Promoting adherence to psychopharmacological treatment among prisoners with mental health problems: Follow-up of a randomized controlled trial

2021 ◽  
Vol 74 ◽  
pp. 101668
Author(s):  
Alexander Muela ◽  
Jone Aliri ◽  
Nekane Balluerka ◽  
Barbara Presa ◽  
Ane Eguren
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacomijn Hofstra ◽  
Jorien van der Velde ◽  
Petra Jannette Havinga ◽  
Lies Korevaar

Abstract Background The onset of mental health problems generally occurs between the ages of 16 and 23 – the years in which young people follow post-secondary education, which is a major channel in our society to prepare for a career and enhance life goals. Several studies have shown that students with mental health problems have a higher chance of early school leaving. Supported Education services have been developed to support students with mental health problems to remain at school. The current project aims to study the effect of an individually tailored Supported Education intervention on remaining at school, study success, and satisfaction of students with mental health problems studying at an institute for intermediate vocational education and a university of applied sciences in the Netherlands. Methods/design The design combines quantitative research (Randomized Controlled Trial; RCT) with qualitative research (monitoring, interviews, focus groups). One hundred students with mental health problems recruited from the two educational institutes will be randomly allocated to either the intervention or control condition. The students in the intervention condition receive the Supported Education intervention given by a Supported Education specialist, the students in the active control condition receive support as usual plus advice from a trained staff member on potential supportive resources regarding studying with mental health problems. The primary outcome ‘remaining at school’, and the secondary outcome ‘study success’ will be determined using data from the school’s administration. The secondary outcome ‘student satisfaction’ and other variables that will be studied in a more exploratory way, such as self-efficacy and study skills, will be determined through online questionnaires at baseline, at 6 and at 12 months follow-up. Focus groups and interviews with the students and Supported Education specialists will be carried out to complement the trial. Discussion This RCT is the first to assess the effect of Supported Education on remaining at school, next to study success and student satisfaction among students with mental health problems. The use of a mixed-methods design will result in a thorough evaluation of the effect of the intervention. Issues regarding the influx and possible attrition of students in the follow-up are discussed. Trial registration The study was registered with Trialregister.nl, no. NL8349, date registered: February 4th 2020. Register name: Community participation through education. Effectiveness of Supported Education for youth with mental health problems, a mixed methods study – Study protocol for a Randomized Controlled Trial. Protocol Version: 3, date: May 28th, 2021.


2020 ◽  
Author(s):  
Paul Bangirana ◽  
Annet Birabwa ◽  
Mary Nyakato ◽  
Ann J. Nakitende ◽  
Maria Kroupina ◽  
...  

Abstract Background: Severe malaria is associated with long-term mental health problems in Ugandan children. This study investigated the effect of a behavioral intervention for caregivers of children admitted with severe malaria, on the children’s mental health outcomes six months after discharge.Methods: This randomized controlled trial was conducted at Naguru Hospital in Kampala, Uganda from January 2018 to July 2019. Caregiver and child dyads were randomly assigned to either a psychoeducation arm providing information about hospital procedures during admission (control group) or a behavioral arm providing information about the child’s possible emotions and behavior during and after admission and providing age appropriate games for the caregiver and child (intervention group). Pre- and post-intervention assessments for caregiver anxiety and depression (Hopkins Symptom Checklist) and child mental health problems (Strength and Difficulties Questionnaire and the Child Behavioral Checklist) were done during admission and six months after discharge respectively. T-tests, analysis of covariance and Chi-Square were used to compare outcomes between the two treatment arms.Results: There were 120 caregiver-child dyads recruited at baseline with children aged 1.45 years to 4.89 years (mean age 2.85 years, SD = 1.01). The intervention and control groups had similar sociodemographic, clinical and behavioral characteristics at baseline. Caregiver depression at baseline, mother’s education and female sex of the child were associated with behavioral problems in the child at baseline (p<0.05). At six months follow-up, there was no difference in the frequency of behavioral problems between the groups (6.8% vs 10% in intervention vs. control groups, respectively, p = 0.72). Caregiver depression and anxiety scores between the treatment arms did not differ at six months follow-up. Conclusion: This behavioral intervention for caregivers and their children admitted with severe malaria had no effect on the child’s mental health outcomes at six months. Further studies need to develop interventions for mental health problems after severe malaria in children with longer follow-up time.ClinicalTrials.gov Identifier: NCT03432039


2019 ◽  
Vol 4 ◽  
pp. 91
Author(s):  
Susanne Schweizer ◽  
Jovita T. Leung ◽  
Rogier Kievit ◽  
Maarten Speekenbrink ◽  
William Trender ◽  
...  

Background: 75% of all mental health problems have their onset before the end of adolescence. Therefore, adolescence may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents’ affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AC-Training) to a placebo training (P-Training) app. In total, 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AC-Training will include three different n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, one month and one year after training. Discussion: If, as predicted, the proposed study finds that AC-Training successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10th 2018 with the International Standard Randomised Controlled Trial Number (Registration number: ISRCTN17213032).


2019 ◽  
Vol 4 ◽  
pp. 91 ◽  
Author(s):  
Susanne Schweizer ◽  
Jovita T. Leung ◽  
Rogier Kievit ◽  
Maarten Speekenbrink ◽  
William Trender ◽  
...  

Background: 75% of all mental health problems have their onset before the end of adolescence. Therefore, adolescence may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents’ affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AffeCT) to a placebo training (P-Training) app. In total, 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AffeCT will include three different n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, one month and one year after training. Discussion: If, as predicted, the proposed study finds that AffeCT successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10th 2018 with the International Standard Randomised Controlled Trial Number (Registration number: ISRCTN17213032).


2021 ◽  
Author(s):  
Maria Antònia Fiol-DeRoque ◽  
Maria Jesús Serrano-Ripoll ◽  
Rafael Jiménez ◽  
Rocío Zamanillo-Campos ◽  
Aina María Yáñez-Juan ◽  
...  

BACKGROUND The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to healthcare workers (HCWs), who are facing heavy workloads under psychologically difficult situations. OBJECTIVE This trial aims to evaluate the effectiveness of a psychoeducational mobile Health (mHealth) intervention to reduce mental health problems in HCWs during the COVID-19 pandemic. METHODS We carried out a blinded randomized controlled trial. HCWs caring for COVID-19 patients in Spain were randomly assigned (1:1) by a computer-generated randomization sequence to the PsyCovidApp intervention (App targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control App (general recommendations about mental healthcare). Data collection was conducted telephonically at baseline and two weeks. The primary endpoint was a composite of depression, anxiety, and stress. Secondary endpoints were insomnia, burnout, posttraumatic stress, self-efficacy, depression, anxiety, and stress. Differences between groups were analyzed using general linear modeling, according to an intention-to-treat protocol. RESULTS Between 14 May and 25 July 2020, 482 HCWs were randomly assigned to PsyCovidApp (n=248) or the control App (n=234). At two weeks, complete outcome data were available for 436 (91%) HCWs. No significant differences were observed between the groups at two weeks in the primary outcome (standardized mean difference -0.04 [95% CI -0.11 to 0.04]; p=0.15) and in the rest of the outcomes. In our prespecified subgroup analyses, we observed significant (p<0.05) improvements among HCWs consuming psychotropic medications in the primary outcome, and posttraumatic stress, insomnia, anxiety, and stress. Similarly, among HCWs receiving psychotherapy, we observed improvements in the primary outcome, insomnia, anxiety, and stress. CONCLUSIONS In HCWs assisting COVID-19 patients in Spain, PsyCovidApp, compared with a control App, reduced mental health problems at two weeks only among HCWs receiving psychotherapy or psychotropic medications. CLINICALTRIAL ClinicalTrials.gov NCT04393818


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