scholarly journals A pilot study of the impact of an integrated individual- and family therapy model for self-harming adolescents on overall healthcare consumption

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Moa Bråthén Wijana ◽  
Inna Feldman ◽  
Richard Ssegonja ◽  
Pia Enebrink ◽  
Ata Ghaderi

Abstract Background Self-harming behaviors in adolescents cause great suffering and can lead to considerable costs to the healthcare system. The aim of the current study was to investigate the cost of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) and to compare the adolescent’s healthcare consumption 1 year before and 1 year after treatment. Method The study had a within group design with repeated measures. The clinical outcomes and the cost of ICT treatment are based on a sample of 49 participants who were previously enrolled in an intervention trial. Participants with significantly improved clinical outcomes (self-harm behavior, or general mental health symptoms) were defined as treatment responders. Calculation of changes in healthcare consumption is based on 25 participants who gave their consent to participate in a retrospective collection of healthcare data from medical records, including inpatient and outpatient care, and prescribed medication. Results The average estimated cost of ICT per person was €5293. There were no significant differences between the cost of healthcare consumption 1 year before and after ICT, but the results suggested that the adolescents consumed less inpatient and specialized care after treatment. There was a significantly higher cost of psychotropic medication after treatment explained by a higher consumption of central stimulants. Treatment responders (general mental health problems) reduced their consumption of healthcare resources significantly more than non-responders, especially regarding hospital visits and total health care costs. Conclusions Good response to the ICT in terms of improved general mental health symptoms seems to be associated with reduced healthcare consumption during the post-treatment period. However, controlled studies with larger sample sizes are needed to draw causal conclusions. The results of this study should be interpreted with caution as it is based on a small sample and attrition rate was high. Trial registration This study has been registered with the ISRCTN: 15885573.

2021 ◽  
pp. 002076402110272
Author(s):  
Dana Alonzo ◽  
Marciana Popescu ◽  
Pinar Zubaroglu-Ioannides

Background: On March 5th, Guatemala declared a ‘State of Calamity’ in response to the COVID-19 pandemic and strict lockdown measures were initiated. The psychological consequences of these measures are yet to be fully understood. There is limited research on the psychological impact of the virus in the general population, and even less focused on Latin America and high-risk communities characterized by poverty, limited mental health resources, and high rates of stigma around mental illness. The goal of this study is to examine the psychological impact of COVID-19 across several highly vulnerable districts in Guatemala. Methods: A semi-structured phone interview was conducted of 295 individuals in multiple districts in Guatemala City to assess self-perceived mental health consequences related to the pandemic. Sociodemographic, medical, and mental health data were collected. Chisquares and t-tests used for categorical and continuous variables, as appropriate, to describe the sample. Binary logistic regressions were estimated to examine associations between sociodemographic characteristics and mental health symptoms (anxiety, stress, depression, burnout, escalation of pre-existing mental health symptoms, and a sense of safety). Results: The results indicate high levels of anxiety and stress in all target communities. Significant differences based on gender, age, and the number of children in the household were identified: women and older adults experience higher rates of stress and anxiety associated with the pandemic; while families with greater number of children experience higher levels of burnout. Conclusion: Contextualizing the current pandemic as a complex emergency can help inform further studies focusing on socioeconomic challenges and higher vulnerabilities as preconditions affecting the impact of the pandemic on mental health. Given the limited available resources for mental health care in Guatemala, informal networks of care may play an important role in meeting the needs of those individuals experiencing increased psychological distress resulting from the pandemic.


2021 ◽  
Author(s):  
Laura Hammond ◽  
Richard Meiser-Stedman ◽  
Anna McKinnon ◽  
Tim Dalgleish ◽  
Patrick Smith ◽  
...  

Post-traumatic stress disorder (PTSD) experienced by children can have a large impact on the wider family. The National Institute for Health and Care Excellence (NICE, 2018) recommend that parents are involved in their child’s PTSD treatment. Studies have found that parents themselves also report high levels of PTSD and other mental health symptoms but few have explored whether these symptoms reduce following their child receiving trauma-focused CBT. In this study, parents (N=29) whose children (ages 8-17 years) were randomly assigned to either 10 sessions of Cognitive Therapy for PTSD (CT-PTSD) or a wait-list control condition (WL) completed the Post Traumatic Stress Diagnostic Scale (PDS), the Patient Health Questionnaire (PHQ-9; to measure depression), the Generalised Anxiety Disorder Questionnaire (GAD-7), and the General Health Questionnaire (GHQ-28; to measure general mental health) for pre-post comparison. Parents whose children were allocated to CT-PTSD reported greater improvements on self-report PTSD, depression, anxiety and general mental health, relative to the WL condition. This trial provides preliminary support for the efficacy of CT-PTSD delivered to children for reducing parent PTSD, depression, anxiety and general mental health symptoms. Replication is needed as well as further exploration of parent factors and frequency of parental involvement required to predict improvements.


2010 ◽  
pp. n/a-n/a ◽  
Author(s):  
Shira Maguen ◽  
Barbara A. Lucenko ◽  
Mark A. Reger ◽  
Gregory A. Gahm ◽  
Brett T. Litz ◽  
...  

2019 ◽  
Vol 6 (4) ◽  
pp. 192-199
Author(s):  
R.S. Schierholz ◽  
I. Zavgorodniy ◽  
S. Darius ◽  
I. Böckelmann

ASSOCIATIONS OF GENERAL MENTAL HEALTH SYMPTOMS WITH SUBJECTIVE SLEEP QUALITY AND INDIVIDUAL DAYTIME SLEEPINESS Schierholz RS, Zavgorodniy I., Darius S., Böckelmann I. Purpose: Sufficient sleep quality plays a significant role for long-term physical and mental health. The aim of this study was to examine the associations of general mental health symptoms with sleep quality and daytime sleepiness. Materials and Methods: A cross-sectional survey with 84 included participants (female: n = 42, male: n = 42) was conducted. General mental health symptoms were assessed using the 12-item General Health Questionnaire (GHQ-12), sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), and daytime sleepiness was evaluated with the Epworth Sleepiness Scale (ESS). Statistical differences were calculated using two-sample t-test and Mann-Whitney U test. For correlation analyses Spearman’s rank correlation was used. Results: Subjects with poor sleep quality reached higher scores in the GHQ-12 and in the ESS than subjects with good sleep quality, but the difference regarding the ESS was not significant. Higher GHQ-12 scores were associated with higher PSQI scores but not with higher ESS scores. Conclusions: Major findings show strong evidence of an association between general mental health symptoms and sleep quality with poor sleepers having a more disturbed mental health than good sleepers. Further evidence of the interrelationship between subjective sleep quality and general mental health symptoms was found. Keywords: Mental health, Work ability, Stress, Sleep, Insomnia   Абстракт ЗВ’ЯЗОК ЗАГАЛЬНИХ СИМПТОМІВ ПСИХІЧНОГО ЗДОРОВ'Я З СУБ'ЄКТИВНОЮ ЯКІСТЮ СНУ ТАІНДИВІДУАЛЬНОЮ ДЕННОЮ СОНЛИВІСТЮ Робін Себастьян Шірхольц*, Ігор Завгородній, Сабіна Даріус, Ірина Беккельман Мета: Достатня якість сну відіграє важливу роль для тривалого фізичного та психічного здоров’я. Метою цьогодослідження було вивчення залежності загальних симптомів психічного здоров’я від якісті сну та денноїсонливості. Матеріали та методи: Було проведено перехресне опитування за участю 84 учасників (жінки: n = 42, чоловіки: n= 42). Загальні симптоми психічного здоров’я оцінювали за допомогою Анкети загального здоров’я (GHQ-12), яка містить 12 пунктів; якість сну оцінювали за допомогою Пітсбургського опитувальника якості сну (PSQI), а денну сонливість оцінювали за Шкалою сонливості Епворта (ESS). Статистичні відмінності розраховувались за допомогою двопробного t-тесту та U-тесту Манна-Вітні. Для кореляційного аналізу було використано рангову кореляцію Спірмена. Результати: Суб'єкти з низькою якістю сну показали більш високі показники у GHQ-12 та ESS, ніж суб'єкти із хорошою якістю сну, але різниця щодо ESS була несуттєвою. Більш високі показники GHQ-12 були пов'язані з більш високими показниками PSQI, але не з більш високими показниками ESS. Висновки: Основні результати виявляють вагомі докази зв'язку між загальними симптомами психічного здоров’я та якістю сну людей, які погано сплять, та людей з міцним сном. У людей з поганим сном більш виражені порушення психічного здоров’я. Були знайдені додаткові докази взаємозв'язку між суб'єктивною якістю сну та загальними симптомами психічного здоров'я. Ключові слова: Психічне здоров'я, працездатність, стрес, сон, безсоння    Абстракт СВЯЗЬ ОБЩИХ СИМПТОМОВ ПСИХИЧЕСКОГО ЗДОРОВЬЯ С СУБЪЕКТИВНЫМ КАЧЕСТВОМ СНА И ИНДИВИДУАЛЬНОЙ ДНЕВНОЙ СОНЛИВОСТЬЮ Робин Себастьян Ширхольц, Игорь Завгородний, Сабина Дариус, Ирина Беккельманн Цель: Достаточное качество сна играет важную роль для долгосрочного физического и психического здоровья. Целью данного исследования было изучение связи общих симптомов психического здоровья с качеством сна и дневной сонливостью. Материалы и методы. Было проведено перекрестное исследование с 84 участниками (женщины: n = 42, мужчины: n = 42). Общие симптомы психического здоровья оценивали с использованием Общего опросника здоровья (GHQ-12), содержащего 12 пунктов; качество сна оценивали с помощью Питтсбургского опросника качества сна (PSQI), а дневную сонливость оценивали по Шкале сонливости Эпворта (ESS). Статистические различия рассчитывали с использованием двухпробного t-теста и U-теста Манна-Уитни. Для корреляционного анализа была использована ранговая корреляция Спирмена. Результаты: Субъекты с плохим качеством сна показали более высокие баллы в GHQ-12 и в ESS, чем субъекты с хорошим качеством сна, но разница в отношении ESS не была значительной. Более высокие показатели GHQ-12 были связаны с более высокими показателями PSQI, но не с более высокими показателями ESS. Выводы: Основные результаты обнаруживают убедительные доказательства связи между общими симптомами психического здоровья и качеством сна людей, которые плохо спят, и людей с крепким сном. У людей с плохим сном более выражены нарушения психического здоровья. Были найдены дополнительные доказательства взаимосвязи между субъективным качеством сна и общими симптомами психического здоровья. Ключевые слова: психическое здоровье, трудоспособность, стресс, сон, бессонница


2019 ◽  
Vol 29 (5) ◽  
pp. 925-931 ◽  
Author(s):  
Ida Blomqvist ◽  
Eva Henje Blom ◽  
Bruno Hägglöf ◽  
Anne Hammarström

Abstract Background Previous studies suggest an overall increase of adolescent mental health symptoms globally since the 1980s until today, especially an increase of internalizing symptoms in girls. Due to methodological limitations of these studies, further studies are warranted to obtain a more solid knowledgebase. Methods This study was cross-sectional and compared two separate but geographically identical groups of adolescents in a middle-sized industrial municipality in Northern Sweden at two time-points [(i) 1981, n = 1083, (505 girls, 577 boys), response rate 99.7%; (ii) 2014, n = 682, (338 girls, 344 boys), response rate 98.3%]. All students in their last year of compulsory school were included. The same self-report questionnaire, consisting of four sub-scales (functional somatic-, anxiety-, depressive symptoms and conduct problems), was used at both occasions. Data were analyzed with descriptive statistics, two-way ANOVA and general linear model. Results Symptoms of anxiety and depression and functional somatic symptoms, increased among both boys and girls from 1981 until 2014 (P < 0.001 for all subscales), and the increase of these symptoms was higher in girls. Conduct problems were significantly higher in boys in 1981 and decreased over time so that in 2014 there was no longer a significant difference between boys and girls regarding conduct problems (P = 0.286). Conclusion In this population-based study spanning over 30 years, both girls and boys showed increasing internalizing problems, while conduct problems decreased. To halt this trend, we need a deeper understanding of the impact of the major societal changes that have occurred during the last three decades.


2017 ◽  
Vol 32 (1) ◽  
pp. 3-21 ◽  
Author(s):  
Katie Cyr ◽  
Claire Chamberland ◽  
Marie-Ève Clément ◽  
Jo-Anne Wemmers ◽  
Delphine Collin-Vézina ◽  
...  

This study documents lifetime experiences of victimizations, polyvictimization, and trauma symptoms among 1,400 adolescents from the province of Québec. The vast majority (81%) of adolescents were victimized during their lifetime, with most victims (82%) being the target of more than one form of victimization. Polyvictimization accounted for most variability in scores of depression, posttraumatic stress disorder (PTSD), and anger/aggression compared to individual victimization categories. Sexual victimization and maltreatment still made an independent contribution in predicting all trauma scores once polyvictimization was considered. Gender differences were found in the victimization experiences contributing to the prediction of mental health symptoms. Sexual victimization was a significant predictor of PTSD and anger/aggression symptoms for girls, whereas witnessing violence predicted anger and PTSD symptoms for boys, and assault predicted their anger. This study outlines the importance of assessing various types of victimization among adolescents. Systematic data and observation of trends on child victimization are needed in Canada and elsewhere.


2019 ◽  
Vol 9 (2) ◽  
pp. 143-152
Author(s):  
Shannon Wagner ◽  
Romana Pasca

Purpose The purpose of this paper is to examine the contribution of work to self-reported mental health symptoms in fire service members. Design/methodology/approach In 2004, the first wave of this data collection was completed with all members of a fire department in a small northern center in British Columbia. The members completed a series of questionnaires measuring mental health, personality and satisfaction. Since 2004, all recruit members entering the department have also completed the same set of questionnaires shortly after hiring. Subsequently, in 2016–2017, the full sample, including recruit members, were invited to complete the Wave 2 data collection cycle, which included a set of questionnaires very similar to that collected in Wave 1. Findings The recruit sample reported significantly fewer mental health symptoms, as compared to career firefighters, at Time 1 (prior to workplace exposure). However, at Time 2 (after workplace exposure), no difference between the groups was evident. Research limitations/implications It is possible that recruit firefighters reported more positive mental health because of social desirability bias upon beginning a new job. Practical implications These results suggest that service as a firefighter could potentially have an impact on mental health and efforts should be made to mitigate this impact. Originality/value To the authors’ knowledge, the current research is the first study that has followed recruit firefighters longitudinally in an effort to prospectively evaluate the impact of workplace exposure on mental health.


Sign in / Sign up

Export Citation Format

Share Document