scholarly journals Determinants of patient-reported outcome trajectories and symptomatic recovery in Improving Access to Psychological Therapies (IAPT) services

2021 ◽  
pp. 1-10
Author(s):  
Jan Stochl ◽  
Emma Soneson ◽  
Freya Stuart ◽  
Jessica Fritz ◽  
Annabel E. L. Walsh ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Severe Depression ◽  
Anxiety Symptoms ◽  
Rate Of Change ◽  
Depression And Anxiety ◽  
Rapid Improvement ◽  
Baseline Severity ◽  
Psychological Therapies ◽  
Patient Reported ◽  
Functionally Impaired

Abstract Background Despite evidence for the general effectiveness of psychological therapies, there exists substantial heterogeneity in patient outcomes. We aimed to identify factors associated with baseline severity of depression and anxiety symptoms, rate of symptomatic change over the course of therapy, and symptomatic recovery in a primary mental health care setting. Methods Using data from a service evaluation involving 35 527 patients in England's psychological and wellbeing [Improving Access to Psychological Therapies (IAPT)] services, we applied latent growth models to explore which routinely-collected sociodemographic, clinical, and therapeutic variables were associated with baseline symptom severity and rate of symptomatic change. We used a multilevel logit model to determine variables associated with symptomatic recovery. Results Being female, younger, more functionally impaired, and more socioeconomically disadvantaged was associated with higher baseline severity of both depression and anxiety symptoms. Being older, less functionally impaired, and having more severe baseline symptomatology was associated with more rapid improvement of both depression and anxiety symptoms (male gender and greater socioeconomic disadvantage were further associated with rate of change for depression only). Therapy intensity and appointment frequency seemed to have no correlation with rate of symptomatic improvement. Patients with lower baseline symptom severity, less functional impairment, and older age had a greater likelihood of achieving symptomatic recovery (as defined by IAPT criteria). Conclusions We must continue to investigate how best to tailor psychotherapeutic interventions to fit patients’ needs. Patients who begin therapy with more severe depression and/or anxiety symptoms and poorer functioning merit special attention, as these characteristics may negatively impact recovery.

Could the Substance Misuse of a Relative be an Important Factor for Those Seeking Help for Anxiety and Depression? A Preliminary Prevalence Study within Improving Access to Psychological Therapies (IAPT)

2016 ◽  
Vol 44 (6) ◽  
pp. 723-729 ◽  
Author(s):  
Elizabeth Newton ◽  
Nicola Shepherd ◽  
Jim Orford ◽  
Alex Copello
Keyword(s):  
Severe Depression ◽  
Routine Data ◽  
Research Area ◽  
Close Relative ◽  
Service Users ◽  
Depression And Anxiety ◽  
Psychological Therapies ◽  
Important Research Area ◽  
Close Relatives ◽  
Drug Problems

Background: The psychological difficulties and emotional impacts resulting from the substance use of close relatives constitute a large, underestimated and frequently unidentified health burden. The development of primary care mental health services in response to the Improving Access to Psychological Therapies initiative provides an opportunity to investigate this in more depth. Aims: A preliminary exploration of prevalence of IAPT service-users being treated for moderate-severe depression and/or anxiety who report that they have relatives with alcohol and/or drug problems. To explore the characteristics of the sample including comparison with those without a substance misusing relative. Method: One hundred service users completed a brief questionnaire. Routine data on depression and anxiety symptoms were accessed for the full consenting sample. Descriptive statistics were used to explore the family members of substance users and differences to the rest of the sample. Results: Twenty-two of the 100 IAPT service users reported having a close relative whose use of substances was of concern to them. The group with a relative who used substances were more depressed at the beginning of treatment than the rest of the sample. Conclusions: A significant number of people seeking psychological help for depression and anxiety within IAPT services reported being concerned about a close relative who misuses substances. They may be more distressed than those without a relative who misuses substances. Further exploration is warranted but preliminary findings indicate that this is an important research area with significant clinical implications.

scholarly journals On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes

2016 ◽  
Vol 209 (5) ◽  
pp. 429-430 ◽  
Author(s):  
Jaime Delgadillo ◽  
Miqdad Asaria ◽  
Shehzad Ali ◽  
Simon Gilbody
Keyword(s):  
Mental Health Problems ◽  
Mental Healthcare ◽  
Healthcare Utilisation ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Depression And Anxiety ◽  
Local Index ◽  
Psychological Therapies ◽  
Socioeconomic Gradient ◽  
Patient Reported

SummarySince 2008, the Improving Access to Psychological Therapies (IAPT) programme has disseminated evidence-based interventions for depression and anxiety problems. In order to maintain quality standards, government policy in England sets the expectation that 50% of treated patients should meet recovery criteria according to validated patient-reported outcome measures. Using national IAPT data, we found evidence suggesting that the prevalence of mental health problems is greater in poorer areas and that these areas had lower average recovery rates. After adjusting benchmarks for local index of multiple deprivation, we found significant differences between unadjusted (72.5%) and adjusted (43.1%) proportions of underperforming clinical commissioning group areas.

scholarly journals Depression and Anxiety in Patients with Chronic Renal Failure: The Effect of Sociodemographic Characteristics

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Paraskevi Theofilou
Keyword(s):  
Mental Health ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Trait Anxiety ◽  
General Health Questionnaire ◽  
Depression Scale ◽  
Severe Depression ◽  
Sociodemographic Characteristics ◽  
Depression And Anxiety ◽  
Patient Reported

“Do the sociodemographic characteristics relate to the levels of depression and anxiety in patients with chronic renal failure in Athens?” The study investigated in a group of renal disease patients differences referring to self-reported mental health, depression, and anxiety, after controlling for gender, age, education, and marital status. Patient-reported assessments included General Health Questionnaire (GHQ-28) of Goldberg, Center for Epidemiological Studies Depression Scale (CES-D), and State-Trait Anxiety Inventory (STAI I & II) of Spielberger. Female patients reported higher scores in thetrait anxietymeasure. Elder patients reported higher scores in the GHQ-28 subscale ofsocial dysfunctionand in the CES-Ddepressionscale, while less educated patients presented higher scores in the GHQ-28 subscales ofanxiety/insomniaandsevere depression. Divorced/widowed patients presented higher scores in thesevere depressionsubscale. Findings provide evidence that sociodemographic variables, like being older, less educated, and divorced/widowed, relate to a more compromised mental health.

scholarly journals Depression and anxiety symptoms in young adults before and during the COVID-19 pandemic: evidence from a Canadian population-based cohort

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kia Watkins-Martin ◽  
Massimiliano Orri ◽  
Marie-Hélène Pennestri ◽  
Natalie Castellanos-Ryan ◽  
Simon Larose ◽  
...  
Keyword(s):  
Young Adults ◽  
Short Form ◽  
Depression Scale ◽  
Severe Depression ◽  
Population Based ◽  
Anxiety Symptoms ◽  
Living Alone ◽  
Depression And Anxiety ◽  
Regression To The Mean ◽  
The Mean

Abstract Background Concerns have been raised that the COVID-19 pandemic could increase risk for adverse mental health outcomes, especially in young adults, a vulnerable age group. We investigated changes in depression and anxiety symptoms (overall and severe) from before to during the pandemic, as well as whether these changes are linked to COVID-19-related stressors and pre-existing vulnerabilities in young adults followed in the context of a population-based cohort. Method Participants (n = 1039) from the Quebec Longitudinal Study of Child Development reported on their depression (Centre for Epidemiological Studies Depression Scale, short form) and anxiety (General Anxiety Disorder-7 Scale) symptoms and completed a COVID-19 questionnaire during the first wave of the COVID-19 pandemic in the summer of 2020 (age 22 years). Assessments at age 20 (2018) were used to estimate pre-pandemic depression and anxiety symptom severity. Results While mean levels of depression and anxiety symptoms did not change from before to during the first wave of the COVID-19 pandemic (e.g., the mean of depressive symptoms was 9.30 in 2018 and 9.59 in 2020), we observed a slight increase in rates of severe depression (scores ≥ 21) from before (6.1%) to during (8.2%) the pandemic. Most COVID-19-related variables (e.g., loss of education/occupation, frequent news-seeking) – except living alone – and most pre-existing vulnerabilities (e.g., low SES, low social support) were not associated with changes in depression or anxiety symptoms. However, results varied as a function of pre-pandemic levels of depression and anxiety: depression and anxiety symptoms increased among adults with the lowest levels of symptoms before the pandemic, while they decreased among those with the highest levels of symptoms, possibly reflecting a regression to the mean. Conclusions Depression and anxiety symptoms in young adults from Québec in Summer 2020 were mostly comparable to symptoms reported in 2018. Most COVID-19-related stressors and pre-existing vulnerabilities were not associated with changes in symptoms, except living alone and pre-existing symptoms of depression and anxiety. However, the increased rate of severe depression warrants further investigation.

scholarly journals An Increase in Mediterranean Dietary Score, Through SunGold® Kiwifruit, Potentially Improves Mental Wellbeing

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 401-401
Author(s):  
Huyen Tran Diep Pham ◽  
Catherine Wall ◽  
Simone Bayer ◽  
Paul Blatchford ◽  
Richard Gearry
Keyword(s):  
Mediterranean Diet ◽  
Dietary Pattern ◽  
Anxiety Symptoms ◽  
Mental Wellbeing ◽  
P Value ◽  
The Novel ◽  
Depression And Anxiety ◽  
Patient Reported ◽  
Habitual Diet ◽  
The Mediterranean

Abstract Objectives Research suggests that high adherence to Mediterranean dietary pattern significantly improve depression and anxiety symptoms. Thus, the objective was to utilize the novel and validated Mediterranean Diet Serving Score (MDSS) method to assess habitual intake of a study cohort, which evaluated SunGold® kiwifruit and psyllium powder interventions, against the Mediterranean diet recommendations. The link between the MDSS and mental wellbeing were then explored. Methods The project's data was collected during the randomized cross-over controlled trial Christchurch Irritable Bowel Syndrome cohort to investigate mechanisms for gut relief and improved transit - Psyllium and Kiwifruit translation study (COMFORT-PSYKI). Participants were randomized into two interventions: psyllium powder or SunGold® kiwifruit. MDSS was evaluated from dietary records with the recommended serving sizes obtained from the New Zealand Food Composition Database. Depression and anxiety score were collected through the Patient-Reported Outcomes Measurement Information System (PROMIS) survey. Results The habitual diet of the participants (n = 45, mean age 39 ± 15 years) had a low MDSS (mean 5.04 ± 2.38, out of 24 points) when compared against the Mediterranean pyramid recommendations. Their MDSS improved with daily consumption of two SunGold® kiwifruit significantly (mean 6.27 ± 2.81, P-value < 0.05) compared to Psyllium powder (mean 5.58 ± 3.05, P-value = 0.906). Moreover, mean depression (42.33 ± 6.08, P-value) and anxiety (43.24 ± 7.71) scores were reported lower with the higher MDSS of SunGold® intervention at 42.33 ± 6.08 (P-value = 0.315) and 43.24 ± 7.71 (P-value = 0.906), respectively. Conclusions This project suggests that consuming two SunGold® kiwifruit daily could significantly enhance participants’ habitual diet to meet the Mediterranean diet recommendations and healthy eating guideline. This improvement could potentially lead to a reduction in depression and anxiety symptoms. The feasibility of the novel MDSS method was also demonstrated to be suitable for dietary pattern assessment among adult New Zealanders. Future investigations are warranted to confirm the association between dietary pattern and mental wellbeing. Funding Sources This project was funded by Zespri International Limited (Zespri) and Callaghan Innovation R&D Experience Grant.

scholarly journals Preliminary evidence of acylated ghrelin association with depression severity in postmenopausal women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maria Fernanda Naufel ◽  
Amanda Paula Pedroso ◽  
Lila Missae Oyama ◽  
Mônica Marques Telles ◽  
Helena Hachul ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Severe Depression ◽  
Premenopausal Women ◽  
Preliminary Evidence ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Acylated Ghrelin ◽  
Model Assessment ◽  
Depression And Anxiety ◽  
Mild Depression

AbstractWe have previously shown increased depression and anxiety scores in postmenopausal overweight women, when compared to overweight premenopausal women. The mechanisms responsible for these alterations are not understood. Although ghrelin involvement in mood modulation has been suggested, its role is still ambiguous and has not been evaluated in postmenopause. Here we investigated the association of ghrelin with depression and anxiety symptoms in postmenopausal women. Fifty-five postmenopausal women with depression symptoms, who were not in use of hormones or antidepressants, were included in the study. Depression symptoms were evaluated by Beck’s Depression Inventory (BDI) and Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms were evaluated by Beck’s Anxiety Inventory (BAI). Women were allocated into three groups, according to BDI classification of mild, moderate, or severe depression symptoms. Anthropometric, biochemical and hormonal parameters were analyzed. Total and acylated ghrelin levels were higher in the severe depression than in the mild depression group. Multivariate regression analyses showed positive associations of BDI scores with acylated ghrelin and BMI, and of PHQ-9 scores with acylated ghrelin and homeostasis model assessment of insulin resistance (HOMA-IR). BAI scores associated positively with waist-to-hip ratio. To the best of our knowledge, this is the first demonstration of an association between acylated ghrelin and the severity of depression symptoms in postmenopausal women. This association may reflect either a physiological response aimed at fighting against depression symptoms or a causal factor of this mental disorder.

scholarly journals Depression and Anxiety Symptoms in Young Adults Before and During the Covid-19 Pandemic: Evidence from a Canadian Population-Based Cohort

2021 ◽  
Author(s):  
K. Watkins-Martin ◽  
Massimiliano Orri ◽  
Marie-Hélène Pennestri ◽  
Natalie Castellanos-Ryan ◽  
Simon Larose ◽  
...  
Keyword(s):  
Young Adults ◽  
Anxiety Symptom ◽  
Severe Depression ◽  
Population Based ◽  
Poor Mental Health ◽  
Anxiety Symptoms ◽  
Depression And Anxiety ◽  
Canadian Population ◽  
Increase Risk ◽  
Severe Anxiety

Background: Concerns have been raised that the Covid-19 pandemic could increase risk for poor mental health, especially in young adults, a vulnerable age group. We investigated changes in depression and anxiety symptoms (overall and severe) from before to during the pandemic, as well as whether these changes are linked to Covid-19 related stressors and pre-existing vulnerabilities in young adults followed in the context of a population-based cohort. Method: Participants (n=1039) from the Quebec Longitudinal Study of Child Development reported on their depression and anxiety and completed a Covid-19 questionnaire during the first wave of the COVID-19 pandemic in Summer 2020 (age 22 years). Assessments at age 20 (2018) were used to estimate pre-pandemic depression and anxiety symptom severity. Results: While overall levels of depression and anxiety symptoms did not change, there was an increase in rates of severe depression (but not severe anxiety) from before (6.1%) to during (8.2%) the pandemic. Covid-19 related variables (e.g., loss of education/occupation, frequent news seeking) and pre-existing vulnerabilities (e.g., low SES, low social support) were not associated with changes in depression or anxiety symptoms. Further, youth with pre-existing depression and anxiety symptoms did not report a greater increase in symptoms during the pandemic, compared to those without; instead, they tended to show an improvement. Interpretation: Depression and anxiety symptoms in young adults from Quebec in Summer 2020 were comparable to symptoms reported in 2018. Most Covid-19 related stressors and pre-existing vulnerabilities were not associated with change in symptoms. However, the increased rate of severe depression is concerning.

scholarly journals Depression and anxiety as risk factors for female sexual pain

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
M. R. Soltan ◽  
T. A. Abdel Raheem ◽  
S. S. Soliman ◽  
N. M. Saleh ◽  
B. H. Khatery
Keyword(s):  
Risk Factors ◽  
Fungal Infection ◽  
Pain Score ◽  
Demographic Data ◽  
Severe Depression ◽  
Significant Negative Correlation ◽  
Anxiety Symptoms ◽  
Depression And Anxiety ◽  
Sexual Pain ◽  
Female Sexual Pain

Abstract Background Female sexual pain is a complex multifactorial condition. Most of researches have focused on underlying biomedical factors. Although psychological, psychiatric, and relational factors have been studied as possible correlates, limited research has been made in this area about the Egyptian population. The present study aimed to evaluate prevalence of female sexual pain among a sample of Egyptian females and detect its correlation with depression and anxiety. Female sexual function index (FSFI) was used to evaluate sexual pain in 450 women calculating their pain domain scores. Their scores were correlated to demographic data, genital health complaints, depression, and anxiety symptoms. Results The prevalence of marked severe sexual pain was 31.6% and that of trivial pain was 68.4% in the studied group. In the study group, 75 (16.7%) females had depressive symptoms, and 40 (8.9%) females had anxiety symptoms. Patients with severe depression had significantly marked severe pain than patients with minimal depression (p < 0.001 respectively). Patients with severe anxiety had significantly lower pain score than patients without (p < 0.001). Pain score had significant negative correlation with each of the depression score (r − 0.524, p < 0.001) and the anxiety score (r − 0.305, p < 0.001). Patients with gynecological causes especially fungal infection had significantly severe marked pain than patients without any other physical causes (< 0.001). Conclusions Anxiety, depression, and the presence of gynecological causes especially fungal infection were significantly independent risk factors for more sexual pain.

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