scholarly journals Shared mental healthcare and somatization: changes in patient symptoms and disability

2015 ◽  
Vol 17 (03) ◽  
pp. 277-286 ◽  
Author(s):  
John M. Haggarty ◽  
Brian P. O’Connor ◽  
Jeremy B. Mozzon ◽  
S. Kathleen Bailey
Keyword(s):  
Primary Care ◽  
Symptom Severity ◽  
Somatic Symptom ◽  
Clinical Sample ◽  
Community Sample ◽  
Mental Healthcare ◽  
Self Report ◽  
World Health ◽  
Control Group ◽  
Functional Changes

AimTo describe the symptoms and functional changes in patients with high levels of somatization who were referred to an outpatient, multidisciplinary, shared mental healthcare (SMHC) service that primarily offered cognitive behavioural therapy. Second, we wished to compare the levels of somatization in this outpatient clinical sample with previously published community norms.BackgroundSomatization is common in primary care, and it can lead to significant impairment, disproportionate resource use, and poses a challenge for management.MethodsAll the patients (18+ years,n=508) who attended three or more treatment sessions in SMHC primary care over a seven-year period were eligible for inclusion to this pre–post study. Self-report measures included the Patient Health Questionnaire’s somatic symptom severity scale (PHQ-15) and the World Health Organization Disability Assessment Schedule (WHODAS II). Normative comparisons were used to assess the degree of symptoms and functional changes.FindingsClinically significant levels of somatization before treatment were common (n=138, 27.2%) and were associated with a significant reduction in somatic symptom severity (41.3% reduction;P<0.001) and disability (44% reduction;P<0.001) after treatment. Patients’ levels of somatic symptom severity and disability approached but did not quite reach the community sample norms following treatment. Multidisciplinary short-term SMHC was associated with significant improvement in patient symptoms and disability, and shows promise as an effective treatment for patients with high levels of somatization. Including a control group would allow more confidence regarding the conclusions about the effectiveness of SMHC for patients impaired by somatization.

Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Silvina Catuara-Solarz ◽  
Bartlomiej Skorulski ◽  
Inaki Estella ◽  
Claudia Avella-Garcia ◽  
Sarah Shepherd ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Intervention Group ◽  
Well Being ◽  
Self Report ◽  
World Health ◽  
Randomised Control Trial ◽  
Control Group ◽  
Mental Well Being ◽  
Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

scholarly journals Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

2016 ◽  
Vol 208 (s56) ◽  
pp. s13-s20 ◽  
Author(s):  
Rahul Shidhaye ◽  
Sanjay Shrivastava ◽  
Vaibhav Murhar ◽  
Sandesh Samudre ◽  
Shalini Ahuja ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Disorders ◽  
Action Plan ◽  
Mental Healthcare ◽  
Theory Of Change ◽  
World Health ◽  
Care Workers ◽  
Care Models ◽  
Health Organization

BackgroundThe large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.AimsTo operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district.MethodMixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility.ResultsThe MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment.ConclusionsThere are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models.

Development and validation of a short form of the Geriatric Anxiety Inventory – the GAI-SF

2010 ◽  
Vol 23 (1) ◽  
pp. 125-131 ◽  
Author(s):  
Gerard J. Byrne ◽  
Nancy A. Pachana
Keyword(s):  
Primary Care ◽  
Older People ◽  
Short Form ◽  
Community Sample ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Cross Sectional ◽  
Medical Settings ◽  
Epidemiological Surveys ◽  
Dsm Iv

ABSTRACTBackground: Anxiety symptoms and anxiety disorders are highly prevalent among older people and are associated with considerable disability burden. While several instruments now exist to measure anxiety in older people, there is a need for a very brief self-report scale to measure anxiety symptoms in epidemiological surveys, in primary care and in acute geriatric medical settings. Accordingly, we undertook the development of such a scale, based on the Geriatric Anxiety Inventory.Methods: This is a cross-sectional study of randomly selected, community-residing, older women (N = 284; mean age 72.2 years) using receiver operating characteristic (ROC) analyses. DSM-IV diagnostic interviews were undertaken using the Mini International Diagnostic Interview, fifth edition (MINI-V).Results: We developed a 5-item version of the Geriatric Anxiety Inventory, which we have termed the Geriatric Anxiety Inventory – Short Form (GAI-SF). We found that a score of three or greater was optimal for the detection of DSM-IV Generalized Anxiety Disorder (GAD) in this community sample. At this cut-point, sensitivity was 75%, specificity was 87%, and 86% of participants were correctly classified. GAI-SF score was not related to age, MMSE score, level of education or perceived income adequacy. Internal consistency was high (Cronbach's α = 0.81) and concurrent validity against the State-Trait Anxiety Inventory was good (rs = 0.48, p < 0.001).Conclusions: The GAI-SF is a short form of the Geriatric Anxiety Inventory, which we recommend for use in epidemiological studies. It may also be useful in primary care and acute geriatric medical settings.

Syndrome stability and psychological predictors of symptom severity in idiopathic environmental intolerance and somatoform disorders

2006 ◽  
Vol 37 (2) ◽  
pp. 271-281 ◽  
Author(s):  
JOSEF BAILER ◽  
MICHAEL WITTHÖFT ◽  
CHRISTIANE BAYERL ◽  
FRED RIST
Keyword(s):  
Symptom Severity ◽  
Somatic Symptom ◽  
Somatoform Disorders ◽  
Somatic Symptoms ◽  
Control Group ◽  
Psychological Predictors ◽  
Idiopathic Environmental Intolerance ◽  
Somatosensory Amplification ◽  
Stable Conditions ◽  
Environmental Intolerance

Background. Previous studies suggest that idiopathic environmental intolerance (IEI) is a variant of somatoform disorders (SFDs) or the so-called functional somatic syndromes. Little is known, however, about the stability and the psychological predictors of IEI.Method. This prospective study examined the 1-year stability of somatic symptoms and IEI features in three diagnostic groups: 49 subjects with IEI, 43 subjects with SFD but without IEI, and 54 subjects (control group, CG) with neither IEI nor SFD. The predictive value of typical psychological predictors for somatization was tested using zero-order correlations and multiple linear regression analyses.Results. Somatic symptoms and IEI features proved to be temporally stable over the 1-year follow-up period. The SFD and IEI groups scored significantly higher than CG on all measures of somatic symptoms and on questionnaires assessing psychological predictors for somatization. Measures of trait negative affectivity (NA), somatic symptom attribution and somatosensory amplification predicted somatic symptom severity within the IEI and SFD groups, both at baseline and 1 year later. The strongest predictors of IEI complaints in the IEI group were somatic attributions, followed by prominent cognitions of environmental threat and a tendency to focus on unpleasant bodily sensations and to consider them as pathological.Conclusions. IEI and SFD are highly stable conditions. In both SFD and IEI, NA and the processes of symptom perception, interpretation and attribution contribute substantially to the persistence of typically somatoform symptoms and IEI complaints. Treatment of IEI and SFD should address these psychological factors and mechanisms.

scholarly journals Converging evidence for enduring perceptions of low social status in individuals in remission from depression.

2021 ◽  
Author(s):  
Julia Gillard ◽  
Siobhan Gormley ◽  
Kirsty Griffiths ◽  
Caitlin Hitchcock ◽  
Jason Stretton ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Social Status ◽  
Community Sample ◽  
Self Report ◽  
Control Group ◽  
Social Risk ◽  
History Of ◽  
Mental Health Difficulties ◽  
Depressive Episodes

BackgroundThe risk of depressive relapse and recurrence is amplified by social risk factors including the perception of low social status. MethodsWe aimed to identify enduring difficulties with the perception of social status in a community sample with a self-reported history of mental health difficulties (Study 1) and, more specifically, in individuals in clinical remission from depression, relative to a never-depressed control group, and relative to a group experiencing a current depressive episode (Study 2). ResultsIn Study 1, elevated depressive symptoms were associated with perceptions of low social status which significantly differed between individuals with and without a self-reported history of mental health difficulties. Study 2 found enduring deficits in perceptions of social status in remitted depressed individuals, in the absence of current symptoms. LimitationsWe were unable to discern between historical or current clinical diagnosis in the community sample of Study 1, as we were reliant on self-report. We were unable to explore the effects of medication or causal relationships between depressive symptoms and social status as the studies were cross-sectional in nature. ConclusionsThese findings suggest that disrupted socio-cognitive profiles across a range of affiliative processes may confer increased vulnerability to future depressive episodes in those in remission.

scholarly journals Criminal Convictions in Norwegian Female and Male Adult ADHD Outpatients: Prevalence and Associations With ADHD Symptom Severity and Emotional Dysregulation

2020 ◽  
Author(s):  
Espen ANKER ◽  
Ylva Ginsberg ◽  
Trond Heir
Keyword(s):  
Symptom Severity ◽  
Adult Adhd ◽  
Clinical Sample ◽  
Antisocial Behaviour ◽  
Emotional Dysregulation ◽  
Self Report ◽  
Male Adult ◽  
Criminal Conviction ◽  
Criminal Convictions ◽  
History Of

Abstract ObjectivesAttention Deficit Hyperactivity Disorder (ADHD) often co-occurs with antisocial behaviour. Several studies have shown high rates of ADHD among prisoners. However, the prevalence of crime among individuals with ADHD is less known. The aim of the present study was to estimate the prevalence of lifetime criminal conviction (CC) in a clinical sample of adults with ADHD, and the associations with severity of ADHD and emotional dysregulation (ED). MethodsPatients were admitted to a private psychiatric outpatient clinic in Oslo between 2014 and 2018. Out of 656 patients diagnosed with ADHD, 629 (95.9%) agreed to participate in the study. CC was determined based on self-reporting of the lifetime history of criminal behaviour. ADHD was diagnosed according to DSM-5 criteria, and the ADHD severity was measured using the Adult ADHD Self Report Scale (ASRS). ED was assessed by the eight-item version of Barkley’s Current Behaviour Scale - Self Report (CBS-SR). ResultsThe prevalence of self-reported CC in this clinical sample was 11.7% among women and 24.5% among men. CC was associated with hyperactive-impulsive severity (p<0.001) and ED (p=0.006).ConclusionsThe prevalence of self-reported lifetime criminal conviction was high for both genders. CC was associated with symptom severity of hyperactivity-impulsivity and emotional dysregulation.

scholarly journals Food Insecurity and Eating Pathology in Adolescents

2021 ◽  
Vol 18 (17) ◽  
pp. 9155
Author(s):  
Brittany H. Kim ◽  
Lisa Ranzenhofer ◽  
Jill Stadterman ◽  
Yvette G. Karvay ◽  
Natasha L. Burke
Keyword(s):  
Binge Eating ◽  
Food Insecurity ◽  
Clinical Sample ◽  
Community Sample ◽  
Eating Pathology ◽  
Self Report ◽  
Significant Relationships ◽  
Episode Frequency ◽  
Ecological Momentary ◽  
The Relationship

Adolescence is a critical period for the emergence of eating disorders, and food insecurity may be related to eating pathology and weight, as evidenced in adults. However, little is known about food insecurity and eating pathology during this developmental period, and associations between food insecurity and body mass index (BMI) are mixed. Therefore, we examined associations between food insecurity and BMI percentile, self-reported eating-related pathology and binge eating, and subgroup differences by race/ethnicity. In a subset, we examined the relationship between food insecurity and real-world hunger, food craving, and loss-of-control eating using ecological momentary assessment (EMA). Fifty-eight adolescents at two sites (clinical sample, n = 38, BMI percentile ≥ 70th; community sample, n = 20, all BMI strata) completed self-report questionnaires. Adolescents were 15.2 ± 2.1 years old, 62% female, 50% Black, 34.5% Hispanic, with BMI percentile = 80.5 ± 25.8 (range 4–99). In the full sample, food insecurity was associated with greater BMI (p < 0.01), higher shape/weight overvaluation (p = 0.04), and greater number of binge eating episodes among those reporting at least one binge episode (p < 0.01), with significant relationships for BMI percentile, shape/weight overvaluation, body dissatisfaction, and binge episode frequency among Hispanic adolescents only (each p < 0.01). As in adults, food insecurity may be a risk factor for eating pathology, particularly for Hispanic teens.

Are ADHD Screeners Safe to Use?

2018 ◽  
Vol 23 (10) ◽  
pp. 1210-1216
Author(s):  
Benjamin J. Lovett ◽  
Alexander H. Jordan
Keyword(s):  
College Students ◽  
Cognitive Abilities ◽  
Adult Adhd ◽  
Rating Scale ◽  
Self Report ◽  
World Health ◽  
Cognitive Tasks ◽  
Control Group ◽  
Group Setting ◽  
Symptom Reports

Objective: To investigate whether administration of a common ADHD screener followed by generic feedback would affect college students’ subsequent symptom reports and cognitive performance. Method: Participants were 157 college students randomly assigned to an experimental group—which completed the World Health Organization Adult ADHD Self-Report Scale screener and received standard generic feedback—or a control group. All participants then completed a battery of cognitive tasks and a long-form symptom rating scale. Results: The experimental and control groups did not differ significantly in terms of their subsequent symptom reports or their performance on any cognitive tasks. These null results remained after considering possibilities such as unequal group variances and interactions between screening effects and gender. Conclusion: When administered judiciously alongside generic feedback in a group setting, this common ADHD screener does not appear to affect college students’ self-perceptions or cognitive abilities.

scholarly journals A Systematic Review of Risk Factors for Intimate Partner Violence

Partner Abuse ◽  
2012 ◽  
Vol 3 (2) ◽  
pp. 231-280 ◽  
Author(s):  
Deborah M. Capaldi ◽  
Naomi B. Knoble ◽  
Joann Wu Shortt ◽  
Hyoun K. Kim
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Clinical Sample ◽  
Community Sample ◽  
Intimate Partner ◽  
Control Group ◽  
School Factors ◽  
Prior Review

A systematic review of risk factors for intimate partner violence IPV was conducted. Inclusion criteria included publication in a peer-reviewed journal, a representative community sample or a clinical sample with a control group comparison, a response rate of at least 50%, use of a physical or sexual violence outcome measure, and control of confounding factors in the analyses. A total of 228 articles were included (170 articles with adult and 58 with adolescent samples). Organized by levels of a dynamic developmental systems perspective, risk factors included (a) contextual characteristics of partners (demographic, neighborhood, community, and school factors), (b) developmental characteristics and behaviors of the partners (e.g., family, peer, psychological/behavioral, and cognitive factors), and (c) relationship influences and interactional patterns. Comparisons to a prior review highlight developments in the field in the past 10 years. Recommendations for intervention and policy along with future directions for IPV risk factor research are presented.

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