scholarly journals Person-fit feedback on inconsistent symptom reports in clinical depression care

2017 ◽  
Vol 48 (11) ◽  
pp. 1844-1852 ◽  
Author(s):  
Rob B. K. Wanders ◽  
Rob R. Meijer ◽  
Henricus G. Ruhé ◽  
Sjoerd Sytema ◽  
Klaas J. Wardenaar ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Depressive Symptomatology ◽  
Clinical Care ◽  
Self Report ◽  
Clinical Usefulness ◽  
Person Fit ◽  
Psychomotor Slowing ◽  
Fit Statistics ◽  
Symptom Reports

BackgroundDepressive patients can present with complex and different symptom patterns in clinical care. Of these, some may report patterns that are inconsistent with typical patterns of depressive symptoms. This study aimed to evaluate the validity of person-fit statistics to identify inconsistent symptom reports and to assess the clinical usefulness of providing clinicians with person-fit score feedback during depression assessment.MethodsInconsistent symptom reports on the Inventory of Depressive Symptomatology Self-Report (IDS-SR) were investigated quantitatively with person-fit statistics for both intake and follow-up measurements in the Groningen University Center of Psychiatry (n = 2036). Subsequently, to investigate the causes and clinical usefulness of on-the-fly person-fit alerts, qualitative follow-up assessments were conducted with three psychiatrists about 20 of their patients that were randomly selected.ResultsInconsistent symptom reports at intake (12.3%) were predominantly characterized by reporting of severe symptoms (e.g. psychomotor slowing) without mild symptoms (e.g. irritability). Person-fit scores at intake and follow-up were positively correlated (r = 0.45). Qualitative interviews with psychiatrists resulted in an explanation for the inconsistent response behavior (e.g. complex comorbidity, somatic complaints, and neurological abnormalities) for 19 of 20 patients. Psychiatrists indicated that if provided directly after the assessment, a person-fit alert would have led to new insights in 60%, and be reason for discussion with the patient in 75% of the cases.ConclusionsProviding clinicians with automated feedback when inconsistent symptom reports occur is informative and can be used to support clinical decision-making.

COGNITIVE BEHAVIOUR THERAPY AND ASSERTION TRAINING GROUPS FOR PATIENTS WITH DEPRESSION AND COMORBID PERSONALITY DISORDERS

2000 ◽  
Vol 28 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Jillian Ball ◽  
Brian Kearney ◽  
Kay Wilhelm ◽  
Jodie Dewhurst-Savellis ◽  
Belinda Barton
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Depressive Symptomatology ◽  
Therapy Group ◽  
Self Report ◽  
Cognitive Behaviour ◽  
Long Term Follow Up ◽  
Assertion Training

Longitudinal evaluations were conducted on 61 adults who were referred to a Mood Disorders Unit with a history of depression (all index episodes reached criteria for DSM-III-R major depression or dysthymia) and who had completed a cognitive behavioural therapy group either on its own or in combination with an assertion training group. Assessment of personality was made using DSM-III-R Axis II personality disorder categories. These categories were aggregated to form three groups: (i) no personality disorder; (ii) Cluster B (dramatic-erratic); and (iii) Cluster C (anxious-fearful), and were used to identify responsiveness to treatment and outcome at long-term follow-up. A battery of self-report measures were administered pretreatment, posttreatment and at long-term follow-up (1–3 years later). Both groups showed significant improvements in mean scores during treatment and these gains were maintained over the follow-up period. However, improvement in those patients without personality disorders was greater at posttreatment and at long-term follow-up, both in level of depressive symptomatology and proportion of cases meeting criteria for recovery. The treatment implications of these results are discussed.

Efficacy of an online intervention for treatment of depressive disorders: a three-arm randomized controlled trial comparing guided and unguided self-help with waitlist control (Preprint)

2021 ◽  
Author(s):  
Krämer Rico
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Intervention Group ◽  
Online Intervention ◽  
Self Report ◽  
Secondary Outcome ◽  
Control Group

BACKGROUND Digital health applications are efficacious treatment options for mild-to-moderate depressive disorders. However, the extent to which psychological guidance increases the efficacy of these applications is controversial. OBJECTIVE We evaluated the efficacy of the online intervention “Selfapy” for unipolar depression. We also investigated differences between a psychotherapist-guided vs. unguided version compared with those from a control group. METHODS A cohort of 401 participants with mild-to-severe depressive disorders were assigned randomly to either participate in a guided version of Selfapy (involving weekly telephone calls of 25-min duration), an unguided version of Selfapy, or to the waiting list (control group). Selfapy is a cognitive behavioral therapy-based intervention for depressive disorders of duration 12 weeks. Symptom assessment was undertaken at T1 (before study entrance), T2 (after 6 weeks), T3 (post-treatment, after 12 weeks), and T4 (follow-up, after 6 months). The main outcome was reduction in depressive symptoms in the Beck Depression Inventory (BDI-II) from T1 to T3. Secondary-outcome parameters were the Quick Inventory of Depressive Symptomatology – Self Report (QIDS-SR 16) and Beck Anxiety Inventory (BAI). RESULTS A total of 297 out of 401 participants (74.06%) completed the post-measurement at T3. In the primary analysis, both intervention groups showed a significantly higher reduction in depressive symptoms (BDI-II) from T1 to T3 compared with that in the control group, with high within-effect sizes (guided: d = 1.46; unguided d = 1.36). No significant differences were found for guided vs. unguided treatment groups. The response rate (BDI-II) for intention-to-treat data in the guided version was 46.4%, 40.0% for the unguided version, and 2.0% in the control group. After 6 months (T4), treatment effects could been maintained for both intervention groups (BDI-II) without differences between either intervention group. CONCLUSIONS Conclusions: Selfapy can help to reduce depressive symptoms in guided or unguided version. Follow-up data suggest that these effects could be maintained. The guided version was not superior to the unguided version. CLINICALTRIAL Trial Registration: Current Controlled Trial DRKS00017191 Date of registration: 14 May 2019 INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s13063-021-05218-4

scholarly journals 977. The Prevalence and Burden of Non-AIDS Co-Morbidities in Women with or At-risk for HIV Infection in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S36-S36
Author(s):  
Lauren F Collins ◽  
Anandi N Sheth ◽  
C Christina Mehta ◽  
Elizabeth T Golub ◽  
Phyllis C Tien ◽  
...  
Keyword(s):  
At Risk ◽  
Clinical Care ◽  
Laboratory Data ◽  
The United States ◽  
Self Report ◽  
Age Related ◽  
Persons Living With Hiv ◽  
Hiv Serostatus ◽  
Hiv Women

Abstract Background Age-related non-AIDS comorbidities (NACM) increasingly account for morbidity and mortality in persons living with HIV. The burden of NACM and its association with HIV is poorly described in women. Methods We analyzed data from HIV+ and at-risk HIV− participants who were followed in the Women’s Interagency HIV Study (WIHS) after 2009 (when >80% of participants used antiretroviral therapy). The prevalence of each NACM (defined by a combination of self-report, clinical measurements, and laboratory data) and the number of NACM were summarized at a most recent follow-up visit and were compared by age and HIV serostatus using unadjusted linear regression models. Results There were 3232 women (2309 HIV+, 923 HIV–) with a median follow-up of 15.3 years. The median age was 50 years, 65% were black, 38% currently smoked, 71% had ever used illicit drugs, 50% had annual income < $12,000, and median body mass index was 30 kg/m2. HIV+ women had a median CD4 count of 618 cells/mm3 and 66% had HIV viral suppression. Among 10 NACM evaluated, the following were more prevalent in HIV+ vs. HIV– women (all P < 0.01): psychiatric illness (57%/48%), liver disease (45%/26%), hyperlipidemia (40%/35%), bone disease (40%/33%), chronic kidney disease (15%/7%), and non-AIDS cancer (11%/7%). There was little difference in the prevalence of hypertension (66%/64%), lung disease (41%/43%), diabetes (22%/24%), and cardiovascular disease (19%/19%). Mean number of NACM was higher in HIV+ vs. HIV– women (3.6 vs. 3.0, P < 0.0001). Regardless of HIV serostatus, NACM burden significantly increased with age (P < 0.0001). Compared with women aged <40 of the same HIV serostatus, the estimated mean difference in NACM (HIV+/HIV–) for those 40–49, 50–59, ≥60 years was 1.1/0.7, 2.3/2.3, and 3.6/3.2, respectively (P < 0.0001 for all). Within-age-group comparisons revealed significantly greater NACM burden in HIV+ vs. HIV− women aged 40–49 years (P < 0.0001) and ≥60 years (P = 0.003), but not in those aged <40 or 50–59 years (HIV*age interaction P = 0.02) (figure). Conclusion NACM burden was high in both HIV+ and at-risk HIV– women, but higher in HIV+ women overall and in certain age groups. Accumulation of NACM has complex implications for clinical care, medication management, and healthcare screening that must be further examined in this population. Disclosures Anandi N. Sheth, MD, MS, Gilead Sciences, Inc.: Research Grant.

scholarly journals Changes in Depression Subtypes Among Men in STAR*D: A Latent Transition Analysis

2015 ◽  
Vol 12 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Christine M. Ulbricht ◽  
Levent Dumenci ◽  
Anthony J. Rothschild ◽  
Kate L. Lapane
Keyword(s):  
Depressive Symptomatology ◽  
Latent Transition Analysis ◽  
Self Report ◽  
Psychomotor Slowing ◽  
Transition Analysis ◽  
Symptom Resolution ◽  
Latent Transition ◽  
Level 1 ◽  
Depression Subtypes ◽  
Men's Experience

The burden of depression in men is high. Current diagnostic criteria may not fully capture men’s experience with depression. Descriptions of the heterogeneity in depression among men are lacking. The purpose of the study was to characterize latent subtypes of major depression and changes in these subtypes among men receiving citalopram in Level 1 of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Latent transition analysis was applied to data from 387 men who completed baseline and Week 12 study visits in Level 1 of STAR*D. Items from the self-report version of the Quick Inventory of Depressive Symptomatology were used as indicators of latent depression subtypes. Four statuses were identified at baseline and Week 12. Baseline statuses were Mild (10% of men), Moderate (53%), Severe with Psychomotor Slowing (20%), and Severe with Psychomotor Agitation (17%). At Week 12, the statuses were Symptom Resolution (41%), Mild (36%), Moderate (18%), and Severe with Psychomotor Slowing (5%). Men in the Mild status were most likely to transition to Symptom Resolution (probability = 69%). Men in the Severe with Agitation status were least likely to transition to Symptom Resolution (probability = 0%). This work highlights the need to not focus solely on summary rating scores but to also consider patterns of symptoms when treating depression.

scholarly journals Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes

2021 ◽  
Vol 8 (4) ◽  
pp. e1014
Author(s):  
Francesc Graus ◽  
Alberto Vogrig ◽  
Sergio Muñiz-Castrillo ◽  
Jean-Christophe G. Antoine ◽  
Virginie Desestret ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Criteria ◽  
Clinical Decision Making ◽  
Checkpoint Inhibitors ◽  
Clinical Care ◽  
Clinical Decision ◽  
Intermediate Risk ◽  
Research Initiatives ◽  
Paraneoplastic Neurologic Syndromes

ObjectiveThe contemporary diagnosis of paraneoplastic neurologic syndromes (PNSs) requires an increasing understanding of their clinical, immunologic, and oncologic heterogeneity. The 2004 PNS criteria are partially outdated due to advances in PNS research in the last 16 years leading to the identification of new phenotypes and antibodies that have transformed the diagnostic approach to PNS. Here, we propose updated diagnostic criteria for PNS.MethodsA panel of experts developed by consensus a modified set of diagnostic PNS criteria for clinical decision making and research purposes. The panel reappraised the 2004 criteria alongside new knowledge on PNS obtained from published and unpublished data generated by the different laboratories involved in the project.ResultsThe panel proposed to substitute “classical syndromes” with the term “high-risk phenotypes” for cancer and introduce the concept of “intermediate-risk phenotypes.” The term “onconeural antibody” was replaced by “high risk” (>70% associated with cancer) and “intermediate risk” (30%–70% associated with cancer) antibodies. The panel classified 3 levels of evidence for PNS: definite, probable, and possible. Each level can be reached by using the PNS-Care Score, which combines clinical phenotype, antibody type, the presence or absence of cancer, and time of follow-up. With the exception of opsoclonus-myoclonus, the diagnosis of definite PNS requires the presence of high- or intermediate-risk antibodies. Specific recommendations for similar syndromes triggered by immune checkpoint inhibitors are also provided.ConclusionsThe proposed criteria and recommendations should be used to enhance the clinical care of patients with PNS and to encourage standardization of research initiatives addressing PNS.

Characterization of depressed bipolar patients with current suicidal ideation

2020 ◽  
pp. 000486742096374
Author(s):  
Bénédicte Nobile ◽  
Jonathan Dubois ◽  
Bruno Aouizerate ◽  
Valerie Aubin ◽  
Joséphine Loftus ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Clinical Features ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Self Report ◽  
Depressed Patients ◽  
Scale Total Score ◽  
Suicidal Patients

Objective: Bipolar disorder is one of the most frequent psychiatric disorders among suicidal patients. A large part of patients with bipolar disorder (30–50%) will attempt suicide. Suicidal ideation being a major risk factor of suicidal act, it is crucial to better characterize patients with suicidal bipolar depression (i.e. depression with current suicidal ideation). The aim of this study was to characterize suicidal bipolar depressed patients in comparison with non-suicidal depressed patients in terms of clinical characteristics, evolution of depression and suicidal ideation course over time, and risk of suicide attempt during follow-up. Methods: Among patients with bipolar disorder recruited from the network of FondaMental expert centres for bipolar disorder between 2009 and 2017, we selected patients with at least mild depression (Montgomery–Åsberg Depression Rating Scale total score >11) and without current manic symptomatology (Young Mania Rating Scale total score <7) at baseline ( N = 938). Suicidal depression was defined by a baseline score ⩾2 for item 12 of the Quick Inventory of Depressive Symptomatology–Self Report ( N = 271, 28.9%). Non-suicidal depression was defined by a baseline item 12 of the Quick Inventory of Depressive Symptomatology–Self Report score <2 ( N = 667, 71.1%). A subsample of about 300 patients (with or without suicidal ideation at baseline) was followed up for 2 years. Results: Baseline clinical features (e.g. depression severity, childhood trauma, global functioning) were more severe in patients with than without suicidal depression. Suicidal patients tended to remain more suicidal throughout the follow-up than patients without suicidal ideation at baseline (3.4-fold higher risk of persistent suicidal ideation at the 2-year visit despite an improvement in depressive symptomatology). Conclusions: Depressed bipolar disorder patients reporting suicidal ideation had more severe clinical features at baseline and were more prone to report persistent suicidal ideation during the follow-up, independently of thymic state. Clinicians should closely monitor this subgroup of patients.

scholarly journals Symptomatic and Radiographic Manifestations of Kidney Stone Recurrence and Their Prediction by Risk Factors: A Prospective Cohort Study

2019 ◽  
Vol 30 (7) ◽  
pp. 1251-1260 ◽  
Author(s):  
Matthew R. D’Costa ◽  
William E. Haley ◽  
Kristin C. Mara ◽  
Felicity T. Enders ◽  
Terri J. Vrtiska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Kidney Stone ◽  
Clinical Care ◽  
Self Report ◽  
Symptomatic Recurrence ◽  
Stone Formers ◽  
Stone Growth ◽  
Stone Passage

BackgroundMeaningful interpretation of changes in radiographic kidney stone burden requires understanding how radiographic recurrence relates to symptomatic recurrence and how established risk factors predict these different manifestations of recurrence.MethodsWe recruited first-time symptomatic stone formers from the general community in Minnesota and Florida. Baseline and 5-year follow-up study visits included computed tomography scans, surveys, and medical record review. We noted symptomatic recurrence detected by clinical care (through chart review) or self-report, and radiographic recurrence of any new stone, stone growth, or stone passage (comparing baseline and follow-up scans). To assess the prediction of different manifestations of recurrence, we used the Recurrence of Kidney Stone (ROKS) score, which sums multiple baseline risk factors.ResultsAmong 175 stone formers, 19% had symptomatic recurrence detected by clinical care and 25% detected by self-report; radiographic recurrence manifested as a new stone in 35%, stone growth in 24%, and stone passage in 27%. Among those with a baseline asymptomatic stone (54%), at 5 years, 51% had radiographic evidence of stone passage (accompanied by symptoms in only 52%). Imaging evidence of a new stone or stone passage more strongly associated with symptomatic recurrence detected by clinical care than by self-report. The ROKS score weakly predicted one manifestation—symptomatic recurrence resulting in clinical care (c-statistic, 0.63; 95% confidence interval, 0.52 to 0.73)—but strongly predicted any manifestation of symptomatic or radiographic recurrence (5-year rate, 67%; c-statistic, 0.79; 95% confidence interval, 0.72 to 0.86).ConclusionsRecurrence after the first stone episode is both more common and more predictable when all manifestations of recurrence (symptomatic and radiographic) are considered.

scholarly journals Person-fit statistics, response sets and survey participation in a population-based cohort study

Psihologija ◽  
2015 ◽  
Vol 48 (4) ◽  
pp. 345-360 ◽  
Author(s):  
Jörg Müller ◽  
Petra Hasselbach ◽  
Adrian Loerbroks ◽  
Manfred Amelang
Keyword(s):  
Social Desirability ◽  
Common Factor ◽  
Population Based ◽  
Person Fit ◽  
Fit Statistics ◽  
Person Parameter ◽  
Response Sets ◽  
Survey Participation ◽  
Scale Scores

Person-fit methodology is a promising technique for identifying subjects whose test scores have questionable validity. Less is known however about this technique?s ability to predict survey participation longitudinally. This study presents theory-derived expectations related to social desirability, the tendency for extreme responding and traitedness for specific deviating answer patterns and an expected consistence of person-fit scores across 27 personality scales. Data from 5,114 subjects (Amelang, 1997) were reanalysed with a polytomous-Rasch model to estimate scale scores and von Davier and Molenaar?s (2003) person-fit statistics. The person-fit statistics of the 27 scales were examined together with the 27 person parameter scores in one common factor analysis. The person-fit scores served as indicators of the latent factor ?scalability? while the person-parameter scores were considered to index the bias introduced by social desirability. The sign of factor loadings showed consistency and validity of the tendency for social desirability and extreme responding. Moreover, the personfit- based subject classification derived from the baseline data was able to predict subjects? participation at a 8,5-year follow-up. However, the nature of those associations was contrary to our predictions. The discussion addresses explanations and practical implications, but also the limitations pertaining to the identification and interpretation of person-fit scores.

scholarly journals Presence and Predictive Value of Obsessive-Compulsive Symptoms in Anxiety and Depressive Disorders

2017 ◽  
Vol 63 (2) ◽  
pp. 85-93 ◽  
Author(s):  
Mieke Klein Hofmeijer-Sevink ◽  
Neeltje M. Batelaan ◽  
Harold J. G. M. van Megen ◽  
Marcel A. van den Hout ◽  
Brenda W. Penninx ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Clinical Care ◽  
Total Sample ◽  
Self Report ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
First Onset ◽  
A Current

Objective: Obsessive-compulsive symptoms (OCS) co-occur frequently with anxiety and depressive disorders, but the nature of their relationship and their impact on severity of anxiety and depressive disorders is poorly understood. In a large sample of patients with anxiety and depressive disorders, we assessed the frequency of OCS, defined as a Young Adult Self-Report Scale–obsessive-compulsive symptoms score >7. The associations between OCS and severity of anxiety and/or depressive disorders were examined, and it was investigated whether OCS predict onset, relapse, and persistence of anxiety and depressive disorders. Methods: Data were obtained from the third (at 2-year follow-up) and fourth wave (at 4-year follow-up) of data collection in the Netherlands Study of Anxiety and Depression cohort, including 469 healthy controls, 909 participants with a remitted disorder, and 747 participants with a current anxiety and/or depressive disorder. Results: OCS were present in 23.6% of the total sample, most notably in those with current combined anxiety and depressive disorders. In patients with a current disorder, OCS were associated with severity of this disorder. Moreover, OCS predicted (1) first onset of anxiety and/or depressive disorders in healthy controls (odds ratio [OR], 5.79; 95% confidence interval [CI], 1.15 to 29.14), (2) relapse in those with remitted anxiety and/or depressive disorders (OR, 2.31; 95% CI, 1.55 to 3.46), and (3) persistence in patients with the combination of current anxiety and depressive disorders (OR, 4.42; 95% CI, 2.54 to 7.70) within the 2-year follow-up period Conclusions: OCS are closely related to both the presence and severity of anxiety and depressive disorders and affect their course trajectories. Hence, OCS might be regarded as a course specifier signaling unfavorable outcomes. This specifier may be useful in clinical care to adapt and intensify treatment in individual patients.

The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction

2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Clinical Decision Making ◽  
Hearing Aid ◽  
Well Being ◽  
Self Report ◽  
Self Management ◽  
Hearing Aid Benefit ◽  
The Relationship

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.

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