Baseline Psychological Treatment Reduces the Effect of Coaching in a Randomised Trial of a Depression Self-Care Intervention

Objective: To explore the effects of baseline psychological and antidepressant medication treatment in a trial of lay telephone coaching in a low-intensity, supported depression self-care intervention. Method: A single blind, individually randomised, pragmatic trial was conducted among primary care adults with chronic physical conditions and comorbid depressive symptoms. Eligible subjects were randomised to receive a depression self-care toolkit with (intervention group) or without (control group) telephone coaching provided by trained lay coaches. For this brief communication, a secondary analysis of the trial data focused on the effects of baseline psychological and antidepressant treatments on mental health outcomes (Patient Health Questionnaire 9 [PHQ-9], SF-12 Mental Component Summary [MCS], Generalized Anxiety Disorder 7 [GAD-7]) and satisfaction with the intervention. Results: In total, 223 patients were randomised, and 165 (74.0%) completed both 3- and 6-month follow-ups. There were 2 significant interactions of baseline treatment and study group for 6-month mental health outcomes. A significant benefit of coaching on 6-month PHQ-9 was seen only among participants who were not receiving baseline psychological treatment. A smaller interaction was found for baseline antidepressant medications and 6-month mental health. There was a significant main effect for baseline psychological treatment and lower 6-month satisfaction. Conclusions: Depressed patients receiving baseline psychological treatment may not benefit from lay coaching offered as part of a low-intensity depression self-care intervention.

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Mental Health Among Adolescents from Returned Portuguese Immigrant Families

Swiss Journal of Psychology ◽

10.1024/1421-0185/a000015 ◽

2010 ◽

Vol 69 (3) ◽

pp. 131-139 ◽

Cited By ~ 5

Author(s):

Félix Neto

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Mental Health Problems ◽

Immigrant Families ◽

Health Problems ◽

Mental Health Outcomes ◽

Control Group ◽

Older Adolescents ◽

The Mean ◽

Portuguese Adolescents

This study investigated mental health problems and their predictors among adolescents from returned immigrant families. The sample consisted of 360 returned adolescents (mean age = 16.8 years; SD = 1.9). The mean duration of a sojourn in Portugal for the sample was 8.2 years (SD = 4.5). A control group of 217 Portuguese youths were also included in the study. Adolescents from immigrant families reported mental health levels similar to those of Portuguese adolescents who have never migrated. Girls showed more mental health problems than boys. Younger adolescents showed fewer mental health problems than older adolescents. Adaptation variables contributed to mental health outcomes even after acculturation variables were accounted for. Implications of the study for counselors are discussed.

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Social services Interventions and the Mental Health and Mortality of care leavers: a population based data linkage study in Northern Ireland and Finland

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1252 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Aideen Maguire ◽

Anne Kouvonen ◽

Dermot O'Reilly ◽

Hanna Remes ◽

Joonas Pitkänen ◽

...

Keyword(s):

Mental Health ◽

Northern Ireland ◽

Health Outcomes ◽

Social Services ◽

Psychiatric Hospital ◽

Poor Mental Health ◽

Mental Health Outcomes ◽

Care Intervention ◽

Increased Risk ◽

Self Harm

BackgroundResearch has highlighted the poor mental health of looked after children compared to those never in care. However, little is known on what becomes of these children and their mental health trajectories after they leave the care of social services. In addition, previous studies are limited in their ability to differentiate between type of social care intervention received; kinship care, foster care or residential care. AimTo utilise nationwide social services data from two countries (Northern Ireland (NI) and Finland), with similar populations but different intervention policies, linked to a range of demographic and health datasets to examine the mental health outcomes of young adults in the years following leaving care. MethodsData from both countries on children born 1991-2000 were linked to social services data, hospital admissions, prescribed medication data and death records. Mental health outcomes were defined after the age of 18years (when statutory care provision ends) examined by care intervention and included admissions to psychiatric hospital, for self-harm and death by suicide. ResultsThe gender split in care in Finland is reflective of the population but more males are in care in NI. Initial results from Finnish data suggest those exposed to care in childhood have an increased risk of self-harm, psychiatric hospital admission and suicide after the age of 18years compared to those never in care. After adjusting for gender, age of entry to care and deprivation at birth those exposed to any care intervention had 3 times the risk of suicide (HR=3.06, 95% CI 1.18,7.98). Risk increased with duration in care but was equivalent across care intervention types. Analysis on the NI data is underway. ConclusionFull results will be available December 2019 and will explore which care pathways are most associated with poor mental health outcomes informing discussion around intervention opportunities and policy.

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A prospective study of pre-employment psychological testing amongst police recruits

Occupational Medicine ◽

10.1093/occmed/kqaa008 ◽

2020 ◽

Vol 70 (3) ◽

pp. 162-168 ◽

Cited By ~ 2

Author(s):

R E Marshall ◽

J S Milligan-Saville ◽

Z Steel ◽

R A Bryant ◽

P B Mitchell ◽

...

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Police Officers ◽

Minnesota Multiphasic Personality Inventory ◽

Mental Health Problems ◽

Conditional Logistic Regression ◽

Mental Health Outcomes ◽

Psychological Injury ◽

Control Group ◽

Police Recruits

Abstract Background Pre-employment psychological screening to detect psychological vulnerability is common amongst emergency service organizations worldwide, yet the evidence for its ability to predict poor mental health outcomes is limited with published studies looking at post-recruitment research data rather than data collected by the organizations themselves. Aims The present study sought to investigate the ability of pre-employment screening to predict later psychological injury-related absenteeism amongst police officers. Methods A nested case–control study using prospective data was conducted. One hundred and fifty police officers with a liability-accepted psychological injury were matched to a control group of 150 psychologically healthy officers. Conditional logistic regression was used to examine associations between Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales measuring factors research has shown to predict psychological injury (Neuroticism, Psychoticism, Introversion, Disconstraint and Aggressiveness) and psychopathology (Depression, Anxiety and post-traumatic stress disorder [PTSD]) with subsequent psychological injury. Results Contrary to expectations, we were unable to demonstrate any association between validated pre-employment measures of personality and psychopathology with mental health outcomes amongst newly recruited police officers over a 7-year follow-up. Conclusions Other measures may be better able to predict future mental health problems in police recruits.

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The Moderating Effect of Positive Father Engagement and Accessibility on a School-Based System of Care Intervention for Mental Health Outcomes of Children

Journal of Child and Family Studies ◽

10.1007/s10826-014-0096-0 ◽

2015 ◽

Vol 24 (10) ◽

pp. 2923-2933 ◽

Cited By ~ 4

Author(s):

Stanley N. Bernard ◽

Melissa Whitson ◽

Joy Kaufman

Keyword(s):

Mental Health ◽

Health Outcomes ◽

System Of Care ◽

Moderating Effect ◽

Mental Health Outcomes ◽

Father Engagement ◽

School Based ◽

Care Intervention

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Brief self-affirmation intervention for adults with psoriasis for reducing anxiety and depression and boosting well-being: Evidence from a randomized controlled trial

Psychological Medicine ◽

10.1017/s0033291721004499 ◽

2021 ◽

pp. 1-11

Author(s):

Patryk Łakuta

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Active Control ◽

Implementation Intentions ◽

Controlled Trial ◽

Well Being ◽

Mental Health Outcomes ◽

Control Group ◽

Post Intervention

Abstract Background There are relatively few studies to address mental health implications of self-affirming, especially across groups experiencing a chronic health condition. In this study, short- and longer-term effects of a brief self-affirmation intervention framed in terms of implementation intentions (if-then plans with self-affirming cognitions; S-AII) were evaluated against an active control group (non-affirming implementation intentions; N-AII), matched to the target condition, and mere goal intention condition (a non-active control) in adults with psoriasis. The three pre-registered primary outcomes captured depression, anxiety, and well-being. Methods Adults with psoriasis (N = 175; Mage = 36.53, s.d. = 11.52) were randomized into S-AII, N-AII, or control. Participants' mental health outcomes were assessed prior to randomization (at baseline), at week 2 (post-intervention), and at a 1-month follow-up. Results Linear mixed models were used and results were reported on the intention-to-treat principle. Analyses revealed that S-AII exerted significantly more improvement in the course of well-being (ds > 0.25), depressive symptoms (ds > −0.40), and anxiety (ds > −0.45) than the N-AII and control group at 2-week post-intervention. Though the differences between groups faded at 1-month follow-up, the within-group changes over time for S-AII in all mental health outcomes remained significant. Conclusions Brief and low-intensity S-AII intervention exerted in the short-term a considerable impact on mental health outcomes. The S-AII shows promising results as a relevant public mental health strategy for enhancing well-being and reducing psychological distress. Future studies could consider whether these effects can be further enhanced with booster interventions.

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Peer-led counselling with problem discussion therapy for adolescents living with HIV in Zimbabwe: A cluster-randomised trial

PLoS Medicine ◽

10.1371/journal.pmed.1003887 ◽

2022 ◽

Vol 19 (1) ◽

pp. e1003887

Author(s):

Victoria Simms ◽

Helen A. Weiss ◽

Silindweyinkosi Chinoda ◽

Abigail Mutsinze ◽

Sarah Bernays ◽

...

Keyword(s):

Mental Health ◽

Viral Load ◽

Health Outcomes ◽

Peer Support ◽

Common Mental Disorders ◽

Randomised Trial ◽

Virological Suppression ◽

Mental Health Outcomes ◽

Cluster Randomised Trial ◽

Living With Hiv

Background Adolescents living with HIV have poor virological suppression and high prevalence of common mental disorders (CMDs). In Zimbabwe, the Zvandiri adolescent peer support programme is effective at improving virological suppression. We assessed the effect of training Zvandiri peer counsellors known as Community Adolescent Treatment Supporters (CATS) in problem-solving therapy (PST) on virological suppression and mental health outcomes. Methods and findings Sixty clinics were randomised 1:1 to either normal Zvandiri peer counselling or a peer counsellor trained in PST. In January to March 2019, 842 adolescents aged 10 to 19 years and living with HIV who screened positive for CMDs were enrolled (375 (44.5%) male and 418 (49.6%) orphaned of at least one parent). The primary outcome was virological nonsuppression (viral load ≥1,000 copies/mL). Secondary outcomes were symptoms of CMDs measured with the Shona Symptom Questionnaire (SSQ ≥8) and depression measured with the Patient Health Questionnaire (PHQ-9 ≥10) and health utility score using the EQ-5D. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using logistic regression adjusting for clinic-level clustering. Case reviews and focus group discussions were used to determine feasibility of intervention delivery. At baseline, 35.1% of participants had virological nonsuppression and 70.3% had SSQ≥8. After 48 weeks, follow-up was 89.5% for viral load data and 90.9% for other outcomes. Virological nonsuppression decreased in both arms, but there was no evidence of an intervention effect (prevalence of nonsuppression 14.7% in the Zvandiri-PST arm versus 11.9% in the Zvandiri arm; AOR = 1.29; 95% CI 0.68, 2.48; p = 0.44). There was strong evidence of an apparent effect on common mental health outcomes (SSQ ≥8: 2.4% versus 10.3% [AOR = 0.19; 95% CI 0.08, 0.46; p < 0.001]; PHQ-9 ≥10: 2.9% versus 8.8% [AOR = 0.32; 95% CI 0.14, 0.78; p = 0.01]). Prevalence of EQ-5D index score <1 was 27.6% versus 38.9% (AOR = 0.56; 95% CI 0.31, 1.03; p = 0.06). Qualitative analyses found that CATS-observed participants had limited autonomy or ability to solve problems. In response, the CATS adapted the intervention to focus on empathic problem discussion to fit adolescents’ age, capacity, and circumstances, which was beneficial. Limitations include that cost data were not available and that the mental health tools were validated in adult populations, not adolescents. Conclusions PST training for CATS did not add to the benefit of peer support in reducing virological nonsuppression but led to improved symptoms of CMD and depression compared to standard Zvandiri care among adolescents living with HIV in Zimbabwe. Active involvement of caregivers and strengthened referral structures could increase feasibility and effectiveness. Trial registration Pan African Clinical Trials Registry PACTR201810756862405.

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Effect of managed transition on mental health outcomes for young people at the child–adult mental health service boundary: a randomised clinical trial

Psychological Medicine ◽

10.1017/s0033291721003901 ◽

2021 ◽

pp. 1-12

Author(s):

S. P. Singh ◽

H. Tuomainen ◽

G. Bouliotis ◽

A. Canaway ◽

G. De Girolamo ◽

...

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Young People ◽

Health Service ◽

Health Outcomes ◽

Transitional Care ◽

Randomised Trial ◽

Mental Health Outcomes ◽

Adult Mental Health ◽

Adult Mental Health Service

Abstract Background Poor transition planning contributes to discontinuity of care at the child–adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). Methods A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial. Results The mean difference in HoNOSCA scores between the MT and UC arms at 15 months was −1.11 points (95% confidence interval −2.07 to −0.14, p = 0.03). The cost of delivering the intervention was relatively modest (€17–€65 per service user). Conclusions MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care.

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