, breakfast consumption, ketogenic diet, broad-spectrum micronutrient supplementation, zinc, magnesium and selenium, probiotics, and a range of phytochemicals. Analysis revealed an association between higher levels of anxiety and high-fat diet, inadequate tryptophan and dietary protein, high intake of sugar and refined carbohydrates, and "unhealthy" dietary patterns. Results are limited by a large percentage of animal and observational studies. Only 10% of intervention studies involved participants with anxiety disorders, limiting the applicability of the findings. High quality intervention studies involving participants with anxiety disorders are warranted.
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Affiliation(s)
- Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
| | - Laura LaChance
- Department of Psychiatry, McGill University, Montreal, QC H3A 0G4, Canada;
- St. Mary’s Hospital Centre, Montreal, QC H3T 1M5, Canada
| | - Umadevi Naidoo
- Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Daniella Remy
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
- Anthrophi Technologies, Toronto, ON M6H1W2, Canada
| | - Tanisha Shekdar
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
| | - Negin Sayar
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
| | - Valentina Cardozo
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
| | - Tara Rawana
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
| | - Irina Chan
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
| | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, ON M2K 1E2, Canada; (D.R.); (T.S.); (N.S.); (V.C.); (T.R.); (I.C.); (K.C.)
- School of Public Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo 2007, Australia
- Pacific College of Health Sciences, San Diego, CA 92108, USA
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore 2480, Australia
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Nuninga JO, Mandl RCW, Siero J, Nieuwdorp W, Heringa SM, Boks MP, Somers M, Sommer IEC. Shape and volume changes of the superior lateral ventricle after electroconvulsive therapy measured with ultra-high field MRI. Psychiatry Res Neuroimaging 2021; 317:111384. [PMID: 34537602 DOI: 10.1016/j.pscychresns.2021.111384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022]
Abstract
The subventricular zone (SVZ) of the lateral ventricles harbors neuronal stem cells in adult mammals. Rodent studies report neurogenic effects in the SVZ of electroconvulsive stimulation. We hypothesize that if this finding translates to depressed patients undergoing electroconvulsive therapy (ECT), this would be reflected in shape changes at the SVZ. Using T1-weighted MR images acquired at ultra-high field strength (7T), the shape and volume of the ventricles were compared from pre to post ECT after 10 ECT sessions (in patients twice weekly) or 5 weeks apart (controls) using linear mixed models with age and gender as covariates. Ventricle shape significantly changed and volume significantly decreased over time in patients for the left ventricle, but not in controls. The decrease in volume of the ventricles was associated to a decrease in depression scores, and an increase in the left dentate gyrus, However, the shape changes of the ventricles were not restricted to the neurogenic niche in the lateral walls of the ventricles, providing no clear evidence for neurogenesis as sole explanation of volume changes in the ventricles after ECT.
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Affiliation(s)
- Jasper O Nuninga
- University Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Groningen, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands.
| | - René C W Mandl
- Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - Jeroen Siero
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands; Spinoza Centre for Neuroimaging, Amsterdam, the Netherlands
| | - Wendy Nieuwdorp
- Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - Sophie M Heringa
- Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - Marco P Boks
- Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - Metten Somers
- Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - Iris E C Sommer
- University Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Groningen, the Netherlands
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43
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Rodríguez-Míguez E, Mosquera Nogueira J. Willingness to pay vs lottery equivalent to value the impact of alcohol misuse on quality of life. Expert Rev Pharmacoecon Outcomes Res 2021; 22:835-844. [PMID: 34779322 DOI: 10.1080/14737167.2022.2004124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To estimate the impact of alcohol disorders using lottery equivalent (LE) and willingness to pay (WTP) methods and compute the WTP for a QALY (WTP-Q) derived from these values. METHODS Two samples of 300 people valued nine states of alcohol misuse. LE and WTP were used in sample 1 and 2, respectively. The ability to discriminate between methods was tested. Regression models were performed to estimate the preference weights of dimensions. Several values of WTP-Q were obtained by combining the estimated values from both samples. RESULTS LE and WTP produce the same ranking of states but LE is more sensitive. The estimated impact of the nine states ranges between 0.91 and 0.22 QALYs, and the WTP for avoiding them ranges between €10,444 and €4132. WTP-Q varies between €11,473 and €19,092 when the mean values of the states are used. The WTP-Q tends to decrease with the severity. CONCLUSIONS Although LE and WTP provide values for cost-utility and cost-benefit analyses, respectively, LE seems to be preferable for measuring the impact of alcohol disorders. As the lower sensitivity of WTP seems to explain a WTP-Q decrease with severity, more research is needed before recommending the use of different WTP-Q values.
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44
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Schopman SME, ten Have M, van Balkom AJ, de Graaf R, Batelaan NM. Course trajectories of anxiety disorders: Results from a 6-year follow-up in a general population study. Aust N Z J Psychiatry 2021; 55:1049-1057. [PMID: 33887978 PMCID: PMC8554495 DOI: 10.1177/00048674211009625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Little is known about the course of anxiety disorders in the general population. This study provides insights into the course of anxiety disorders in the general population taking into account transition to residual symptoms and to other diagnostic categories. METHODS Using data from three waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 6646), subjects with anxiety disorders (T0;n = 243) were divided into three mutually exclusive course trajectories according to their diagnostic status at 3-year (T1) and 6-year (T2) follow-up: remission group (no disorder at T2), intermittent course group (no disorder at T1 and disorder at T2) and chronic course group (disorder at all measurements). Transition to residual symptoms or other psychopathology were studied. In addition, predictors of course trajectories were assessed. RESULTS During 6-year follow-up, 77.8% of subjects achieved remission, 14.0% followed an intermittent course and 8.2% a chronic course. Of those in remission, residual anxiety symptoms remained in 46.6%, while 7.9% developed another disorder between T0 and T2. Compared with the remitting group, a chronic course was predicted by not living with a partner, multiple negative life events, neuroticism, lower mental functioning, severity of anxiety symptoms, use of mental health care and medication use. LIMITATIONS The intermittent and chronic course groups were small, limiting statistical power. As a result, certain predictors may not have reached significance. CONCLUSIONS In the general population at 6-year follow-up, 77.8% of subjects with anxiety disorders achieved remission. Because of transition to residual symptoms or another diagnostic category, only 52.4% of those subjects had a true favourable outcome.
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Affiliation(s)
- Simone ME Schopman
- Department of Psychiatry, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, The Netherlands,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands,Simone M Schopman, Department of Psychiatry, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam and Amsterdam UMC, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands.
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Anton J van Balkom
- Department of Psychiatry, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, The Netherlands,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, The Netherlands,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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45
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Binasis T, Groves D, Wootton BM, Moses K. Psychometric properties of the DSM-5 social anxiety disorder dimensional scale in an Australian community sample. J Clin Psychol 2021; 78:938-950. [PMID: 34704259 DOI: 10.1002/jclp.23262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/01/2021] [Accepted: 10/06/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The Social Anxiety Disorder Dimensional Scale (SAD-D) is a 10-item scale developed by the Diagnostic and Statistical Manual (Fifth Edition) Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorder work group to supplement current dichotomous approaches to assessment of Social Anxiety Disorder (SAD). The aim of the present study was to evaluate the psychometric properties of the SAD-D in an Australian community sample. METHODS Two-hundred and ninety-one participants (72.9% female) aged 18-76 years (M =28.46; SD = 12.30) completed the study. RESULTS Confirmatory factor analysis indicated support for the unidimensional structure of the SAD-D (root mean square error of approximation [RMSE] = 0.08; comparative fit index [CFI] = 0.97). The measure demonstrated strong internal consistency (α = 0.94), as well as good divergent validity. The SAD-D showed excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.93). CONCLUSIONS Overall, the SAD-D appears to be a brief and reliable measure of SAD symptomatology. Limitations, including the use of a predominantly female convenience sample, and failure to include the mental health and background of the sample, are discussed.
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Affiliation(s)
- Theodora Binasis
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - David Groves
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Bethany M Wootton
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Karen Moses
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
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46
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Zarrabian S, Jamali S, Fazli-Tabaei S, Haghparast A. The cross-talk between dopaminergic and nitric oxide systems in the medial septal nucleus, and their distinct effects on anxiety-like behaviors in male rats. J Psychiatr Res 2021; 141:124-135. [PMID: 34198193 DOI: 10.1016/j.jpsychires.2021.06.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/04/2021] [Accepted: 06/22/2021] [Indexed: 12/12/2022]
Abstract
Anxiety disorders, which have a noticeable global prevalence and may be caused by many factors, include a spectrum of disorders that share features of excessive fear- and anxiety-related behavioral disturbances. Different brain areas and neurotransmitter systems have been under investigation for anxiety-related disorders. In this study, we investigated the possible interaction between the dopaminergic and nitric oxide (NO) neurotransmitter systems in the medial septal nucleus and their roles in anxiety-like behaviors using elevated plus-maze (EPM) test in male rats. Our results showed that: (i) both D1-and D2-like receptor agonists, SKF-38393 and quinpirole, augmented anxiety-like behaviors at their two highest applied doses in the EPM test; (ii) both D1-and D2-like receptor antagonists, SCH- 23390 and sulpiride, reduced anxiety-like behaviors at their two highest applied doses in the EPM test; (iii) L-Arginine, a NO precursor, increased anxiety-like behaviors, but L-NAME, a non-specific nitric oxide synthase (NOS) inhibitor, reduced them in the EPM test; (iv) L-NAME could not reverse the anxiety-like parameters produced by SKF-38393, but it significantly reduced the anxiety-like behaviors induced by quinpirole; (v) Neither SCH- 23390 nor sulpiride changed anxiety-related behaviors induced by L-Arginine. It can be concluded that both dopaminergic and nitric oxide systems in the medial septal nucleus are involved in modulating anxiety-like behaviors. While NO has an involvement in the exerted effects by the D2-like agonist, such effects were not observed at the applied range of the doses for D1-and D2-like antagonists.
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Affiliation(s)
- Shahram Zarrabian
- Department of Anatomical Sciences & Cognitive Neuroscience, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Shole Jamali
- Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Fazli-Tabaei
- Department of Physiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Abbas Haghparast
- Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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47
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Boecking B, Biehl R, Brueggemann P, Mazurek B. Health-Related Quality of Life, Depressive Symptoms, Anxiety, and Somatization Symptoms in Male and Female Patients with Chronic Tinnitus. J Clin Med 2021; 10:jcm10132798. [PMID: 34202097 PMCID: PMC8267833 DOI: 10.3390/jcm10132798] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: To investigate the joint impact of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other somatization symptoms on health-related quality of life (HRQoL) in female vs. male patients with chronic tinnitus. Method: Three-hundred-and-fifty-two patients with chronic tinnitus completed audiological testing and a psychological assessment battery that comprised—among other measures—German versions of the Tinnitus Questionnaire, Hospital Anxiety and Depression Scale, Somatic Symptom Scale-8, and Health-Related Quality of Life scale. Descriptive analyses examined associations as well as within- and between-gender differences of the measured variables. Gender-specific serial indirect effects analyses aimed to explain the impact of TRD on HRQoL through psychological processes, notably anxiety, depressive symptoms, and somatization symptoms. Results: Both female and male patients yielded lower mental than physical HRQoL and negative associations between the measured psychological variables and HRQoL. Compared to male patients, female patients reported higher levels of tinnitus-related- and wider psychological distress, other somatization symptoms (e.g., headaches), and impairments in mental and physical HRQoL. For each gender, depressive symptoms, anxiety, and somatization symptoms fully mediated the effect of TRD on mental and physical HRQoL. A double-dissociation revealed an interaction of somatization symptoms and depression on the TRD-HRQoL association in women, and of somatization symptoms and anxiety in men. Conclusions: In patients with chronic tinnitus, psychological constructs account for reported impairments in both mental and physical HRQoL. To improve patients’ HRQoL, treatment conceptualizations should consider gender-specific psychological expressions of low mood or anxiety.
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Affiliation(s)
| | | | | | - Birgit Mazurek
- Correspondence: ; Tel.: +49-30-450-009; Fax: +49-30-450-555-907
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48
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Harkko J, Nordquist H, Pietiläinen O, Piha K, Mänty M, Lallukka T, Rahkonen O, Kouvonen A. Frequent short sickness absence, occupational health service utilisation and long-term sickness absence due to mental disorders among young employees. Int Arch Occup Environ Health 2021; 94:1549-1558. [PMID: 34095973 PMCID: PMC8384820 DOI: 10.1007/s00420-021-01728-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
Objectives We examined whether frequent short-term sickness absence (FSTSA) and primary care use in occupational health service (OHS) were associated with medically-certified long-term sickness absence (LTSA) due to mental disorders among young employees. Methods We used record-linkage data covering the young employees (< 35 years) of the City of Helsinki, Finland (n = 8,282) from 2010 to 2014. The outcome was LTSA due to mental disorders. Cox regression models were fitted. Results FSTSAs were associated with subsequent LTSA. Also OHS use predicted LTSA due to mental disorders; however, this association was not found for those with prior FSTSA. Conclusions Both FSTSA and primary care use indicate subsequent LTSA independently, and together these indicators identify a larger proportion of individuals at risk of LTSA due to mental disorders.
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Affiliation(s)
- Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,South Eastern Finland, University of Applied Sciences, Kotka, Finland
| | - Olli Pietiläinen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kustaa Piha
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Minna Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Unit of Strategy and Research, City of Vantaa, Vantaa, Finland
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Administrative Data Research Centre, Northern Ireland, Centre for Public Health, Queen's University, Belfast, UK
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49
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Petrova NN, Palkin YR, Faddeev DV, Zinovieva AG. [Comorbidity of depression and anxiety in clinical practice]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:31-37. [PMID: 34037352 DOI: 10.17116/jnevro202112104131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The study was the comparative characterization of depressed patients depending on the presence of comorbid anxiety. MATERIAL AND METHODS Thirty patients of the Clinic of neuroses named after acad. I.P. Pavlov Clinic of Neuroses. Comparison groups included 15 patients with comorbid anxiety and depressive disorders and 15 patients with depressive disorder without comorbid anxiety. The groups were comparable by sex and age. Clinical-catamnestic, clinical-therapeutic, and clinical-scale methods, including the Hamilton Depression and Anxiety Scales, were used during the study. RESULTS The structure of clinically diagnosed comorbid anxiety and depressive disorders was shown to be characterized by high representation of somato-vegetative symptoms and higher level of depression in comparison to depressive disorder without comorbid anxiety. According to psychometric assessment results, the level of anxiety did not differ in comparison groups, while clinically, according to ICD-10 criteria, anxiety was not diagnosed, indicating a discrepancy between clinical and scale assessments of anxiety and depressive disorders and greater accuracy of clinical and scale assessment of the condition. The effectiveness of combined treatment, including psychotropic therapy and psychotherapy, was lower in patients with comorbidity of anxiety and depression according to parameters of the degree of reduction of psychopathological symptoms, duration of treatment, and quality of remission. The structure of incomplete remission was similar in patients with comorbid anxiety and depressive disorders and depression. CONCLUSION The obtained data suggest the expediency of continuous systematization of affective disorders and the need to improve the diagnostic criteria of comorbid anxiety and depressive disorders on the basis of combined clinical and scale assessment.
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Affiliation(s)
- N N Petrova
- Saint-Petersburg State University, St. Petersburg, Russia
| | - Yu R Palkin
- Pavlov City Psychiatric Hospital No. 7, St. Petersburg, Russia
| | - D V Faddeev
- Pavlov City Psychiatric Hospital No. 7, St. Petersburg, Russia
| | - A G Zinovieva
- Saint-Petersburg State University, St. Petersburg, Russia
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50
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Schaub C, Bigoni C, Baumeler Q, Faouzi M, Alexandre K. The influence of psychosocial factors on the intention to incorporate complementary and integrative medicine into psychiatric clinical practices. Complement Ther Clin Pract 2021; 44:101413. [PMID: 33991959 DOI: 10.1016/j.ctcp.2021.101413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/07/2021] [Accepted: 05/01/2021] [Indexed: 11/18/2022]
Abstract
Complementary and integrative medicine (CIM) can be of great support to individuals suffering from psychiatric conditions; however, it is still rarely incorporated into clinical practice. OBJECTIVE To examine the influences of psychosocial and sociodemographic factors on health-care professionals' intention to use CIM in their psychiatric clinical practice. METHOD One-hundred-and-five participants completed a questionnaire developed from an adapted version of Triandis' Theory of Interpersonal Behavior (TIB). Intentions to use CIM (yes or no) were analyzed using logistic regression models. RESULTS The multivariate model retained three main factors: affect, perceived social norms, and conditions facilitating CIM. These predicted health-care professionals' intention to use CIM with an AUC = 94.7%. RESULTS underlined that positive affective attitudes towards CIM, feeling that CIM was congruent with professional and institutional goals, and having sufficient skills in CIM were essential to ensuring that health-care professionals would integrate CIM into their clinical practice.
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Affiliation(s)
- Corinne Schaub
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland.
| | - Catherine Bigoni
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland.
| | - Quentin Baumeler
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland; The Swiss Peak LLC, Chemin des Epinettes 8, CH-1007, Lausanne, Switzerland.
| | - Mohamed Faouzi
- Biostatistics Unit, Center for Primary Care and Public Health(Unisanté), University of Lausanne, Route de Berne 113, CH-1010, Lausanne, Switzerland.
| | - Kétia Alexandre
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland.
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