scholarly journals T91. THE POSITIVE AND NEGATIVE SYNDROME SCALE SUPERIOR TO A SELF-REPORT QUESTIONNAIRE IN THE PHARMACOTHERAPY MONITORING AND OUTCOME SURVEY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S266-S266
Author(s):  
Annegien Bartels-Velthuis ◽  
Koen Ties ◽  
Ellen Visser ◽  
Johan Arends ◽  
Marieke Pijnenborg ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Data Set ◽  
Syndrome Scale ◽  
Outcome Monitoring ◽  
Negative Syndrome

Abstract Background Aiming to improve the quality of care for patients with a psychotic disorder, the ongoing Pharmacotherapy Monitoring Outcome Survey (PHAMOUS) started in 2006 in four large mental health care organizations in the Northern Netherlands, by adding it to the at that time mandatory Routine Outcome Monitoring program. However, since the cuts in the financial budgets for mental health care, research nurses are increasingly experiencing time-pressure in the assessments. The Positive and Negative Syndrome Scale (PANSS), part of the assessment, is a time-consuming interview, taking approximately 30 minutes. Therefore, we developed and validated a short self-report questionnaire assessing positive psychotic symptoms, the Brief Positive Symptoms Questionnaire (BPSQ). Methods The BPSQ was added to PHAMOUS and filled in once by patients in four mental health care institutions in 2017 and 2018. The BPSQ consists of nine items and takes about 2–3 minutes to complete. It was validated against the PANSS positive scale and two items of the Health of the Nations Outcome Scale (HoNOS), with item 6 assessing the problems that patients experience due to hallucinations and delusions and item 8 assessing further mental and behavioural problems. Results BPSQ data were obtained from n=287 patients (mean age 47.1 years, 67.6% male). The PANSS was assessed in n=244 and HoNOS data were available for n=156 patients. Scores of one patient were considered unreliable and thus removed from the data set. The BPSQ had a Cronbach’s alpha of .81. Spearman’s correlation coefficient of the BPSQ and the PANSS positive scale was significant (ρ(243) = .63, p < .05). Correlations between the BPSQ and HoNOS items 6 and 8 were significant (ρ(155) = .488, p < .05 and ρ(155) = .251, p < .05 respectively). Post hoc analysis showed that the more severely psychotic the patients were, the less the BPSQ and the PANSS positive scale were corresponding. Discussion Given the medium correlation of the BPSQ with the PANSS positive scale and the low concurrent validity with the two relevant HoNOS items, we argue that the widely used and validated PANSS is indispensable in the PHAMOUS assessment of positive symptoms in a chronic population with psychotic disorders. Replication of this study in first-episode psychotic patients is recommended.

Mental Health Problems and Help-Seeking among Adolescents

2021 ◽  
pp. 189-202
Author(s):  
E.V. Rezun ◽  
◽  
H.R. Slobodskaya ◽  
N.B. Semenova ◽  
T.O. Rippinen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Help Seeking ◽  
Sleep Disturbances ◽  
Mental Health Problems ◽  
Health Problems ◽  
Self Report ◽  
Emotional And Behavioral Problems ◽  
Seeking Help

The mental health problems among adolescents have long-lasting effects throughout life. However, research evidence indicates that only 10–30% of adolescents who needed mental health care had received specialized help. The present study reports the prevalence of mental health problems and help-seeking among adolescents, taking into account gender and age differences. The sample included 1752 adolescents (47 % boys,) aged 12-17 years. Data were collected on in two Siberian cities (Novosibirsk and Krasnoyarsk) using an international self-report questionnaire developed for the school-based Eurasian Child Mental Health Study. Participants were recruited from 18 schools, students completed questionnaires anonymously during school lessons. Statistical analysis included analysis of variance (ANOVA), multiple regression analysis, and crosstabs using a chi-squared test. The level of emotional and behavioral problems in Siberian adolescents was slightly higher than that found in European and Asian countries. Twenty three percent of adolescents reported frequent headaches (at least once a week), 11 % reported frequent abdominal pain and 14% suffered from frequent sleep disturbances (3–5 times a week or more). Girls reported a significantly higher level of problems than boys, with the largest gender differences for emotional problems, recurrent pains and sleep disturbances. Weekly consumption of alcohol and daily use of nicotine among boys was more common than among girls (3 % and 6 %, respectively), whereas less frequent use of alcohol and nicotine was commoner in girls (16 %) than in boys (10 %); 7 % of boys and girls had tried drugs at least once. Suicidal thoughts were reported by 22 % of adolescents, 6 % reported suicide attempts and 6 % reported repeated self-harm. One third of adolescents considered seeking outside help and 9 % had actually done so. Girls reported more help-seeking than boys; older girls sought help more often than younger and middle-aged ones. Around one third of adolescents sought help from their relatives; 26 % from friends, the Internet or other non-professional sources; 5 % reported seeking help from a doctor or nurse, and 3 % from a psychologist. The most important independent predictors of seeking help were emotional symptoms, suicidal ideation and hyperactivity/inattention. The results suggest a need for future investigation of the factors associated with help-seeking behavior among adolescents. It is also necessary to develop mental health promotion programs for adolescents, interventions to improve mental health literacy and access to mental health care.

Mental health economics: current methodological issues

2011 ◽  
Vol 20 (3) ◽  
pp. 239-243 ◽  
Author(s):  
P. McCrone
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Services ◽  
Self Report ◽  
Economic Evaluations ◽  
Methodological Issues ◽  
Care Services ◽  
Life Years ◽  
Mental Health Economics

Background:Investment in innovative mental health care services requires the use of scarce resources that could be used in alternative ways. Economic evaluation is essential to ensure that such an investment is appropriately compared with investment elsewhere.Method:A non-systematic review of mental health evaluations identifies key methodological issues pertaining to economic studies.Results:Economic evaluations require the measurement and combination of costs and outcomes, and clarity about how this measurement is undertaken is required. Regarding costs, important considerations relate to the perspective to be taken (e.g., health service or societal), method of measurement (patient self-report or use of databases) and valuation (actual costs, fees or expenditure). Decision makers frequently need to compare evidence both within and between clinical areas and therefore there is a tension between the use of condition specific and generic outcome measures. Quality-adjusted life years are frequently used in economic evaluations, but their appropriateness in mental health care studies is still debated.Conclusions:Economic evaluations in the area of mental health care are increasing in number and it is essential that researchers continue to develop and improve methods used to conduct such studies.

scholarly journals Measurement issues of shared decision making in mental health: challenges and opportunities

2017 ◽  
Vol 22 (3) ◽  
pp. 214-232 ◽  
Author(s):  
Lilisbeth Perestelo-Perez ◽  
Amado Rivero-Santana ◽  
Yolanda Alvarez-Perez ◽  
Yaara Zisman-Ilani ◽  
Emma Kaminskiy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Mental Health Care ◽  
Shared Decision Making ◽  
Self Report ◽  
Psychometric Validation ◽  
Shared Decision ◽  
Deliberative Process ◽  
Content Type

Purpose Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences and concerns in a deliberative process with the health care provider. Many existing instruments assess the antecedents, process, or the outcomes of SDM. The purpose of this paper is to identify the SDM-related measures applied in a mental health context. Design/methodology/approach The authors performed a systematic review in several electronic databases from 1990 to October 2016. Studies that assessed quantitatively one or more constructs related to SDM (antecedents, process, and outcomes) in the field of mental health were included. Findings The authors included 87 studies that applied 48 measures on distinct SDM constructs. A large majority of them have been developed in the field of physical diseases and adapted or directly applied in the mental health context. The most evaluated construct is the SDM process in consultation, mainly by patients’ self-report but also by external observer measures, followed by the patients’ preferences for involvement in decision making. The most applied instrument was the Autonomy Preference Index, followed by the Observing Patient Involvement in Decision Making (OPTION) and the Control Preferences Scale (CPS). The psychometric validation in mental health samples of the instruments identified is scarce. Research limitations/implications The bibliographic search is comprehensive, but could not be completely exhaustive. Effort should be invested in the development of new SDM for mental health tools that will reflect the complexity and specific features of mental health care. Originality/value The authors highlight several limitations and challenges for the measurement of SDM in mental health care.

Patients who somatize in primary care: a longitudinal study of cognitive and social characteristics

1996 ◽  
Vol 26 (5) ◽  
pp. 937-951 ◽  
Author(s):  
Laurence J. Kirmayer ◽  
James M. Robbins
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Depressive Symptomatology ◽  
Emotional Problem ◽  
Somatic Symptoms ◽  
Self Report ◽  
Care Utilization ◽  
Sociodemographic Characteristics

SynopsisWe examined the cognitive and sociodemographic characteristics of patients making somatic presentations of depression and anxiety in primary care. Only 15% of patients with depressive symptomatology on self-report, and only 21 % of patients with current major depression or anxiety disorders on diagnostic interview, presented psychosocial symptoms to their GP. The remainder of patients with psychiatric distress presented exclusively somatic symptoms and were divided into three groups - initial, facultative and true somatizers - based on their willingness to offer or endorse a psychosocial cause for their symptoms. Somatizers did not differ markedly from psychologizers in sociodemographic characteristics except for a greater proportion of men among the true somatizers. Compared to psychologizers, somatizers reported lower levels of psychological distress, less introspectiveness and less worry about having an emotional problem. Somatizers were also less likely to attribute common somatic symptoms to psychological causes and more likely to endorse normalizing causes. In the 12 months following their initial visit, somatizers made less use of speciality mental health care and were less likely to present emotional problems to their GP. Somatizers were markedly less likely to talk about personal problems to their GP and reported themselves less likely to seek help for anxiety or sadness. Somatization represents a persistent pattern of illness behaviour in which mental health care is not sought despite easily elicited evidence of emotional distress. Somatization is not, however, associated with higher levels of medical health care utilization than that found among patients with frank depression or anxiety.

scholarly journals Predictors of viewing progress notes among users of VA’s electronic health portal who receive mental health care

JAMIA Open ◽  
2018 ◽  
Vol 1 (1) ◽  
pp. 122-127 ◽  
Author(s):  
Steven K Dobscha ◽  
Lauren M Denneson ◽  
Maura K Pisciotta ◽  
Donald S Bourne ◽  
Jason I Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Medical Center ◽  
Self Report ◽  
Mental Health Clinicians ◽  
Health Administration ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Clinical Notes

Abstract Objective Consistent with the OpenNotes movement, the Veterans Health Administration (VHA) offers patients online access to their clinical notes through the Blue Button feature in its electronic patient health portal, My HealtheVet. We identified demographic, diagnostic, and knowledge-related predictors of viewing clinical notes among veterans receiving VHA mental health care who recently used My HealtheVet. Materials and Methods Three hundred and thirty-eight patients receiving mental health care from 1 VHA medical center who had logged into My HealtheVet in the prior 6 months completed self-report questionnaires assessing their viewing of clinical notes. Additional data were extracted from VHA’s Patient Care Database. Multivariable logistic regression was used to examine predictors of viewing notes. Results Fifty percent of respondents reported having read their notes. In the final multivariable model, post-traumatic stress disorder (PTSD) diagnosis [odds ratio (OR) = 2.30 (1.31–4.07)], speaking with their mental health clinician about their ability to view notes [OR = 3.84 (1.69–8.72)], and being very or extremely confident in understanding the purpose and uses of Blue Button [OR = 9.80 (2.23–43.07) and OR = 13.36 (2.74–65.20), respectively] were associated with viewing notes. Discussion Patient recall of mental health clinicians speaking to them about their ability to view notes, and confidence in understanding the use and purposes of Blue Button, were stronger predictors of viewing notes than demographic variables. PTSD diagnosis was the only clinical characteristic associated with viewing notes. Conclusion The findings support the value of mental health clinicians openly discussing the availability of notes with patients if they wish to help them take advantage of their potential benefits.

scholarly journals Challenges in Investigating the Effective Components of Feedback from Routine Outcome Monitoring (ROM) in Youth Mental Health Care

2020 ◽  
Author(s):  
Maartje A. M. S. van Sonsbeek ◽  
Giel J. M. Hutschemaekers ◽  
Jan W. Veerman ◽  
Ad Vermulst ◽  
Marloes Kleinjan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Symptom Severity ◽  
Youth Mental Health ◽  
Routine Outcome Monitoring ◽  
Effective Components ◽  
Outcome Monitoring

Abstract BackGround Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic. Objective To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used. Method Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants’ age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity. Results No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians’ poor adherence to feedback conditions. Conclusions The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care. Trial registration Dutch Trial Register NTR4234 .

scholarly journals Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ya-Wen Jen ◽  
Tzung-Jeng Hwang ◽  
Hung-Yu Chan ◽  
Ming H. Hsieh ◽  
Chen-Chung Liu ◽  
...  
Keyword(s):  
Prolactin Level ◽  
Age At Onset ◽  
Psychotic Symptoms ◽  
Warning Sign ◽  
Multivariable Logistic Regression Analysis ◽  
Early Age ◽  
Positive Symptoms ◽  
Cumulative Proportion ◽  
Syndrome Scale ◽  
Negative Syndrome

Abstract Background Switching to aripiprazole from other antipsychotics can avoid antipsychotic-induced hyperprolactinemia but may result in an abnormally low prolactin level. This study aimed to assess whether the aripiprazole-induced abnormally low prolactin level was a biomarker for subsequent rebound of positive symptoms in schizophrenia patients. Methods Participants were 63 patients in an 8-week trial of switching to aripiprazole, in which preswitching antipsychotics were maintained for the first 2 weeks and aripiprazole was fixed at 15 mg orally throughout the trial. A prolactin level of < 3.7 ng/ml was defined as abnormally low, and an increase of two or more points in the positive subscore of the Positive and Negative Syndrome Scale at two adjacent ratings was defined as a psychotic rebound. Results Among 63 patients, 25 (39.7%) had an abnormally low prolactin level and 21 (33.3%) had a psychotic rebound after switching to aripiprazole. In patients with abnormally low prolactin levels, 48.0% of them had a rebound in psychotic symptoms, whereas in those without abnormally low prolactin levels 23.7% did so. Multivariable logistic regression analysis with adjustment for sex, early age at onset, and preswitching medications revealed that abnormally low prolactin levels were associated with psychotic rebound (adjusted odds ratio = 3.55, 95% confidence interval = 1.02, 12.5). Furthermore, there was concurrency between the trend of the cumulative proportion of patients having an abnormally low prolactin level and that of the cumulative proportion of patients having a rebound in psychotic symptoms. Conclusions An abnormally low prolactin level after switching to aripiprazole in schizophrenia patients was a potential warning sign of a psychotic rebound. Hence, monitoring of prolactin levels after switching to aripiprazole may help avoid such rebound in schizophrenia. Trial registration NCT00545467; Date of registration: 17/10/2007.

Information sharing and risk: a survey of psychiatrists

2007 ◽  
Vol 24 (3) ◽  
pp. 94-98 ◽  
Author(s):  
Larkin Feeney ◽  
Paul Moran
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Medical Model ◽  
Clinical Information ◽  
Data Set ◽  
Emergency Mental Health ◽  
Alert Message ◽  
Health Assessments ◽  
Multidisciplinary Model

AbstractObjectives: Historical information is central to decision making in mental health care. Clinical information in the Irish mental health services is currently mostly paper based. Mental health care in Ireland has moved from an institutional medical model towards a community based multidisciplinary model in recent years. This change has resulted in a dispersal of information between multiple sites and professionals, rendering it less accessible, particularly in emergency settings.This study sought to find out if psychiatrists working in Ireland were experiencing information problems, their ideas about and attitudes towards electronic solutions to these problems, and their views as to what particular pieces of information are indispensable in emergency mental health assessments.Method: A questionnaire was designed to answer these questions and sent to a representative sample of 150 psychiatrists working in Ireland.Results: One hundred and nineteen questionnaires (79.3%) were returned complete. Of the 119 respondents 98(82.4%) stated that they had performed emergency mental health assessments within the past year without access to key information and 79(66.4%) said they would have made different decisions in some cases had they had all the available information. Information deficits were particularly apparent in liaison and forensic psychiatry.Of the respondents 110(92.4%) stated that they would welcome an electronic database designed to support emergency mental health assessments. Misgivings were expressed regarding forms of consent, data quality, breach of confidentiality, resources and much more. Risk factors (ie. self-harm potential), a high alert message and medication details were the data items thought to be most critical.Conclusions: A shareable set of essential pieces of information (a minimum data set) would offer a balance between patient safety, confidentiality and shareability. A wider debate about solutions to the information deficits in mental health care in Ireland needs to take place among all stakeholders so that this idea can be moved forward.

scholarly journals Patients’ care dependency in mental health care: Development of a self‐report questionnaire and preliminary correlates

2018 ◽  
Vol 74 (7) ◽  
pp. 1189-1206 ◽  
Author(s):  
Naline Geurtzen ◽  
Ger P. J. Keijsers ◽  
Johan C. Karremans ◽  
Giel J. M. Hutschemaekers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Self Report ◽  
Care Dependency ◽  
Care Development

scholarly journals Shifts in positive and negative psychotic symptoms and anger: effects on violence

2018 ◽  
Vol 48 (14) ◽  
pp. 2428-2438 ◽  
Author(s):  
Jeremy W. Coid ◽  
Constantinos Kallis ◽  
Mike Doyle ◽  
Jenny Shaw ◽  
Simone Ullrich
Keyword(s):  
Community Violence ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Protective Effects ◽  
Post Discharge ◽  
Affective Symptoms ◽  
Syndrome Scale ◽  
Negative Syndrome

BackgroundChanges in positive and negative symptom profiles during acute psychotic episodes may be key drivers in the pathway to violence. Acute episodes are often preceded by fluctuations in affect before psychotic symptoms appear and affective symptoms may play a more important role in the pathway than previously recognised.MethodsWe carried out a prospective cohort study of 409 male and female patients discharged from medium secure services in England and Wales to the community. Measures were taken at baseline (pre-discharge), 6 and 12 months post-discharge using the Positive and Negative Syndrome Scale. Information on violence was obtained using the McArthur Community Violence Instrument and Police National Computer.ResultsThe larger the shift in positive symptoms the more likely violence occurred in each 6-month period. However, shifts in angry affect were the main driving factor for positive symptom shifts associated with violence. Shifts in negative symptoms co-occurred with positive and conveyed protective effects, but these were overcome by co-occurring shifts in anger. Severe but stable delusions were independently associated with violence.ConclusionsIntensification of angry affect during acute episodes of psychosis indicates the need for interventions to prevent violence and is a key driver of associated positive symptoms in the pathway to violence. Protective effects against violence exerted by negative symptoms are not clinically observable during symptom shifts because they are overcome by co-occurring anger.

Sign in / Sign up

Export Citation Format

Share Document