scholarly journals Early identification of postpartum depression using demographic, clinical, and digital phenotyping

2020 ◽  
Author(s):  
Lisa Hahn ◽  
Simon B. Eickhoff ◽  
Ute Habel ◽  
Elmar Stickeler ◽  
Patricia Schnakenberg ◽  
...  
Keyword(s):  
Early Intervention ◽  
Postpartum Depression ◽  
Validation Cohort ◽  
Adjustment Disorder ◽  
Screening Tools ◽  
Accurate Identification ◽  
Experienced Clinician ◽  
Accurate Detection ◽  
Digital Phenotyping ◽  
Self Assessments

AbstractBackgroundPostpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention.AimsTo evaluate combinations of anamnestic, clinical and remote assessments for an early and accurate identification of PPD and AD.MethodTwo cohorts of mothers giving birth were included in the study (N=308 and N=193). At baseline, participants underwent a detailed anamnestic and clinical interview. Remote assessments were collected over twelve weeks comprising mood and stress levels as well as depression and attachment scores. At twelve weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, prospectively validated in the second cohort.ResultsCombinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93% and 79% for differentiation of PPD and AD from HC in the prospective validation cohort. Differentiation between AD and PPD, with a balanced accuracy of 73 % was possible at week 6 based on mood levels only.ConclusionsCombinations of in clinic and remote self-assessments allowed for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children.

scholarly journals Early identification of postpartum depression using demographic, clinical, and digital phenotyping

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lisa Hahn ◽  
Simon B. Eickhoff ◽  
Ute Habel ◽  
Elmar Stickeler ◽  
Patricia Schnakenberg ◽  
...  
Keyword(s):  
Early Intervention ◽  
Postpartum Depression ◽  
Validation Cohort ◽  
Adjustment Disorder ◽  
Screening Tools ◽  
Accurate Identification ◽  
Experienced Clinician ◽  
Accurate Detection ◽  
Digital Phenotyping ◽  
Self Assessments

AbstractPostpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention. Combinations of anamnestic, clinical, and remote assessments were evaluated for an early and accurate identification of PPD and AD. Two cohorts of mothers giving birth were included in the study (N = 308 and N = 193). At baseline, participants underwent a detailed sociodemographic-anamnestic and clinical interview. Remote assessments were collected over 12 weeks comprising mood and stress levels as well as depression and attachment scores. At 12 weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, validated in a prospective second cohort. Combinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93 and 79% for differentiation of PPD and AD from HC in the validation cohort and balanced accuracies of 87 and 91% in the first cohort. Differentiation between AD and PPD, with a balanced accuracy of 73% was possible at week 6 based on mood levels only with a balanced accuracy of 73% in the validation cohort and a balanced accuracy of 76% in the first cohort. Combinations of in clinic and remote self-assessments allow for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children.

scholarly journals Accuracy of Depression Screening Tools for Identifying Postpartum Depression Among Urban Mothers

PEDIATRICS ◽  
2010 ◽  
Vol 125 (3) ◽  
pp. e609-e617 ◽  
Author(s):  
L. H. Chaudron ◽  
P. G. Szilagyi ◽  
W. Tang ◽  
E. Anson ◽  
N. L. Talbot ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Screening Tools ◽  
Depression Screening ◽  
Urban Mothers

scholarly journals The Adjustment Disorder Diagnosis, Its Importance to Liaison Psychiatry, and its Psychobiology

2019 ◽  
Vol 16 (23) ◽  
pp. 4645 ◽  
Author(s):  
James J. Strain
Keyword(s):  
Psychiatric Diagnosis ◽  
Adjustment Disorder ◽  
Screening Tools ◽  
Medical Setting ◽  
Psychiatric Diagnoses ◽  
Liaison Psychiatry ◽  
Common Features ◽  
Biological Studies ◽  
Depression Scales ◽  
The Military

Adjustment Disorder (AD) is one of the most common psychiatric diagnoses employed. In fact, it is the most frequent diagnosis utilized for psychiatric disorders in the military and in children, and is often utilized in the consultation-liaison medical setting. However, it is acknowledged that the diagnosis is not reliable, it cannot be validated, and it has an important degree of subjective consideration in its use. Commonly used screening tools like the Hamilton and Beck Depression Scales do not give an assessment of AD. Furthermore, its use is accompanied with descriptors of depression, anxiety, mixed affects, etc., so that it crosses over several areas of psychiatric dysfunction. It does allow the placement of a patient within a psychiatric diagnosis when they do not reach criteria for a major psychiatric nomenclature. To date, biological studies have not been reported. It is not known if AD with depression is closer to the biological characteristics of depression, or AD with anxiety would have similar characteristics to that seen with major anxiety. It is also not known if AD has a biological signature that would make them an entity with common features, or if they may be more closely allied biologically with the descriptor that accompanies them. Nevertheless, AD is an important category in any psychiatric lexicon and warrants further study and biological understanding.

Does chemotherapy reduce stress?

2010 ◽  
Vol 8 (4) ◽  
pp. 455-460 ◽  
Author(s):  
Francisco Gil ◽  
G. Costa ◽  
F.J. Pérez
Keyword(s):  
Cancer Patients ◽  
Performance Status ◽  
Adjustment Disorder ◽  
Clinical Interview ◽  
Screening Tools ◽  
Anxiety And Depression ◽  
Chemotherapy Treatment ◽  
Psychological Care ◽  
Care Needs ◽  
Low Performance

AbstractObjective:The purpose of this study was to assess the psychological care needs of cancer patients throughout the healthcare process: after diagnosis, after medical treatment (surgery, chemotherapy, radiotherapy) and during follow-up.Method:A total of 703 ambulatory cancer patients were assessed in this study. The inclusion period was from April 1, 2005 to April 30, 2007. The first psychological scales used were the 14-item Hospital Anxiety and Depression Scales (HADS), which has two sub-scales for anxiety (7 items) and for depression (7 items). All patients with a score ≥14 were assessed through the Structured Clinical Interview for Psychiatric Disorder (SCID-I) of the DSM-IV. All data were compared with sociodemographic and medical characteristics.Results:Of the 703 cancer patients in the study, 349 were men and 354 women, with a mean age of 53 years. The median time between the cancer diagnosis and our clinical interview was 6 months (range, 12 days to 190 months). Overall, the screening tools indicated that one in four patients needed psychological care. The most common psychiatric diagnosis was adjustment disorder (129 cases), whereas 10 patients were diagnosed with major depression. Using a HADS cut-off score of >7 for anxiety and depression, 28% and 17% of patients, respectively, were classified as “possible clinical cases.” Risk factors for distress included age <65 years, asthenia, constipation, and a low performance status. However, chemotherapy treatment was found to be a protector against distress in cancer patients.Significance of Results:Chemotherapy treatment is interpreted by the patients as a protector against cancer, thereby reducing distress levels.

scholarly journals Portuguese Early Literacy Screening Tool- RaLEPE: Pilot Study

2021 ◽  
Vol 11 (2) ◽  
pp. e71711
Author(s):  
Sara Pereira Sapage ◽  
Anabela Cruz-Santos
Keyword(s):  
Early Intervention ◽  
Pilot Study ◽  
Early Literacy ◽  
Screening Tool ◽  
Age Groups ◽  
Internal Validity ◽  
Academic Failure ◽  
Learning Disorders ◽  
Screening Tools ◽  
Analysis Of Results

Early literacy development is an indicator of a child’s overall cognitive-linguistic development and affects their academic, social, emotional and behavioural skills. Research suggests that early detection in preschool years can have an important role in the prevention of academic failure. There is a lack of early literacy screening tools for Portuguese preschool children. This study aims to present preliminary data results of the development and validation of the Preschool Early Literacy Screening Tool (Rastreio de Literacia Emergente Pré-escolar- RaLEPE). A pilot study was carried out with a sample of 128 screenings, answered by the parents/caregivers of the Portuguese children in the target age groups. The analysis of results shown the reliability of the tool, with a very good internal consistency for RaLEPE total scale and the different sections. Therefore, preliminary results of this study indicate internal validity of the RaLEPE and confirm this as screening tool usefulness for early intervention childhood, to provide early diagnosis and contribute to early intervention for children with language and learning disorders.

A proprietary multianalyte test for predicting extreme resistance to neoadjuvant 5-FU based chemoradiation (CTRT) in esophageal adenocarcinoma (EC).

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 51-51
Author(s):  
Weiwei Shan ◽  
Natalie Lassen ◽  
Clare Johnson ◽  
Yaeli Biermann-Harrar ◽  
Kristen M. Oelschlager ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Predictive Value ◽  
Validation Cohort ◽  
Neoadjuvant Treatment ◽  
Clinical Validation ◽  
Training Set ◽  
Extreme Resistance ◽  
Accurate Identification ◽  
Response To Chemotherapy ◽  
Gli 1

51 Background: Standard of care for localized EC is neoadjuvant CTRT followed by surgery. Although 5-FU based regimens are still commonly used, other regimens (CROSS) are also prescribed. Published EC studies report 20-25% of patients exhibit extreme resistance (exCTRT) to 5-FU based neoadjuvant treatment (NT); these patients may benefit from alternative treatment regimens. We have developed a proprietary assay using a training set of 167 patients to accurately identify patients with exCTRT (ROC 0.96). The results presented herein constitute an independent clinical validation. Methods: Biopsy samples from 71 pts diagnosed to have EC and who had undergone surgical excision following NT were obtained. IHC detection of NF-kB, SHH, and Gli-1 proteins in FFPE sections was performed in a CLIA approved lab. A GI pathologist and an expert clinical scientist blindly evaluated resection specimens and assigned a labeling index (LI) score. The LI for each case was compared to the established training set and the predicted response determined using a logistic regression algorithm. Blinded pathology scoring for exCTRT vs. non-exCTRT was performed for all samples using both CAP Tumor Response Grade (TRG) and the Rohatgi research scale. Results: Of the 71 EC cases in the clinical validation cohort, 24 had an outcome of exCTRT (<50% reduction in tumor following neoadjuvant treatment; TRG 3) and 47 had an outcome of non-exCTRT (>50% reduction in tumor; TRG 0-2). ROC for the validation cohort was 0.85. The positive predictive value for the validation study was 83%, reflecting an assay that can accurately predict those likely to have some degree of response to chemotherapy / radiation. Conversely, a negative predictive value of 83% with specificity of 94% was achieved indicating accurate identification of those not likely to benefit from neoadjuvant treatment. Conclusions: The analysis of NF-kB, SHH, and Gli-1 in EC tissue can accurately identify patients unlikely to respond to 5-FU based NT. These results are now confirmed using a CLIA accredited lab and a multicenter independent validation cohort of esophageal adenocarcinoma biopsies.

scholarly journals Highly Accurate Identification of Cystic Precursor Lesions of Pancreatic Cancer Through Targeted Mass Spectrometry: A Phase IIc Diagnostic Study

2018 ◽  
Vol 36 (4) ◽  
pp. 367-375 ◽  
Author(s):  
Karolina S. Jabbar ◽  
Liisa Arike ◽  
Caroline S. Verbeke ◽  
Riadh Sadik ◽  
Gunnar C. Hansson
Keyword(s):  
Mass Spectrometry ◽  
Pancreatic Cancer ◽  
Carcinoembryonic Antigen ◽  
Validation Cohort ◽  
Malignant Potential ◽  
Cyst Fluid ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Cystic Lesions ◽  
Accurate Identification

Purpose Pancreatic cystic lesions are common incidental findings on imaging, but up to half may be forerunners of pancreatic cancer. Therefore, accurate differential diagnosis is crucial for correct patient management. Unfortunately, currently available diagnostic methods cannot robustly identify premalignant and malignant pancreatic cystic lesions. Methods Cyst fluid samples obtained by routine endoscopic ultrasound-guided aspiration were used for the analyses. In a cohort of 24 patients, eight biomarker candidates for malignant potential and high-grade dysplasia/cancer were identified by an explorative proteomic approach. Subsequently, a quantitative analysis, using 30 heavy-labeled peptides from the biomarkers and parallel reaction monitoring mass spectrometry, was devised, tested in a training cohort of 80, and prospectively evaluated in a validation cohort of 68 patients. End points were surgical pathology diagnosis/clinical follow-up. Diagnostic assessments were blinded to mass spectrometry results. Results The optimal set of markers for detecting malignant potential was a panel of peptides from mucin-5AC and mucin-2, which could discriminate premalignant/malignant lesions from benign with an accuracy of 97% (95% CI, 89% to 99%) in the validation cohort. This result compared favorably with the accuracy of standard analyses: cyst fluid carcinoembryonic antigen (61%; 95% CI, 46% to 74%; P < .001) and cytology (84%; 95% CI, 71% to 92%; P = .02). A combination of proteins mucin-5AC and prostate stem-cell antigen could identify high-grade dysplasia/cancer with an accuracy of 96% (95% CI, 90% to 99%), and detected 95% of malignant/severely dysplastic lesions, compared with 35% and 50% for carcinoembryonic antigen and cytology ( P < .001 and P = .003, respectively). Conclusion Targeted mass spectrometry analysis of just three cyst fluid biomarkers provides highly accurate identification and assessment of cystic precursors to pancreatic adenocarcinoma. Additional studies should determine whether the method can facilitate timely cancer diagnosis, successful intervention, and prevention.

Postpartum Depression Screening Tools: A Review

2018 ◽  
Vol 59 (3) ◽  
pp. 211-219 ◽  
Author(s):  
Nneamaka Ukatu ◽  
Camille A. Clare ◽  
Mary Brulja
Keyword(s):  
Postpartum Depression ◽  
Screening Tools ◽  
Depression Screening
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