PMH10 EFFECTIVENESS AND COST-EFFECTIVENESS OF LIFESTYLE INTERVENTIONS IN PERSONS WITH SEVERE MENTAL DISORDERS. A SYSTEMATIC REVIEW

Objective Telepsychiatry involves use of telecommunications technology to deliver psychiatric care and offers promise to reduce costs and increase access to mental health services. This systematic review examined cost reporting of telepsychiatry programmes for mental healthcare. Methods We systematically searched electronic databases for studies reporting costs, including economic evaluations such as cost-effectiveness analyses, or costs of developing telepsychiatry programmes for clinical care of mental disorders. Included studies enrolled participants with mental disorders and involved telepsychiatry for depression, anxiety disorders, serious mental illnesses including schizophrenia spectrum disorders and bipolar disorder, post-traumatic stress disorder, dementia or epilepsy. Results Twenty-six unique studies met inclusion criteria (17,967 participants), with most targeting depression ( n = 7; 27%), general mental disorders and screening ( n = 7; 27%), child mental health ( n = 4; 15%) and geriatric mental health ( n = 4; 15%). Nearly all studies ( n = 25; 96%) compared telepsychiatry programme costs with either standard in-person consultation or usual care, with 15 (60%) reporting that telepsychiatry programmes were less expensive, and 8 (32%) showing telepsychiatry programmes were more expensive. Three studies reported cost-effectiveness analyses, favouring telepsychiatry programmes, but at highly elevated cost-effectiveness thresholds. Few studies reported costs of developing or delivering telepsychiatry programmes. Conclusion Costs of telepsychiatry programmes varied widely, with substantial heterogeneity in how costs were defined and reported. Some programmes cost less than in-person services while others cost more. Therefore, rigorous cost-effectiveness studies following established standards in economic evaluation are needed to inform implementation and sustainability of these programmes in health systems.

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Behavioural symptoms and impairments in multiple sclerosis: a systematic review and meta-analysis

Multiple Sclerosis Journal ◽

10.1177/1352458512439437 ◽

2012 ◽

Vol 19 (1) ◽

pp. 31-45 ◽

Cited By ~ 19

Author(s):

Eija Rosti-Otajärvi ◽

Päivi Hämäläinen

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Mental Disorders ◽

Literature Search ◽

Web Of Science ◽

Meta Analysis ◽

Adjustment Disorder ◽

Subjective Symptoms ◽

Severe Mental Disorders ◽

Behavioural Symptoms

Behavioural problems are not well recognized in multiple sclerosis (MS). In this review we aimed to evaluate the prevalence of behavioural symptoms and impairments in MS. A systematic search was carried out from MEDLINE, PsycINFO, Web of Science, CINAHL and COCHRANE. In total, 23 studies (1831 participants) were identified. Based on the literature search, behavioural symptoms and impairments are observed in MS. Aggression (23%), apathy (22%), euphoria (12%) and lack of insight (11%) were the most frequent symptoms, and adjustment disorder (17%) the most frequent impairment. Severe mental disorders are more infrequent than changes in behaviour, manner of reaction, and way of action. In conclusion the objective behavioural impairments and especially subjective symptoms are present in patients with MS. These manifestations should be taken into account in the diagnostics and treatment of the disease.

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The Effectiveness of Lifestyle Interventions to Reduce Cardiovascular Risk in Patients with Severe Mental Disorders: Meta-Analysis of Intervention Studies

Community Mental Health Journal ◽

10.1007/s10597-013-9614-6 ◽

2013 ◽

Vol 50 (1) ◽

pp. 81-95 ◽

Cited By ~ 33

Author(s):

Maria Isabel Fernández-San-Martín ◽

Luis Miguel Martín-López ◽

Roser Masa-Font ◽

Noemí Olona-Tabueña ◽

Yuani Roman ◽

...

Keyword(s):

Cardiovascular Risk ◽

Mental Disorders ◽

Intervention Studies ◽

Meta Analysis ◽

Lifestyle Interventions ◽

Severe Mental Disorders

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Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02120-x ◽

2021 ◽

Author(s):

Yohannes Gebreegziabhere Haile ◽

Kassahun Habatmu ◽

Andualem Derese ◽

Hetta Gouse ◽

Stephen M. Lawrie ◽

...

Keyword(s):

Systematic Review ◽

Mental Disorders ◽

Psychometric Properties ◽

Low Income ◽

Measurement Properties ◽

Severe Mental Disorders ◽

Middle Income ◽

Middle Income Countries ◽

Brief Assessment ◽

Low And Middle Income

Abstract Background Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs). Objective To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs. Methods We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population. Results We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation. Conclusions Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.

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