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Hsieh MH, Nfor ON, Hsu SY, Liaw YP. The correlation between patient health questionnaire-4 scores and major depressive disorder: a population-based study. Front Public Health 2025; 13:1483615. [PMID: 40129581 PMCID: PMC11930801 DOI: 10.3389/fpubh.2025.1483615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 02/24/2025] [Indexed: 03/26/2025] Open
Abstract
Background This study aims to investigate the association between PHQ-4 scores and major depressive disorder (MDD) among participants from the Taiwan Biobank. Methods We analyzed data from 5,629 individuals who completed the PHQ-4 questionnaire. Self-reported MDD cases in the Taiwan Biobank (TWB) were linked to their information in the National Health Insurance Research Database (NHIRD), requiring at least two outpatient visits or one inpatient hospitalization for confirmation. The PHQ-4 scores, a validated screening tool for anxiety and depression, were assessed as continuous variables due to the small sample size. Logistic regression models, adjusted for relevant covariates, were employed to examine the relationship between PHQ-4 scores and MDD. Results Participants with MDD exhibited significantly higher mean PHQ-4 scores (mean ± SD: 2.17 ± 2.61) compared to controls (1.02 ± 1.69, p < 0.001). The odds ratio (OR) for a one-unit increase in PHQ-4 score was 1.26 (95% CI: 1.19-1.34), indicating a 26% increased risk of MDD. The combined OR for anxiety items (PHQ1 and PHQ2) was 1.51 (95% CI: 1.36-1.68), while for depression items (PHQ3 and PHQ4), the OR was 1.42 (95% CI: 1.28-1.58). Notably, females had an OR of 1.22, while males had a higher OR of 1.31. Additionally, older adults (≥70 years) showed an OR of 4.56. Unemployed individuals had an OR of 1.83, and current smokers had an OR of 2.18. Conclusion The findings highlight a significant association between higher PHQ-4 scores and the prevalence of MDD, suggesting that depression and anxiety components may contribute to the overall correlation with MDD.
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Affiliation(s)
- Ming-Hong Hsieh
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Oswald Ndi Nfor
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Yi Hsu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yung-Po Liaw
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Medical Imaging and Big Data Center, Chung Shan Medical University Hospital, Taichung, Taiwan
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Hodgson CG, Bonifay W, Yang W, Herman KC. Establishing the measurement precision of the patient health questionnaire in an adolescent sample. J Affect Disord 2023; 342:76-84. [PMID: 37708980 DOI: 10.1016/j.jad.2023.09.013] [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: 04/18/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Technically sound measures are necessary for accurately identifying youth at risk for depression, but many studies rely on classical test theory metrics or adult samples to evaluate measures. This study examined the use of the PHQ-8, a common and freely available pediatric depression screener, in an adolescent sample using item response theory (IRT). METHODS Secondary analyses were conducted on data from a study conducted in Midwestern middle schools in which 1224 youth completed the PHQ-8 as part of a battery of surveys. Polytomous IRT analyses (a Graded Response Model) were used to evaluate the PHQ-8. Items were examined for their ability to distinguish between respondents of different latent depression severity and for differential item functioning (DIF) across demographic categories. RESULTS All PHQ-8 items had adequate discriminative abilities. Items measuring anhedonia and psychomotor disturbances performed relatively poorly, and items measuring somatic symptoms (appetite and sleep) were most informative when respondents endorsed extreme response options ("not at all" or "nearly every day"). No DIF was found across grade level or race, but several items were flagged for DIF by gender and student income level. LIMITATIONS These results might not be generalizable to a broader youth population due to administration setting and the unique demographic characteristics of this sample (76.0 % African American). CONCLUSIONS Tools such as the PHQ-8 are appropriate to quickly screen for depression in adolescents, but further scrutiny of adolescent response patterns is warranted. Future research should examine items measuring anhedonia and psychomotor and somatic disturbances in adolescents.
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Affiliation(s)
| | - Wes Bonifay
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA
| | - Wenxi Yang
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA.
| | - Keith C Herman
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA
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Medication Adherence of People Living with HIV in Japan-A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11040451. [PMID: 36832986 PMCID: PMC9957380 DOI: 10.3390/healthcare11040451] [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: 12/23/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Long-term medical care for people living with HIV (PLHIV) is critical for treatment efficacy, and various studies have examined reasons for antiretroviral therapy (ART) non-adherence. In Japan, doctors assume patients maintain high adherence. However, little is known about real-world treatment adherence. We conducted an anonymous self-administered web-based survey asking about adherence for a total of 1030 Japanese PLHIV who were currently on ART. Adherence was determined using the eight-item Morisky Medication Adherence Scale (MMAS-8), for which scoring ranged from 0 to 8 and scores < 6 points were classified as low adherence. Data were analyzed based on patient-related factors; therapy-related factors; condition-related factors, such as a comorbidity with depression (utilizing the Patient Health Questionnaire 9, PHQ-9); and healthcare/system-related factors. Among 821 PLHIV who responded to the survey, 291 responders (35%) were identified as being in the low adherence group. A statistically significant relationship was found between the number of missed anti-HIV drug doses within the previous 2 weeks and long-term adherence, per the MMAS-8 score (p < 0.001). Risk factors for low adherence included age (younger than 21 years, p = 0.001), moderate to severe depression (p = 0.002, using the PHQ-9), and drug dependence (p = 0.043). Adherence was also influenced by a shared decision-making process, including treatment selection, doctor-patient relations, and treatment satisfaction. Adherence was mainly affected by treatment decision factors. Hence, support of care providers should be considered critical for improving adherence.
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Jang Y, Choi EY, Wu B, Dong X, Kim MT. Linguistic Adaptation and Cognitive Function in Older Chinese and Korean Immigrants in the United States: A Cross-Sectional Study. J Aging Health 2022; 34:951-960. [PMID: 35387521 PMCID: PMC9950789 DOI: 10.1177/08982643221083107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To examine the cross-sectional association of linguistic adaptation with cognitive function, as well as its interactions with sociodemographic and health profiles in older Chinese and Korean immigrants in the U.S. METHODS Using harmonized data (N = 5063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we examined between- and within-group differences in the role of linguistic adaptation (English use in older Chinese Americans and English proficiency in older Korean Americans) in cognitive function. RESULTS The positive association between linguistic adaptation and cognitive function was common in both groups. We also found that the relationship was pronounced among subgroups with the underlying linguistic and cognitive vulnerabilities (i.e., the very old, women, those with low education, and newly immigrated individuals). DISCUSSION Findings show the importance of linguistic adaptation in older immigrants' cognitive health and suggest a need for targeted interventions for high-risk groups.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Jersey, NJ, USA
| | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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Junaid K, Akram I, Daood M, Khan A. Validity of the patient health questionnaires (phq-2 and phq-9) for screening depression among human immunodeficiency virus patients in Lahore, Pakistan. World J Virol 2022; 11:341-351. [PMID: 36188737 PMCID: PMC9523320 DOI: 10.5501/wjv.v11.i5.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/06/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Many human immunodeficiency virus (HIV) infected patients suffer from depr-ession, but a little focus is given to detecting and treating depression in primary health care. Detection of depression can be improved by introducing short, reliable, and valid screening instruments.
AIM To determine the psychometric properties of the patient health questionnaire-2 (PHQ-2) and patient health questionnaire-9 (PHQ-9) for depression screening and diagnosis, and the sensitivity and specificity of the PHQ-2 in HIV infected patients.
METHODS A cross-sectional study was conducted on 158 HIV-infected patients aged 18 years and above in Lahore, Pakistan. PHQ-2 was implemented to screen depression. PHQ-9 was implemented to diagnose major depressive disorder as a reference standard. Reliability, Validity tests and receiver operating characteristic curve were computed.
RESULTS The Cronbach's alpha of PHQ-2 and PHQ-9 were 0.732 and 0.759, respectively. The study results showed that the score of 2 on PHQ-2 indicates the highest Youden's index of 0.924, with both sensitivity and specificity of 0.96, and the area under the curve for PHQ-2 was 0.98 (95%CI: 0.953-0.998).
CONCLUSION Good psychometric properties for the PHQ-2 and PHQ-9 indicated their significant potential as tools for depression screening and diagnosis in the HIV-infected population.
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Affiliation(s)
- Khunsa Junaid
- Department of Community Medicine, King Edward Medical University, Lahore 54000, Punjab Province, Pakistan
| | - Iqra Akram
- Department of Pulmonology, General Hospital, Lahore 54000, Punjab Province, Pakistan
| | - Muhammad Daood
- Department of Community Medicine, King Edward Medical University, Lahore 54000, Punjab Province, Pakistan
| | - Amjad Khan
- Department of Public Health and Nutrition, the University of Haripur, Haripur 22781, Khyber Pakhtunkhwa, Pakistan
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Snegireva N, Derman W, Patricios J, Welman KE. Blink duration is increased in concussed youth athletes: a validity study using eye tracking in male youth and adult athletes of selected contact sports. Physiol Meas 2022; 43. [PMID: 35709708 DOI: 10.1088/1361-6579/ac799b] [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: 12/30/2021] [Accepted: 06/16/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Diagnosing a sports-related concussion (SRC) remains challenging, and research into diagnostic tools is limited. This study investigated whether selected eye tracking variables would be a valid tool to diagnose and monitor SRC in adult and youth participants in selected contact sports, such as Rugby Union (rugby) and football (soccer). METHODS This prospective cohort study, with 70 concussed and 92 non-concussed adult and youth athletes, assessed the validity of five previously selected eye tracking variables for SRC diagnostics and management. The performance between concussed and age-matched control (non-concussed) athletes, as well as between three successive testing sessions in the concussed athletes were compared. Self-paced saccade count in adult group; blink duration in the memory-guided saccade and sinusoidal smooth pursuit tasks, proportion of antisaccade errors, and gain of diagonal smooth pursuit in the youth group were assessed. RESULTS The youth concussed group had higher blink duration in the fast memory-guided saccades task (p = 0.001, η2 = 0.17) and a tendency for higher blink duration in the sinusoidal smooth pursuit task (p = 0.016, η2 = 0.06) compared to the youth control group. In both tasks the blink duration in the concussed youth group decreased from session 1 to session 2 by 24% and 18%, accordingly, although statistical significance was not reached. The concussed adult group demonstrated a lower number of self-paced saccades compared to controls (p = 0.05, η2 = 0.09), which gradually increased, with the largest difference between session 1 and session 3 (p = 0.02). CONCLUSIONS Blink duration in youth athletes holds promise as a valid metric for concussion diagnostics and monitoring. It is recommended to focus future studies on comparing eye tracking performance within the same concussed athletes over time rather than comparing them to healthy controls.
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Affiliation(s)
- Nadja Snegireva
- Sports Science, Stellenbosch University Faculty of Medicine and Health Sciences, Suidwal Road, Coetzenburg, Cape Town, Western Cape, 7601, SOUTH AFRICA
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Francie Van Zijl Dr, Parow, Cape Town, Western Cape, 7505, SOUTH AFRICA
| | - Jon Patricios
- Wits Institute for Sport and Health, University of the Witwatersrand Faculty of Health Sciences, 27 St Andrews Rd, Parktown, Johannesburg, Gauteng, 2193, SOUTH AFRICA
| | - Karen Estelle Welman
- Sports Science, Stellenbosch University Faculty of Medicine and Health Sciences, Suidwal Road, Coetzenburg, Cape Town, Western Cape, 7601, SOUTH AFRICA
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Eye tracking to assess concussions: an intra-rater reliability study with healthy youth and adult athletes of selected contact and collision team sports. Exp Brain Res 2021; 239:3289-3302. [PMID: 34467416 DOI: 10.1007/s00221-021-06205-6] [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: 03/28/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
Eye movements that are dependent on cognition hold promise in assessing sports-related concussions but research on reliability of eye tracking measurements in athletic cohorts is very limited. This observational test-retest study aimed to establish whether eye tracking technology is a reliable tool for assessing sports-related concussions in youth and adult athletes partaking in contact and collision team sports. Forty-three youth (15.4 ± 2.2 years) and 27 adult (22.2 ± 2.9 years) Rugby Union and soccer players completed the study. Eye movements were recorded using SMIRED250mobile while participants completed a test battery twice, with a 1-week interval that included self-paced saccade (SPS), fixation stability, memory-guided sequence (MGS), smooth pursuit (SP), and antisaccades (AS) tasks. Intra-class correlation coefficient (ICC), measurement error (SEM) and smallest real difference (SRD) were calculated for 47 variables. Seventeen variables achieved an ICC > 0.50. In the adults, saccade count in SPS had good reliability (ICC = 0.86, SRD = 146.6 saccades). In the youth, the average blink duration in MGS had excellent reliability (ICC = 0.99, SRD = 59.4 ms); directional errors in AS tasks and gain of diagonal SP had good reliability (ICC = 0.78 and 0.77, SRD = 25.3 and 395.1%, respectively). Four metrics were found in this study to be reliable candidates for further biomarker validity research in contact and collision sport cohorts. Many variables failed to present a sufficient level of robustness for a practical diagnostic tool; possibly, because athletic cohorts have higher homogeneity, along with latent adverse effects of undetected concussions and repetitive head impacts. Since reliability of a measure can influence type II error, effect sizes, and confidence intervals, it is strongly advocated to conduct dedicated reliability evaluations prior to any validity studies.
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Mate K, Fulmer T, Pelton L, Berman A, Bonner A, Huang W, Zhang J. Evidence for the 4Ms: Interactions and Outcomes across the Care Continuum. J Aging Health 2021; 33:469-481. [PMID: 33555233 PMCID: PMC8236661 DOI: 10.1177/0898264321991658] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: An expert panel reviewed and summarized the literature related to the evidence for the 4Ms-what matters, medication, mentation, and mobility-in supporting care for older adults. Methods: In 2017, geriatric experts and health system executives collaborated with the Institute for Healthcare Improvement (IHI) to develop the 4Ms framework. Through a strategic search of the IHI database and recent literature, evidence was compiled in support of the framework's positive clinical outcomes. Results: Asking what matters from the outset of care planning improved both psychological and physiological health statuses. Using screening protocols such as the Beers' criteria inhibited overprescribing. Mentation strategies aided in prevention and treatment. Fall risk and physical function assessment with early goals and safe environments allowed for safe mobility. Discussion: Through a framework that reduces cognitive load of providers and improves the reliability of evidence-based care for older adults, all clinicians and healthcare workers can engage in age-friendly care.
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Affiliation(s)
- Kedar Mate
- Institute for Healthcare Improvement, Cambridge, MA, USA
| | - Terry Fulmer
- The John A. Hartford Foundation, New York, NY, USA
| | - Leslie Pelton
- Institute for Healthcare Improvement, Cambridge, MA, USA
| | - Amy Berman
- The John A. Hartford Foundation, New York, NY, USA
| | - Alice Bonner
- Institute for Healthcare Improvement, Cambridge, MA, USA
| | - Wendy Huang
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Jinghan Zhang
- Columbia University Mailman School of Public Health, New York, NY, USA
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Obikane E, Baba T, Shinozaki T, Obata S, Nakanishi S, Murata C, Ushio E, Suzuki Y, Shirakawa N, Honda M, Sasaki N, Nishi D, O'Mahen H, Kawakami N. Internet-based behavioural activation to improve depressive symptoms and prevent child abuse in postnatal women (SmartMama): a protocol for a pragmatic randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:314. [PMID: 33879065 PMCID: PMC8057289 DOI: 10.1186/s12884-021-03767-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child abuse and postnatal depression are two public health problems that often co-occur, with rates of childhood maltreatment highest during the first year of life. Internet-based behavioural activation (iBA) therapy has demonstrated its efficacy for improving postnatal depression. No study has examined whether the iBA program is also effective at preventing child abuse. This study aims to investigate whether iBA improves depressive symptoms among mothers and prevents abusive behaviours towards children in postpartum mothers in a randomized controlled trial, stratifying on depressive mood status. The study also evaluates the implementation aspects of the program, including how users, medical providers, and managers perceive the program in terms of acceptability, appropriateness, feasibility, and harm done. METHODS The study is a non-blinded, stratified randomized controlled trial. Based on cut-off scores validated on Japanese mothers, participants will be stratified to either a low Edinburgh Postnatal Depression Scale (EPDS) group, (EPDS 0-8 points) or a high EPDS group (EPDS ≥9 points). A total of 390 postnatal women, 20 years or older, who have given birth within 10 weeks and have regular internet-access will be recruited at two hospitals. Participants will be randomly assigned to either treatment, with treatment as usual (TAU) or through intervention groups. The TAU group receives 12 weekly iBA sessions with online assignments and feedback from trained therapists. Co-primary outcomes are maternal depressive symptoms (EPDS) and psychological aggression toward children (Conflict Tactic Scale 1) at the 24-week follow-up survey. Secondary outcomes include maternal depressive symptoms, parental stress, bonding relationship, quality of life, maternal health care use, and paediatric outcomes such as physical development, preventive care attendance, and health care use. The study will also investigate the implementation outcomes of the program. DISCUSSION The study investigates the effectiveness of the iBA program for maternal depressive symptoms and psychological aggression toward children, as well as implementation outcomes, in a randomized-controlled trial. The iBA may be a potential strategy for improving maternal postnatal depression and preventing child abuse. TRIAL REGISTRATION The study protocol (issue date: 2019-Mar-01, original version 2019005NI-00) was registered at the UMIN Clinical Trial Registry (UMIN-CTR: ID UMIN 000036864 ).
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Affiliation(s)
- Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Chie Murata
- Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Emiko Ushio
- Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Mari Honda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Depression, risk factors, and coping strategies in the context of social dislocations resulting from the second wave of COVID-19 in Japan. BMC Psychiatry 2021; 21:33. [PMID: 33435930 PMCID: PMC7802816 DOI: 10.1186/s12888-021-03047-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/01/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Social dislocations resulting from coronavirus disease 2019 (COVID-19) pandemic have been prolonged, which has led to general population social suppression. The present study aimed to reveal risk factors associated with mental health problems and suggest concrete coping strategies in the context of COVID-19. METHODS A web-based survey was conducted in July when Japan was experiencing a second wave of COVID-19. Demographics, Patient Health Questionnaire-9 (PHQ-9), state anger, anger control, and the Brief Coping Orientation to Problems Experienced were measured. Multivariate logistic regression analysis on PHQ-9 scores by set variables was conducted. RESULTS The participants were 2708 individuals, and 18.35% of them were depressed. Logistic regression analysis showed that in the order of odds ratios (ORs), underlying disease (OR = 1.96, 95% confidence interval (CI) = 1.32-2.92), not working (OR = 1.85, CI = 1.22-2.80), negative economic impact (OR = 1.33, CI = 1.01-1.77), state anger (OR = 1.17, CI = 1.14-1.21), anger control (OR = 1.08, CI = 1.04-1.13), age (OR = 0.97, CI = 0.96-0.98), high income (OR = 0.45, CI = 0.25-0.80), and being married (OR = 0.53, CI = 0.38-0.74) were predictors of depressive symptoms. Regarding coping strategies, planning (OR = 0.84, CI = 0.74-0.94), use of instrumental support (OR = 0.85, CI = 0.76-0.95), denial (OR = 0.88, CI = 0.77-0.99), behavioural disengagement (OR = 1.28, CI = 1.13-1.44), and self-blame (OR = 1.47, CI = 1.31-1.65) were associated with probable depression. CONCLUSIONS During prolonged psychological distress caused by COVID-19 pandemic, the prevalence of depressive symptoms in Japan was two to nine times as high as before the COVID-19 pandemic, even though Japan was not a lockdown country. Although some coping strategies were useful for maintaining mental health, such as developing ways, alone or with others, to address or avoid social dislocations, the influence of demographics was more powerful than these coping strategies, and medical treatments are needed for high-risk individuals.
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Sudom K. Validation of the Patient Health Questionnaire-2 to screen for depression in Canadian Armed Forces personnel. MILITARY PSYCHOLOGY 2020; 32:417-424. [PMID: 38536352 PMCID: PMC10013510 DOI: 10.1080/08995605.2020.1802401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/23/2020] [Indexed: 10/22/2022]
Abstract
Post-deployment screening within the Canadian Armed Forces (CAF) aims to capture those with mental health issues so that appropriate and timely treatment can be provided. However, the process is lengthy and places considerable burden on CAF members and clinicians. Evaluation of shorter measures of mental health is an important step toward reducing the length of the process while still capturing those in need of care. This study evaluated the 2-item Patient Health Questionnaire (PHQ-2) as a potential brief measure of depression to be included in screening. Operating characteristics of the PHQ-2 were assessed against the full scale using existing recommended cutoffs, as well as clinician impressions of depression being of major concern. Correlations of the PHQ-2 with other measures of health were also examined. The PHQ-2 demonstrated good sensitivity and specificity for detecting depression compared to the full scale and to clinician impressions, at cutoffs similar to those found in past research. As well, it exhibited high correlations with other measures of mental health. This study provides evidence for the validity of the PHQ-2 as a brief screening tool for depression in CAF members following deployment.
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Affiliation(s)
- Kerry Sudom
- Department of National Defence, Defence Research and Development Canada, Ottawa, Ontario, Canada
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12
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Fang S, Wang XQ, Yang BX, Liu XJ, Morris DL, Yu SH. Survey of Chinese persons managing depressive symptoms: Help-seeking behaviours and their influencing factors. Compr Psychiatry 2019; 95:152127. [PMID: 31669791 DOI: 10.1016/j.comppsych.2019.152127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/24/2019] [Accepted: 09/09/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To explore help-seeking behaviours of Chinese persons managing depressive symptoms and factors that influence these behaviours. METHODS A survey of residents living in communities in Wuhan, China was conducted using stratified random sampling. The Patient Health Questionnaire (PHQ-2), the Actual Help-Seeking Questionnaire (AHSQ) and a socio-demographic questionnaire were completed by participants. Descriptive statistics were analyzed. A multiple linear regression model was used to explore factors associated with help-seeking behaviours. RESULTS Of the 1785 respondents, 672 (37.6%) reported that they experienced depressive symptoms during the past year, and of these respondents, 517 (76.9%) indicated that they sought assistance. Among help-seeking sources utilized by participants, informal help was sought most frequently (72.9%), followed by hotline/Internet assistance (14.3%), mental health professionals (MHPs) (7.9%) and general physicians (GPs) (3.7%). The results of multilinear regression analysis showed that participants who were adults (aged 25-64 years), attended junior and high school (7-12 years education), and lived in urban areas were more likely to seek additional assistance for their depressive symptoms. CONCLUSION Mental health promotion and education efforts are needed to improve the public's mental health literacy and to promote appropriate utilization of informal sources of assistance in managing depressive symptoms such as a hotline or the Internet. Further interventions need to be considered to reinforce use of social supports and mental health professionals, especially in rural areas.
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Affiliation(s)
- Shu Fang
- School of Health Sciences, Wuhan University, China
| | | | | | - Xiu Jun Liu
- Affiliated Mental Health Center, Tongji Medical College of Huazhong, University of Science & Technology, China
| | - Diana L Morris
- Florence Cellar Associate Professor of Gerontological Nursing, Frances Payne Bolton School of Nursing, University Center on Aging & Health, Case Western Reserve University, USA
| | - Si Hong Yu
- School of Health Sciences, Wuhan University, China
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Mahlich J, Schaede U, Sruamsiri R. Shared Decision-Making and Patient Satisfaction in Japanese Rheumatoid Arthritis Patients: A New "Preference Fit" Framework for Treatment Assessment. Rheumatol Ther 2019; 6:269-283. [PMID: 31049848 PMCID: PMC6513920 DOI: 10.1007/s40744-019-0156-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION We have developed a new framework to assess shared decision-making (SDM) as a tool to improve patient satisfaction. This framework is based on a "preference fit" index that relates SDM to patient treatment preferences and patient satisfaction in a sample of rheumatoid arthritis (RA) patients in Japan. METHODS We surveyed 500 RA patients in Japan and explored the interactions between the treatment preference fit index, SDM, and overall patient satisfaction. RESULTS Our new preference fit index reveals significant impact on patient satisfaction: the better the fit between SDM and patient preferences, the higher the patient satisfaction with the current treatment. Patients treated with biologic agents were more satisfied. Patients suffering from depression or migraines scored significantly lower both on our preference fit measure and for overall patient satisfaction. CONCLUSION The association between depression and a low treatment preference fit suggests that depression may pose challenges to SDM and that doctors in Japan are less attuned to the SDM preferences of depressed patients. FUNDING Janssen Pharmaceutical KK.
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Affiliation(s)
- Jörg Mahlich
- Health Economics and Outcomes Research, Janssen-Cilag, Neuss, Germany.
- Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany.
| | | | - Rosarin Sruamsiri
- Center of Pharmaceutical Outcomes Research, Naresuan University, Phitsanulok, Thailand
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Hirayama T, Ogawa Y, Yanai Y, Suzuki SI, Shimizu K. Behavioral activation therapy for depression and anxiety in cancer patients: a case series study. Biopsychosoc Med 2019; 13:9. [PMID: 31168316 PMCID: PMC6487522 DOI: 10.1186/s13030-019-0151-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background Behavioral activation therapy (BAT) directly addresses activities that individuals value most highly, and may be easily applicable to cancer patients. However, there is no established evidence of the use of BAT in this population. In this study, we examined the possibility of a BAT program for depression and anxiety in cancer patients. Case presentation We retrospectively reviewed the medical records of cancer patients with each of the following characteristics: 1) were outpatients or inpatients visiting the psycho-oncology division of the National Cancer Center Hospital in Japan; 2) met criteria for Major Depressive Disorder or Adjustment Disorders; and 3) participated in a BAT program. The primary outcome was the program completion percentage. Secondary outcomes were self-reported depression severity (Patient Health Questionnaire-9 (PHQ-9) score), anxiety disorder status (Generalized Anxiety Disorder-7 (GAD-7) score), and clinical improvement (Clinical Global Impression-Improvement (CGI-I) score) after the program. We analyzed both depression and anxiety by the matched paired t-test. Ten patients participated in the program, and nine completed it. One dropped out due to cognitive impairment secondary to brain metastasis. Both the PHQ-9 scores (pre: 14.4 (SD, 6.1); post: 5.1 (SD, 5.8)) and the GAD-7 scores (pre: 11.9 (SD, 4.9); post: 4.7 (SD, 5.5)) significantly improved after the program (PHQ-9: P = 0.0014; GAD-7: P = 0.0004). CGI-I scores ranged from 1 to 3, and all subjects except the patient who dropped out improved clinically. Among the ten patients, three distinctive cases could be observed as follows. Case 1; a 45-year-old housewife with breast cancer who did not agree to take antidepressants because of concerns about the side effects achieved remission without antidepressants and began to live an active life. Case 4; a 66-year-old housewife was so shocked after endometrial cancer diagnosis that she was absent-minded and her compliance with the assigned homework was poor, therefore, her depression did not improve much. Case 9; a 62-year-old man with laryngeal cancer who had recurrent anxiety. Increased business activity, on which he put great value, gradually allowed him to be able to live his life actively without concerns. Conclusions This study suggests that BAT would be effective for the depression and anxiety of cancer patients.
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Affiliation(s)
- Takatoshi Hirayama
- 1Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Yuko Ogawa
- 2Faculty of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama, Tokyo 359-1192 Japan
| | - Yuko Yanai
- 1Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
| | - Shin-Ichi Suzuki
- 2Faculty of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama, Tokyo 359-1192 Japan
| | - Ken Shimizu
- 1Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan
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Schuler M, Strohmayer M, Mühlig S, Schwaighofer B, Wittmann M, Faller H, Schultz K. Assessment of depression before and after inpatient rehabilitation in COPD patients: Psychometric properties of the German version of the Patient Health Questionnaire (PHQ-9/PHQ-2). J Affect Disord 2018; 232:268-275. [PMID: 29499510 DOI: 10.1016/j.jad.2018.02.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/05/2018] [Accepted: 02/16/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression is a frequent comorbidity of COPD and leads to worse clinical COPD-outcomes. PHQ-9 and PHQ-2 are two widely used brief instruments to assess depression. However, psychometric properties in COPD patients are unknown. This study examines factorial validity, measurement invariance and composite reliability (CR) of PHQ-9/PHQ-2, respectively, and concordance between both tools. METHODS This is a secondary analysis of N = 561 COPD patients who filled out the PHQ-9 at the begin (T0), the end (T1) and 3/6/9/12 (T2/T3/T4/T5) months after pulmonary inpatient rehabilitation. Structural equation modeling was used to examine factorial validity and measurement invariance between gender, GOLD disease severity groups and over time. Concordance was assessed using Cohen's Kappa, Yules Y, positive and negative agreement. RESULTS A one-factor model (with one freed residual covariance) showed best model fit. At least partial scalar invariance could be established. Concordance between both instruments was substantial. 31.7% (26.2%) COPD patients showed clinically relevant depression according to PHQ-9 (PHQ-2) at T0. At T0-T2, PHQ-9 classified more patients as depressed than did PHQ-2. According to both measures, depression rates declined after rehabilitation. Reliability was high for both PHQ-9 (CR = 0.94) and PHQ-2 (CR = 0.89). LIMITATIONS No gold-standard (clinical interview) to assess depression was used. Therefore, diagnostic accuracy for PHQ-9/PHQ-2 remains unclear. CONCLUSIONS PHQ-9 and PHQ-2 fulfill important psychometric criteria (factorial validity, invariance, reliability) for measuring depression in COPD. The results support their use in clinical practice to assess severity of depression. Diagnostic accuracy to identify major/minor depression of both instruments should be examined in future studies.
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Affiliation(s)
- Michael Schuler
- University of Würzburg, Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Würzburg, Germany.
| | - Miriam Strohmayer
- University of Würzburg, Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Würzburg, Germany
| | - Stephan Mühlig
- Chemnitz University of Technology, Clinical Psychology and Psychotherapy, Chemnitz, Germany
| | - Birgit Schwaighofer
- Bad Reichenhall Clinic, Centre for Rehabilitation, Pneumology and Orthopedics, Bad Reichenhall, Germany
| | - Michael Wittmann
- Bad Reichenhall Clinic, Centre for Rehabilitation, Pneumology and Orthopedics, Bad Reichenhall, Germany
| | - Hermann Faller
- University of Würzburg, Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Würzburg, Germany
| | - Konrad Schultz
- Bad Reichenhall Clinic, Centre for Rehabilitation, Pneumology and Orthopedics, Bad Reichenhall, Germany
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16
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van Aartsen J, van Aswegen H. Changes in biopsychosocial outcomes for a mixed cohort of ICU survivors. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2018; 74:427. [PMID: 30135920 PMCID: PMC6093101 DOI: 10.4102/sajp.v74i1.427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 02/06/2018] [Indexed: 01/18/2023] Open
Abstract
Background Prolonged inflammation and infection associated with being critically ill and the ensuing physical inactivity has proven negative effects on the recovery of physical function, psychological health and reintegration into society for intensive care unit (ICU) survivors. Limited evidence is available on changes in biopsychosocial outcomes for South Africans recovering from an episode of critical illness. Objectives To determine changes in biopsychosocial outcomes for a mixed cohort of ICU survivors in hospital and at 1 month and 6 months after discharge. Method A prospective, observational, longitudinal study was conducted. Severity of illness, mechanical ventilation (MV) duration and ICU and hospital length of stay (LOS) were recorded. Physical function in ICU test-scored (PFIT-s) was performed at discharge from ICU and hospital. At 1 month and 6 months, peripheral muscle strength, exercise endurance, health-related quality of life (HRQOL), depression status and return to work were assessed. Descriptive and inferential statistics were used. Results Participants (n = 24) had a median age of 51.5 years, majority were male (n = 19; 79%) and most were employed before admission (n = 20; 83%). At 6 months, 11 participants (n = 11) were part of the final sample. Median PFIT-s changed significantly (0.3 points; p = 0.02) between ICU and hospital discharge. Peripheral muscle strength improved significantly for upper and lower limbs over 6 months (p = 0.00–0.03) but change in median 6-minute walk test distance (65m) was not significantly different. Significant improvements occurred in mean Medical Outcomes Short Form-36 (SF-36) physical health component scores (8.8 ± 7.6; p = 0.00). Mean SF-36 mental health component scores had a strong negative relationship with MV duration (r = −0.7; p = 0.01), LOS (r = −0.56; p = 0.04) and Patient Health Questionnaire 9 scores (r = −0.72; p = 0.01). Six participants (55%) returned to employment. Conclusion Clinically important improvements in biopsychosocial outcomes related to physical function and social factors were observed. Limitations in mental aspects of HRQOL were present at 6 months and some reported mild depressive symptoms. Clinical implications Intensive care unit survivors with a history of prolonged MV duration and hospital LOS who exhibit limitations in mental HRQOL, and signs of depressive symptoms should be referred to a psychologist for evaluation.
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Affiliation(s)
| | - Helena van Aswegen
- Department of Physiotherapy, University of the Witwatersrand, South Africa
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Poritz JMP, Mignogna J, Christie AJ, Holmes SA, Ames H. The Patient Health Questionnaire depression screener in spinal cord injury. J Spinal Cord Med 2018; 41:238-244. [PMID: 28355958 PMCID: PMC5901461 DOI: 10.1080/10790268.2017.1294301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT Although depression is not inevitable following spinal cord injury/dysfunction (SCI/D), it can have a negative impact on rehabilitation. Evidence-based assessment of depression utilizing self-report instruments, such as the Patient Health Questionnaire-9 (PHQ-9), is considered good clinical practice. Although the PHQ-9 has been studied in individuals with SCI/D, little is known about the clinical utility of the Patient Health Questionnaire-2 (PHQ-2). Traditional cutoff scores for the PHQ-2 were examined to explore their operating characteristics as related to PHQ-9 results. METHODS Archival data were collected for 116 Veterans with SCI/D who completed the PHQ-2 and PHQ-9 as one component of their routine, comprehensive SCI annual evaluation at a Veterans Affairs Medical Center. Logistic regressions were performed to determine the impact of different cutoff scores for the PHQ-2 on the likelihood that participants would endorse clinically significant levels of depressive symptoms on the PHQ-9 (≥10). RESULTS Using a cutoff score of 3 or greater correctly classified 94.8% of the cases, outperforming the other cutoff scores. A cutoff score of 3 or greater had a sensitivity of 83.3% and specificity of 97.8%, and yielded a positive predictive value of 90.9% and a negative predictive value of 95.7%. CONCLUSION The PHQ-2 shows promise as a clinically useful screener in the community-residing SCI/D population. Findings regarding the presence of suicidal ideation emphasize the importance of routine screening for depressive symptomatology in the SCI/D population. Future research should investigate the role of the PHQ-2 in clinical decision-making and treatment monitoring.
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Affiliation(s)
| | - Joseph Mignogna
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA,Central Texas Veterans Health Care System, Temple, Texas, USA,Texas A&M College of Medicine, Temple, Texas, USA
| | - Aimee J. Christie
- Michael E. DeBakey VA Medical Center, Houston, Texas, USA,Baylor College of Medicine, Houston, Texas, USA
| | - Sally A. Holmes
- Michael E. DeBakey VA Medical Center, Houston, Texas, USA,Baylor College of Medicine, Houston, Texas, USA
| | - Herb Ames
- Michael E. DeBakey VA Medical Center, Houston, Texas, USA,Baylor College of Medicine, Houston, Texas, USA,Correspondence to: Herb Ames, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, Texas 77030 USA.
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Fujino H, Shingaki H, Suwazono S, Ueda Y, Wada C, Nakayama T, Takahashi MP, Imura O, Matsumura T. Cognitive impairment and quality of life in patients with myotonic dystrophy type 1. Muscle Nerve 2017; 57:742-748. [PMID: 29193182 DOI: 10.1002/mus.26022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 11/25/2017] [Accepted: 11/27/2017] [Indexed: 01/25/2023]
Abstract
INTRODUCTION This study sought to clarify whether specific cognitive abilities are impaired in patients with myotonic dystrophy type 1 (DM1) as well as to investigate the relationships among quality of life (QoL), cognitive function, and psychological factors. METHODS Sixty patients with DM1 were evaluated on cognitive functioning (abstract reasoning, attention/working memory, executive function, processing speed, and visuoconstructive ability), apathy, depression, excessive daytime sleepiness, fatigue, and QoL. QoL was assessed by 2 domains of the Muscular Dystrophy Quality of Life Scale (Psychosocial Relationships and Physical Functioning and Health). RESULTS More than half of the patients exhibited cognitive impairment in attention/working memory, executive function, processing speed, and visuoconstructive ability. The Psychosocial Relationships factor was associated with processing speed, attention/working memory, and apathy, whereas depression and fatigue were associated with 2 QoL domains. DISCUSSION Our study identified specific cognitive impairments in DM1. Specific cognitive functions and psychological factors may be potential contributors to QoL. Muscle Nerve 57: 742-748, 2018.
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Affiliation(s)
- Haruo Fujino
- Department of Special Needs Education, Oita University, 700 Dannoharu, Oita, Japan, 870-1192.,Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Honoka Shingaki
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Shugo Suwazono
- Department of Neurology, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | | | - Chizu Wada
- Department of Neurology, National Hospital Organization Akita National Hospital, Yurihonjo, Japan
| | | | - Masanori P Takahashi
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Osaka, Japan
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Sruamsiri R, Kaneko Y, Mahlich J. The underrated prevalence of depression in Japanese patients with rheumatoid arthritis - evidence from a Nationwide survey in Japan. BMC Rheumatol 2017; 1:5. [PMID: 30886949 PMCID: PMC6383594 DOI: 10.1186/s41927-017-0003-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/19/2017] [Indexed: 01/06/2023] Open
Abstract
Background To determine the prevalence of depression among Japanese people with rheumatoid arthritis (RA) and explore the relationships between depression and an array of variables. Methods Nation-wide, cross-sectional online survey (n = 500) of people with RA including the Patient Health Questionnaire (PHQ-9) to measure the presence and severity of depressive symptoms were performed. Results While only 5% of the population studied had been officially diagnosed with depression, 35% had PHQ-9 scores indicating depression was present. People with RA are more likely to experience depression if they are younger, have greater functional impairment, or whose treatment regimen includes pain medications not biologic agents. Conclusions It is a potential risk of under-diagnosis and under-reporting of depression in Japanese people with RA. People with RA are more likely to experience depression if they are younger, have greater functional impairment, or whose treatment regimen includes pain medications without biologic drugs. Electronic supplementary material The online version of this article (10.1186/s41927-017-0003-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosarin Sruamsiri
- Health Economics, Janssen Pharmaceutical KK, 5-2, Nishi-kanda 3-chome Chiyoda-ku, Tokyo, 101-0065 Japan.,2Center of Pharmaceutical Outcomes Research, Naresuan University, Phitsanulok, Thailand
| | - Yuko Kaneko
- 3Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jörg Mahlich
- Health Economics, Janssen Pharmaceutical KK, 5-2, Nishi-kanda 3-chome Chiyoda-ku, Tokyo, 101-0065 Japan.,4Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany
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Sruamsiri R, Mahlich J, Tanaka E, Yamanaka H. Productivity loss of Japanese patients with rheumatoid arthritis - A cross-sectional survey. Mod Rheumatol 2017; 28:482-489. [PMID: 28849715 DOI: 10.1080/14397595.2017.1361893] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was (1) to determine productivity costs due to absenteeism and presenteeism among Japanese workers with rheumatoid arthritis (RA), and (2) to identify additional factors associated with productivity loss among workers with RA. METHODS An online survey of 500 RA Japanese patients was used. The Japanese version of the Stanford Health Assessment Questionnaire (J-HAQ) was used to measure patients' functional disability. The patient health questionnaire-9 item (PHQ-9) was used to measure symptoms and severity of depression. To assess work productivity the 'work productivity and activity impairment questionnaire' for rheumatoid arthritis (WPAI-RA), a six-item validated instrument was used. RESULTS Percentages of absenteeism and presenteeism were found to be 1% and 23%, respectively. The annual combined productivity costs of both absenteeism and presenteeism was 7877 USD per patient. Factors significantly associated with a higher productivity loss were functional disability, depressive symptoms, and time since RA diagnosis, while age, and biological disease-modifying antirheumatic drugs (bDMARDs) treatment were significantly associated with a lower productivity loss. CONCLUSION Treatment of RA with bDMARDs would likely result in decreased productivity loss among Japanese patients.
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Affiliation(s)
- Rosarin Sruamsiri
- a Center of Pharmaceutical Outcomes Research , Naresuan University , Muang Phitsanulok , Thailand.,b Health Economics , Janssen Pharmaceutical KK , Tokyo , Japan
| | - Jörg Mahlich
- b Health Economics , Janssen Pharmaceutical KK , Tokyo , Japan.,c Düsseldorf Institute for Competition Economics (DICE) , University of Düsseldorf , Düsseldorf , Germany
| | - Eiichi Tanaka
- d Institute of Rheumatology , Tokyo Women's Medical University Hospital , Tokyo , Japan
| | - Hisashi Yamanaka
- d Institute of Rheumatology , Tokyo Women's Medical University Hospital , Tokyo , Japan
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Mahlich J, Sruamsiri R. Preference for shared decision-making in Japanese patients with rheumatoid arthritis. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1353262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Jörg Mahlich
- Department of Health Economics, Janssen Pharmaceutical KK, 5-2, Nishi-kanda 3-chome Chiyoda-ku, Tokyo 101-0065, Japan
- Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany
| | - Rosarin Sruamsiri
- Department of Health Economics, Janssen Pharmaceutical KK, 5-2, Nishi-kanda 3-chome Chiyoda-ku, Tokyo 101-0065, Japan
- Center of Pharmaceutical Outcomes Research, Naresuan University, Phitsanulok, Thailand
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Liu ZW, Yu Y, Hu M, Liu HM, Zhou L, Xiao SY. PHQ-9 and PHQ-2 for Screening Depression in Chinese Rural Elderly. PLoS One 2016; 11:e0151042. [PMID: 26978264 PMCID: PMC4792401 DOI: 10.1371/journal.pone.0151042] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 02/23/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to explore cut-off scores of the 9-item Patient Health Questionnaire (PHQ-9) and 2-item Patient Health Questionnaire (PHQ-2) for depression screening in Chinese rural elderly. Methods A cross-sectional study was conducted on 839 residents aged 60 years and above in rural areas of Liuyang County. PHQ-9 was adopted to evaluate depression. The Structured Clinical Interview for DSM Disorders (SCID-I) was adopted to diagnose major depressive disorder (MDD) as a golden standard. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, Youden’s index and the receiver operating characteristic (ROC) curve were analyzed on PHQ-9 and PHQ-2. Results The Cronbach's alphas of PHQ-9 and PHQ-2 were 0.82 and 0.76, respectively. The score of 8 of the PHQ-9 showed the highest Youden’s index of 0.85, with a sensitivity of 0.97 and specificity of 0.89 respectively, and the area under the ROC curve (AUC) was 0.97 (95% CI: 0.96–0.98). The score of 3 of PHQ-2 showed the highest Youden’s index of 0.79, with both sensitivity and specificity were 0.90 and the AUC was 0.94 (95% CI: 0.90–0.97). Conclusions Both PHQ-9 and PHQ-2 are valid screening instruments for depression in the rural elderly in China, with recommended cut-off scores of 8 and 3 respectively.
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Affiliation(s)
- Zi-wei Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Hui-ming Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Liang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shui-yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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