Validation of the K6 and its depression and anxiety subscales for detecting nonspecific psychological distress and need for treatment

2018 ◽  
Vol 39 (5) ◽  
pp. 1552-1561 ◽  
Author(s):  
John W. Lace ◽  
Zachary C. Merz ◽  
Alex F. Grant ◽  
Natalie A. Emmert ◽  
Katherine L. Zane ◽  
...  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Glareh Koochakpoor ◽  
Asma Salari-Moghaddam ◽  
Ammar Hassanzadeh Keshteli ◽  
Hamid Afshar ◽  
Ahmad Esmaillzadeh ◽  
...  

Abstract Background There is no previous study that examined the association between branched-chain amino acids (BCAAs) intake and odds of psychological disorders. The aim of this study was to investigate the association between dietary BCAAs and odds of psychological disorders including depression, anxiety, and psychological distress in a large sample of Iranian adults. Methods In this cross-sectional study on 3175 Iranian adults aged 18–55 years, a validated food frequency questionnaire was used to assess dietary intakes. BCAAs intake was computed by summing up the amount of valine, leucine, and isoleucine intake from all food items in the questionnaire. Psychological health was examined through the use of Iranian validated version of the Hospital Anxiety and Depression Scale (HADS). Psychological distress was assessed using General Health Questionnaire (GHQ). For depression and anxiety, scores of 8 or more on either subscale were considered as psychological disorders and scores of 0–7 were defined as “normal”. In terms of psychological distress, the score of 4 or more was defined as psychological distress. Results Mean age of study participants was 36.2 ± 7.8 years. Overall, 26.4% (n = 837) of study subjects had depression, 11.9% (n = 378) had anxiety and 20.9% (n = 665) were affected by psychological distress. After controlling for potential confounders, participants in the highest tertile of total BCAAs intake had lower odds of depression (OR: 0.76; 95% CI: 0.60–0.96) and anxiety (OR: 0.66; 95% CI: 0.47–0.91) compared with those in the lowest tertile. Participants in the top tertile of valine intake had a lower odds of depression (OR: 0.76; 95% CI: 0.60–0.96) and anxiety (OR: 0.65; 95% CI: 0.47–0.90) compared with those in the bottom tertile. A significant inverse association was also seen between leucine intake and depression (OR: 0.77; 95% CI: 0.61–0.98) and anxiety (OR: 0.66; 95% CI: 0.47–0.91). In addition, a significant inverse association was observed between isoleucine intake and odds of depression (OR: 0.75; 95% CI: 0.59–0.95) and anxiety (OR: 0.62; 95% CI: 0.45–0.86). There was no significant association between isoleucine intake and odds of psychological distress. Conclusion Evidence indicating an inverse association between dietary intake of BCAAs and odds of depression and anxiety was found. Prospective studies are required to confirm these findings.


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
ACJ Van Der Lingen ◽  
MT Rijnierse ◽  
AM Hooghiemstra ◽  
S Elshout ◽  
VP Van Halm ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background Psychological distress, such as symptoms of anxiety and depression, are frequently present in patients receiving an implantable cardioverter defibrillator (ICD) and they are associated with adverse outcomes. Multiple pathophysiological mechanisms may explain the link between psychological distress and cardiovascular disease, such as autonomic dysfunction, neuro-endocrine alterations and chronic inflammation. Purpose The present study aims to examine the prevalence of psychological distress at time of ICD implantation and evaluates the complex interplay between psychological distress, autonomic function, neuro-endocrine alterations and inflammatory status in ICD patients. Methods We conducted a prospective study that included ICD patients receiving an ICD for primary and secondary prevention of sudden cardiac death. Prior to implantation, patients underwent extensive psychological evaluation, including validated questionnaires for depression, anxiety and personality traits. Cardiac status was evaluated by left ventricular ejection fraction (LVEF) assessment, New York Heart Association (NYHA) functional class evaluation, 6-minute walk test (6MWT), and 24-hour Holter monitoring for heart rate variability (HRV). Thyroid function, catecholamine levels and inflammatory status were also evaluated. Results Of 178 patients included (age 64 ± 12, 79% male, LVEF 35 ± 13%), 35% had symptoms of depression and 32% had symptoms of anxiety. Symptoms of depression and anxiety increased significantly with higher NYHA functional class (P < 0.001). Depressive symptoms were associated with a reduced 6MWT (411 ± 128 m versus 488 ± 89 m, P < 0.001), lower LVEF (29 ± 9% versus 36 ± 13%, P = 0.03), higher heart rate (74 ± 13 bpm versus 70 ± 13 bpm, P = 0.02), higher thyroid stimulating hormone levels (1.8 [1.3-2.8] mU/L versus 1.5 [1.0-2.2] mU/L, P = 0.04) and multiple HRV parameters, indicating reduced HRV. Anxiety symptoms were only associated with a reduced 6MWT (433 ± 112 m versus 477 ± 102, P = 0.02). Symptoms of depression or anxiety were not correlated with c-reactive protein, NT-proBNP or catecholamine levels. Conclusion A substantial part of ICD patients has symptoms of depression and anxiety at time of ICD implantation. Depression was correlated with a higher NYHA class, reduced exercise capacity,  reduced LV-function and alterations in autonomic function, suggesting a biological link between depression and cardiac status. Whether depression and anxiety leads to an increase in ventricular arrhythmias will be determined during further follow-up. Abstract Figure. NYHA class and psychological distress


Author(s):  
Kate A Neilson ◽  
Annabel C Pollard ◽  
Ann M Boonzaier ◽  
June Corry ◽  
David J Castle ◽  
...  

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1662-e1670
Author(s):  
Gina Evans-Hudnall ◽  
Mary O Odafe ◽  
Adrienne Johnson ◽  
Nicholas Armenti ◽  
Jennifer O’Neil ◽  
...  

Abstract Introduction Obesity is highly comorbid with psychological symptoms in veterans, particularly post-traumatic stress disorder (PTSD), depression, and anxiety. Obese veterans with comorbid psychological symptoms often display suboptimal weight loss and poor physical functioning when participating in weight management programs. The MOVE! program aims to increase healthy eating and physical activity to promote weight loss in obese veterans. Adequately addressing psychological barriers is necessary to maximize outcomes in MOVE! for veterans with PTSD, depression, and anxiety. We examined the preliminary outcomes of administering the Healthy Emotions and Improving Health BehavioR Outcomes (HERO) intervention. HERO is adjunctive cognitive-behavioral therapy to MOVE! that addresses PTSD, depression, and anxiety symptom barriers to engagement in physical activity. Materials and Methods All recruitment and study procedures were approved by the institutional review board and research and development committees of the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, Texas. Participants gave written informed consent before enrollment. Thirty-four obese veterans with a diagnosis of PTSD, depression, and/or anxiety who were attending MOVE! were assigned to the 8-session HERO group or the usual care (UC) group. Veterans completed assessments of PTSD, depression and anxiety symptoms, physical activity, physical functioning, and weight at baseline, 8 and 16 weeks post treatment. Changes from baseline to 8- and 16-week follow-up on the self-report and clinician-rated measures were assessed, using independent samples t-tests and analyses of covariance. Results At 8 weeks post treatment, participants in the HERO group had significantly higher step counts per day than participants in the UC group. Similarly, at 16 weeks post-treatment, participants in the HERO group continued to experience a significant increase in daily steps taken per day, as well as statistically and clinically significantly lower scores on the depression symptom and PTSD symptom severity. Participants in the HERO group also demonstrated significantly higher scores on the physical functioning inventory than participants in the UC group (44.1 ± 12.1 vs. 35.7 ± 10.7, P = 0.04) at 16 weeks post treatment. Conclusions Findings of this small trial have important implications pending replication in a more rigorously designed large-scale study. Providing an adjunctive treatment to MOVE! that addresses psychological distress has potential benefits for psychological symptom reduction, engagement in healthy dietary habits, and greater physical activity for individuals who traditionally experience barriers to making positive weight management changes.


2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi201-vi201
Author(s):  
Sophia Landay ◽  
Maya Anand ◽  
Nora Horick ◽  
Jamie Jacobs ◽  
Kit Quain ◽  
...  

Abstract BACKGROUND Caregivers of patients with newly diagnosed malignant gliomas experience high rates of psychological distress. However, the factors associated with distress in this population have not been well described. We sought to evaluate patient-related, caregiver-related and tumor-related factors associated with depression and anxiety in this caregiver population. METHODS We conducted a prospective study in patients with newly diagnosed malignant gliomas and their caregivers, collecting self-report data within 6 weeks of diagnosis. Patients’ and caregivers’ depression and anxiety were assessed using the Hospital Anxiety and Depression Scale, with subscale scores >7 considered clinically significant. Information about the tumor location and molecular features was extracted from the medical record. We used univariate and multivariate linear models to evaluate the association between caregiver anxiety and depression at baseline and specific caregiver-, patient- and tumor-related factors. RESULTS We enrolled 61 patient-caregiver dyads in this study. 26.2% (16/61) of caregivers had significant depression symptoms, and 47.5% (29/61) had significant anxiety. In the multivariable analysis, factors associated with higher caregiver depression score included younger caregiver age (< 65 years old; B=4.24, p=0.0002), left-sided tumor location (B=1.98, p=0.030), IDH wild-type tumor status (B=3.44, p=0.0008) and patient anxiety (B=2.28, p=0.017). Factors associated with higher caregiver anxiety were younger caregiver age (B=2.47, p=0.089) and left-sided tumor location (B=4.23, p=0.001). CONCLUSIONS Younger caregiver age and caring for a patient with a tumor on the left side of the brain were associated with worse caregiver depression and anxiety. Higher caregiver depression was correlated with caregivers whose loved one had significant anxiety or had an IDH wild-type tumor. Understanding the factors associated with caregiver anxiety and depression may guide neuro-oncology clinicians in identifying caregivers who may be at an increased risk for psychological distress at the time of their loved one’s diagnosis, allowing for earlier initiation of support services for these caregivers.


2018 ◽  
Vol 122 (1) ◽  
pp. 340-359 ◽  
Author(s):  
John W. Lace ◽  
Kristen A. Haeberlein ◽  
Paul J. Handal

This study investigated the dimensionality of the Langner Symptom Survey and replicated a recent finding regarding a clinically validated cutoff score in emerging adults. Nine hundred thirteen (631 females and 282 males) students at a private university in the Midwestern United States participated online as part of a larger study and completed the Langner Symptom Survey and a demographic questionnaire. Results from exploratory principal components and confirmatory factor analyses provided support for both a six- and three-factor model of the Langner Symptom Survey, with the three-factor model offering marginally better confirmatory fit indices and greater parsimony of interpretation. A cutoff score of 5 denoting clinically significant psychological distress and need for treatment was supported through analysis of receiver-operating characteristic, sensitivity, specificity, and total classification accuracy based on psychological service utilization, and this result successfully replicated a recently published finding. The Langner Symptom Survey may function as a multidimensional measure of psychological distress and need for treatment in emerging adults that may need a lexical update.


2017 ◽  
Vol 44 ◽  
pp. 97-103 ◽  
Author(s):  
S. Otte ◽  
N. Vasic ◽  
S. Nigel ◽  
J. Streb ◽  
T. Ross ◽  
...  

AbstractBackground:Previous research indicates that prisoners have severe psychological distress. To assess their distress level and potential need for treatment, the present study compared the subjective psychological distress of long- and short-term prisoners with that of psychiatric and forensic patients.Methods:Long- (n = 98) and short-term prisoners (n = 94) and forensic (n = 102) and psychiatric (n = 199) patients completed the German versions of the Symptom Checklist Revised (SCL-90-R) and Brief Symptom Inventory (BSI).Results:In general, long-term prisoners showed the same level of mental distress as psychiatric patients and more than that reported by forensic patients. Short-term prisoners reported the least level of distress. Long- but not short-term prisoners showed clinically significant results on the scales for depression, paranoid ideation, and psychosis.Conclusions:The improvements in psychiatric treatment for inmates demanded by many stakeholders need to differentiate between long- and short-term prisoners. Because depression seems to cause the most psychological distress among inmates, suicide prevention seems to be an important issue in prisons.


2019 ◽  
Author(s):  
Bárbara Pereira Antunes ◽  
Pedro Pereira Rodrigues ◽  
Irene J. Higginson ◽  
Pedro Lopes Ferreira

Abstract Background: patients with palliative needs often experience high symptom burden which causes suffering to themselves and their families. Depression and psychological distress should not be considered a “normal event” in advanced disease patients and should be screened, diagnosed, acted on and followed-up. Psychological distress has been associated with greater physical symptom severity, suffering, and mortality in cancer patients. A holistic, but short measure should be used for physical and non-physical needs assessment. The Integrated Palliative care Outcome Scale is one such measure. This work aims to determine palliative needs of patients and explore screening accuracy of two items pertaining to psychological needs. Methods: multi-centred observational study using convenience sampling. Data were collected in 9 Portuguese centres. Inclusion criteria: ≥18 years, mentally fit to give consent, diagnosed with an incurable, potentially life-threatening illness. Exclusion criteria: patient in distress ("unable to converse for a period of time"), cognitively impaired. Descriptive statistics used for demographics. Receiving Operator Characteristics curves and Area Under the Curve for anxiety and depression discriminant properties against the Hospital Anxiety and Depression Scale. Results: 1703 individuals were screened between July 1st, 2015 and February 2016. A total of 135 (7.9%) were included. Main reason for exclusion was being healthy (75.2%). The primary care centre screened most individuals, as they have the highest rates of daily patients and the majority are healthy. Mean age is 66.8 years (SD 12.7), 58 (43%) are female. Most patients had a cancer diagnosis 109 (80.7%). Items scoring highest (=4) were: family or friends anxious or worried (36.3%); feeling anxious or worried about illness (13.3%); feeling depressed (9.6%). Using a cut-off score of 2/3, Area Under the Curve for depression and anxiety items were above 70%. Conclusions: main palliative needs were psychological, family related and spiritual. This suggests that clinical teams may better manage physical issues and there is room for improvement regarding non-physical needs. Using the Integrated Palliative care Outcome Scale systematically could aid clinical teams screening patients for distressing needs and track their progress in assisting patients and families with those issues. Trial Registration: Not applicable. This was not an intervention study.


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