scholarly journals Do welfare benefit reassessments of people with mental health conditions lead to worse mental health? A prospective cohort study

2019 ◽  
Vol 66 (2) ◽  
pp. 136-149
Author(s):  
Ruth Stuart ◽  
Sanchika Campbell ◽  
Beatrice Osumili ◽  
Emily J Robinson ◽  
Mary Frost-Gaskin ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Health Service ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Exposed Group ◽  
Health Conditions ◽  
Control Group ◽  
Mental Health Conditions

Background: There have been cases of suicide following the Work Capability Assessment (WCA), a questionnaire and interview for those claiming benefits due to ill health or disability in the United Kingdom. Aims: To examine whether experiencing problems with welfare benefits, including WCA, among people with pre-existing mental health conditions was associated with poorer mental health and wellbeing and increased health service use and costs. Methods: A prospective cohort study of an exposed group ( n = 42) currently seeking help from a Benefits Advice Service in London and a control group ( n = 45) who had recently received advice from the same service. Questionnaires at baseline and 3-, 6- and 12-month follow-ups. Results: The exposed group had higher mean scores for anxiety ( p = .008) and depression ( p = .016) at baseline and the control group higher mean scores for wellbeing at baseline ( p = .034) and 12 months ( p = .035). However, loss to follow-up makes overall results difficult to interpret. The control group had higher incomes throughout the study, particularly at the 12-month follow-up ( p = .004), but the differences could have been accounted for by other factors. Health service costs were skewed by a few participants who used day-care services intensively or had inpatient stays. Over the study period the proportion of exposed participants engaged in benefits reassessment ranged from 50% to 88%, and 40% to 76% of controls. Conclusion: The hardship of living with financial insecurity and a mental health condition made it difficult for our participants to sustain involvement in a 12-month study and the frequency of benefit reviews meant that the experiences of our controls were similar to our exposed group. These limitations limit interpretation but confirm the relevance of our research. The control data raise the question of whether people with mental health conditions are being disproportionately reassessed.

scholarly journals Early retirement in cancer patients with or without comorbid mental health conditions: A prospective cohort study

Cancer ◽  
2014 ◽  
Vol 120 (14) ◽  
pp. 2199-2206 ◽  
Author(s):  
Susanne Singer ◽  
Alexandra Meyer ◽  
Sabine Wienholz ◽  
Susanne Briest ◽  
Anna Brown ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Cancer Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Early Retirement ◽  
Health Conditions ◽  
Mental Health Conditions

Continuous use of antipsychotics and its association with mortality and hospitalization in institutionalized Chinese older adults: an 18-month prospective cohort study

2011 ◽  
Vol 23 (10) ◽  
pp. 1640-1648 ◽  
Author(s):  
Tuen-Ching Chan ◽  
James Ka-Hay Luk ◽  
Yat-Fung Shea ◽  
Ka-Hin Lau ◽  
Felix Hon-Wai Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Nursing Homes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Exposed Group ◽  
Control Group ◽  
Chinese Older Adults ◽  
Influenza A H1n1 ◽  
Continuous Use

ABSTRACTBackground: Previous meta-analyses have suggested that antipsychotics are associated with increased mortality in dementia patients with behavioral and psychological symptoms (BPSD). Subsequent observational studies, however, have produced conflicting results. In view of this controversy and the lack of any suitable pharmacological alternative for BPSD, this study aimed to investigate the relationship between continuous use of antipsychotics and mortality as well as hospitalizations in Chinese older adults with BPSD residing in nursing homes.Methods: This was a prospective cohort study conducted in nursing homes in the Central & Western and Southern Districts of Hong Kong from July 2009 to December 2010. Older adults were stratified into the exposed group (current users of antipsychotics) and control group (non-users). Demographics, comorbidity according to the Charlson Comorbidity Index (CCI), Barthel Index (BI(20)), Abbreviated Mental Test (AMT), and vaccination status for pandemic Influenza A (H1N1) 2009, seasonal influenza and pneumococcus were collected at baseline. Subjects were followed up at 18 months. All-cause mortality and all-cause hospitalizations were recorded.Results: 599 older adults with dementia from nine nursing homes were recruited. The 18-month mortality rate for the exposed group was 24.1% while that for control group was 27.5% (P = 0.38). The exposed group also had a lower median rate of hospitalizations (56 (0–111) per 1000 person-months vs 111 (0–222) per 1000 person-months, median (interquartile range), p<0.001).Conclusions: The continuous use of antipsychotics for BPSD does not increase mortality among Chinese older adults with dementia living in nursing homes. Furthermore, our results show that the use of antipsychotics can lead to decreased hospitalizations.

scholarly journals Effect of food insecurity on mental health of patients with tuberculosis in Southwest Ethiopia: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045434
Author(s):  
Matiwos Soboka ◽  
Markos Tesfaye ◽  
Kristina Adorjan ◽  
Wolfgang Krahl ◽  
Elias Tesfaye ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Food Insecurity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Mental Distress ◽  
Early Assessment ◽  
Southwest Ethiopia ◽  
Effect Of Food

ObjectiveThe objective of this study is to investigate the effect of food insecurity on the mental health of patients with tuberculosis (TB) in Ethiopia.DesignA prospective cohort study.SettingHealth centres and hospitals located in Jimma zone, Southwest Ethiopia.ParticipantsPatients with TB who had recently been diagnosed with TB and started directly observed treatment in the selected 26 health institutions from October 2017 to October 2018. A total of 268 patients were followed for 6 months and data were collected at recruitment and two follow-up visits (at 2 and 6 months). Patients with multidrug-resistant TB were not included in the study.Main outcome measuresMental distress was measured by the Self-Reporting Questionnaire-20 while food insecurity was assessed by using the Household Food Insecurity Access Scale.ResultsA total of 268 patients were recruited and there was no lost to follow-up. The prevalence of food insecurity at baseline, first and second follow-up was 49.3%, 45.9% and 39.6%, respectively. Of these, 28.0% of them reported severe food insecurity at baseline which declined to 23.5% at the end of the sixth month. Likewise, the prevalence of mental distress at baseline was 61.2% but declined to 22.0% at the second follow-up. At baseline, 77.3% of patients with mental distress reported severe food insecurity but declined to 46.0% at second follow-up. In the final model, severe food insecurity (OR 4.7, 95% CI 2.4 to 9.4) and being a government employee (adjusted odds ratio (aOR) 0.3, 95% CI 0.1 to 0.9) were associated with mental distress.ConclusionIn this study, food insecurity was associated with mental distress over the course of follow-up. Likewise, there is a high prevalence of food insecurity and mental distress among patients with TB on treatment. Therefore, early assessment and interventions for food insecurity may improve the mental health of patients with TB on treatment.

scholarly journals A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy

2020 ◽  
Author(s):  
Jason B Luoma
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Effect Size ◽  
Monoamine Oxidase Inhibitor ◽  
Health Conditions ◽  
Control Group ◽  
Placebo Control ◽  
Controlled Clinical Trials ◽  
Mental Health Conditions

After a two-decade hiatus in which research on psychedelics was essentially halted, placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have begun to be published. We identified nine randomized, placebo-controlled clinical trials of psychedelic-assisted therapy published since 1994. Studies examined psilocybin, LSD (lysergic acid diethylamide), ayahuasca (which contains a combination of N,N-dimethyltryptamine and harmala monoamine oxidase inhibitor alkaloids), and MDMA (3,4-methylenedioxymethamphetamine). We compared the standardized mean difference between the experimental and placebo control group at the primary endpoint. Results indicated a significant mean between-groups effect size of 1.21 (Hedges g), which is larger than the typical effect size found in trials of psychopharmacological or psychotherapy interventions. For the three studies that maintained a placebo control through a follow-up assessment, effects were generally maintained at follow-up. Overall, analyses support the efficacy of psychedelic-assisted therapy across four mental health conditions—post-traumatic stress disorder, anxiety/depression associated with a life-threatening illness, unipolar depression, and social anxiety among autistic adults. While study quality was high, we identify several areas for improvement regarding the conduct and reporting of trials. Larger trials with more diverse samples are needed to examine possible moderators and mediators of effects, and to establish whether effects are maintained over time.

scholarly journals Mental health symptoms identify workers at risk of long-term sickness absence due to mental disorders: prospective cohort study with 2-year follow-up

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Marieke F. A. van Hoffen ◽  
Catelijne I Joling ◽  
Martijn W. Heymans ◽  
Jos W. R. Twisk ◽  
Corné A. M. Roelen
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Cohort Study ◽  
Mental Disorders ◽  
Sickness Absence ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Health Symptoms

scholarly journals A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy

2020 ◽  
Author(s):  
Jason B Luoma ◽  
Christina Chwyl ◽  
Geoff Bathje ◽  
Alan K. Davis ◽  
Rafael Lancelotta
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Effect Size ◽  
Monoamine Oxidase Inhibitor ◽  
Health Conditions ◽  
Control Group ◽  
Placebo Control ◽  
Controlled Clinical Trials ◽  
Mental Health Conditions

After a two-decade hiatus in which research on psychedelics was essentially halted, placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have begun to be published. We identified nine randomized, placebo-controlled clinical trials of psychedelic-assisted therapy published since 1994. Studies examined psilocybin, LSD (lysergic acid diethylamide), ayahuasca (which contains a combination of N,N-dimethyltryptamine and harmala monoamine oxidase inhibitor alkaloids), and MDMA (3,4-methylenedioxymethamphetamine). We compared the standardized mean difference between the experimental and placebo control group at the primary endpoint. Results indicated a significant mean between-groups effect size of 1.21 (Hedges g), which is larger than the typical effect size found in trials of psychopharmacological or psychotherapy interventions. For the three studies that maintained a placebo control through a follow-up assessment, effects were generally maintained at follow-up. Overall, analyses support the efficacy of psychedelic-assisted therapy across four mental health conditions—post-traumatic stress disorder, anxiety/depression associated with a life-threatening illness, unipolar depression, and social anxiety among autistic adults. While study quality was high, we identify several areas for improvement regarding the conduct and reporting of trials. Larger trials with more diverse samples are needed to examine possible moderators and mediators of effects, and to establish whether effects are maintained over time.

Wait-and-See Policy for Clinical Complete Responders After Chemoradiation for Rectal Cancer

2011 ◽  
Vol 29 (35) ◽  
pp. 4633-4640 ◽  
Author(s):  
Monique Maas ◽  
Regina G.H. Beets-Tan ◽  
Doenja M.J. Lambregts ◽  
Guido Lammering ◽  
Patty J. Nelemans ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Selection Criteria ◽  
Complete Response ◽  
Control Group ◽  
Wait And See ◽  
Strict Selection

Purpose Neoadjuvant chemoradiotherapy for rectal cancer can result in complete disappearance of tumor and involved nodes. In patients without residual tumor on imaging and endoscopy (clinical complete response [cCR]) a wait-and-see-policy (omission of surgery with follow-up) might be considered instead of surgery. The purpose of this prospective cohort study was to evaluate feasibility and safety of a wait-and-see policy with strict selection criteria and follow-up. Patients and Methods Patients with a cCR after chemoradiotherapy were prospectively selected for the wait-and-see policy with magnetic resonance imaging (MRI) and endoscopy plus biopsies. Follow-up was performed 3 to 6 monthly and consisted of MRI, endoscopy, and computed tomography scans. A control group of patients with a pathologic complete response (pCR) after surgery was identified from a prospective cohort study. Functional outcome was measured with the Memorial Sloan-Kettering Cancer Center (MSKCC) bowel function questionnaire and Wexner incontinence score. Long-term outcome was estimated by using Kaplan-Meier curves. Results Twenty-one patients with cCR were included in the wait-and-see policy group. Mean follow-up was 25 ± 19 months. One patient developed a local recurrence and had surgery as salvage treatment. The other 20 patients are alive without disease. The control group consisted of 20 patients with a pCR after surgery who had a mean follow-up of 35 ± 23 months. For these patients with a pCR, cumulative probabilities of 2-year disease-free survival and overall survival were 93% and 91%, respectively. Conclusion A wait-and-see policy with strict selection criteria, up-to-date imaging techniques, and follow-up is feasible and results in promising outcome at least as good as that of patients with a pCR after surgery. The proposed selection criteria and follow-up could form the basis for future randomized studies.

scholarly journals Effects of self-reported health conditions and pesticide exposures on probability of follow-up in a prospective cohort study

2009 ◽  
pp. n/a-n/a ◽  
Author(s):  
Martha P. Montgomery ◽  
Freya Kamel ◽  
Jane A. Hoppin ◽  
Laura E. Beane Freeman ◽  
Michael C.R. Alavanja ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Health Conditions ◽  
Pesticide Exposures ◽  
Reported Health
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