Identifying patient-reported anxiety and depression in older adults with cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11556-11556
Author(s):  
Reena Jayani ◽  
Can-Lan Sun ◽  
Kemeberly Charles ◽  
Enrique Soto Perez De Celis ◽  
Leana Chien ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Controlled Trial ◽  
Well Being ◽  
Anxiety And Depression ◽  
High Anxiety ◽  
Cut Points ◽  
Cut Point ◽  
Patients With Cancer ◽  
Patient Reported

11556 Background: Anxiety and depression are associated with decreased quality of life, treatment adherence, and survival in patients with cancer. Mental Health Inventory (MHI-17) is a validated screening tool for psychological well-being, but cut points for older adults with cancer are unknown. The goal of this study is to identify cut points on MHI-17 Anxiety (MHI-A) and Depression (MHI-D) subscales which correlate with patient-reported anxiety and depression in older adults with cancer. Methods: This is a secondary analysis of baseline data from a randomized controlled trial in adults aged 65+ with solid tumors starting chemotherapy. At baseline, patients completed MHI-17. MHI-A and MHI-D were calculated (range 0-100; higher scores represent better mental health). Self-reported anxiety was obtained from single-item Linear Analog Scale Assessment (0-5 = low, 6-10 = high). Self-reported depression was obtained from Yale Depression Screen, “Do you often feel sad or depressed?” The association of MHI-A and MHI-D with the patient-reported outcomes was analyzed using logistic regression. Youden’s index was used to determine the optimal cut points for MHI-A and MHI-D for identifying patients with high anxiety and depression. Results: 458 patients (median age 71 (range 65-91), 57% female, 55% non-Hispanic white) were included in this analysis. The most common cancer types were: GI (31%), breast (19%), GU (18%), and pulmonary (16%); 75% had stage IV cancer. Twenty-four percent (N = 110) reported high anxiety and 21% (N = 97) depression. Median scores for MHI-A and MHI-D were 75 (range 0-100) and 80 (range 0-100). The optimal cut point for high anxiety on MHI-A was 65; this had an accuracy of 76.1%, a sensitivity of 71.8%, and a specificity of 77.5%. The optimal cut point for depression on MHI-D was 70; this had an accuracy of 80.1%, a sensitivity of 80.4%, and a specificity of 79.8%. Conclusions: The current study identified optimal cut points for MHI-Anxiety and MHI-Depression subscales to identify older adults with cancer starting chemotherapy with self-reported anxiety and depression. In the absence of patient-reported anxiety and depression, these cut points could be used to identify older patients with cancer at risk for poor mental health.

Mental Health of Community-Dwelling Older Adults and Related Factors: A Cross-Sectional Study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Roohollah Farhadloo ◽  
Sarallah Shojaei ◽  
Hamid Torabian ◽  
Mostafa Vahedian ◽  
Masoumeh Zakerimoghadam ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Urban Areas ◽  
Good Condition ◽  
Well Being ◽  
The Elderly ◽  
Community Dwelling ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Distress Scale

Background: Improving lifestyle, increasing lifespan and life expectancy have led to the phenomenon of aging in societies. The increasing population of older adults is one of the most important economic, social, and health challenges in the current century. Objectives: This study was conducted to measure the mental health of older adults in Qom City and its relationship with socioeconomic factors. Methods: This is a cross-sectional descriptive-analytical study on 400 older adults over 60 years in the urban areas of Qom in 2018. A multi-stage sampling method was used for this study. The research tools were a demographic questionnaire, the Kessler Psychological Distress scale (K6), and a standard psychological well-being scale. Data were analyzed by Stata 12 software using the t-test. The significance level was considered less than 0.05. Results: Considering the mental health status, based on the K6, 55% of the elderly showed signs of low depression anxiety, 34% moderate, and 11% showed severe anxiety symptoms. Regarding the status of well-being, 49.50% were in good condition (11.3 ± 3.3), 27.75% were in moderate condition (13.8 ± 2.9), and 22.75% were in poor condition (7.3 ± 2.6). Anxiety and depression had significant relationships with gender, having an illness, marital status, having a caregiver, and income. Conclusions: The results showed that about half of the elderly in Qom had moderate anxiety and depression disorders, as well as moderate mental well-being, which indicates the moderate level of anxiety and mental disorders in the elderly in Qom.

Comparison of PROMIS Anxiety and Depression, PHQ-8, and GAD-7 to screen for anxiety and depression among patients presenting for spine surgery

2019 ◽  
Vol 30 (4) ◽  
pp. 524-531
Author(s):  
Taylor E. Purvis ◽  
Brian J. Neuman ◽  
Lee H. Riley ◽  
Richard L. Skolasky
Keyword(s):  
Major Depression ◽  
Spine Surgery ◽  
Characteristic Curve ◽  
Depression Scale ◽  
Data Driven ◽  
Anxiety And Depression ◽  
Measurement Information ◽  
Generalized Anxiety ◽  
Cut Points ◽  
Patient Reported

OBJECTIVEIn this paper, the authors demonstrate to spine surgeons the prevalence and severity of anxiety and depression among patients presenting for surgery and explore the relationships between different legacy and Patient-Reported Outcomes Measurement Information System (PROMIS) screening measures.METHODSA total of 512 adult spine surgery patients at a single institution completed the 7-item Generalized Anxiety Disorder questionnaire (GAD-7), 8-item Patient Health Questionnaire (PHQ-8) depression scale, and PROMIS Anxiety and Depression computer-adaptive tests (CATs) preoperatively. Correlation coefficients were calculated between PROMIS scores and GAD-7 and PHQ-8 scores. Published reference tables were used to determine the presence of anxiety or depression using GAD-7 and PHQ-8. Sensitivity and specificity of published guidance on the PROMIS Anxiety and Depression CATs were compared. Guidance from 3 sources was compared: published GAD-7 and PHQ-8 crosswalk tables, American Psychiatric Association scales, and expert clinical consensus. Receiver operator characteristic curves were used to determine data-driven cut-points for PROMIS Anxiety and Depression. Significance was accepted as p < 0.05.RESULTSIn 512 spine surgery patients, anxiety and depression were prevalent preoperatively (5% with any anxiety, 24% with generalized anxiety screen-positive; and 54% with any depression, 24% with probable major depression). Correlations were moderately strong between PROMIS Anxiety and GAD-7 scores (r = 0.72; p < 0.001) and between PROMIS Depression and PHQ-8 scores (r = 0.74; p < 0.001). The observed correlation of the PROMIS Depression score was greater with the PHQ-8 cognitive/affective score (r = 0.766) than with the somatic score (r = 0.601) (p < 0.001). PROMIS Anxiety and Depression CATs were able to detect the presence of generalized anxiety screen-positive (sensitivity, 86.0%; specificity, 81.6%) and of probable major depression (sensitivity, 82.3%; specificity, 81.4%). Receiver operating characteristic curve analysis demonstrated data-driven cut-points for these groups.CONCLUSIONSPROMIS Anxiety and Depression CATs are reliable tools for identifying generalized anxiety screen-positive spine surgery patients and those with probable major depression.

scholarly journals Older Adults’ Subjective Well-being Following an Exergame Intervention “Bandit the Dolphin”: Focus Group Findings

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 169-170
Author(s):  
Brittany Drazich ◽  
Breanna Crane ◽  
Kyle Moored ◽  
Karl Shieh ◽  
Janiece Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Focus Groups ◽  
Well Being ◽  
Community Dwelling ◽  
Mental Illness Stigma ◽  
Subjective Well Being ◽  
Future Health ◽  
Adult Participants

Abstract Due to generational mental illness stigma and under diagnosis of mental illness, older adults do not always receive the mental health help that they need. One unique technology that has the potential to improve mood in older adults is exergames, or exercise video games. The objective of this sub-study (main study: Stimulation With Intricate Movements “SWIM” Study) was to explore older adults’ mood following an exergame intervention called “Bandit the Dolphin,” created by the Johns Hopkins KATA Studio. Researchers conducted three focus groups with 14 community-dwelling older adult participants who took part in the SWIM Study exergame intervention. The semi-structured focus groups were transcribed, coded, and analyzed using deductive and inductive techniques described by Ray Maietta’s “sort and sift, think and shift” method. Three themes related to playing “Bandit the Dolphin” and mood emerged. First, participants described their perceived association between activity and mood. Participants felt that both active and passive activities, “Bandit the Dolphin” and otherwise, improved their mood through the “fun” factor, and through feelings of achievement. Second, the participants described that the competition and frustration of playing “Bandit the Dolphin” increased eventual feelings of achievement. Third, participants described how feelings of immersion, or being absorbed in the game, helped them forget their other life concerns. These findings provide a better understanding of older adults’ perceived relationship between an exergame intervention, “Bandit the Dolphin,” and short-term improved mood. Future health and engineering researchers should explore exergames as a potential tool to improve the mental health of older adults.

scholarly journals Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2093
Author(s):  
Tina Vilovic ◽  
Josko Bozic ◽  
Marino Vilovic ◽  
Doris Rusic ◽  
Sanja Zuzic Furlan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Perceived Stress ◽  
Depression Scale ◽  
Family Physicians ◽  
Knowledge Score ◽  
Well Being ◽  
Anxiety And Depression ◽  
Event Scale ◽  
The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

Transdiagnostic versus Diagnosis-Specific Group Cognitive Behavioral Therapy for Anxiety Disorders and Depression: A Randomized Controlled Trial

2021 ◽  
pp. 1-14
Author(s):  
Nina Reinholt ◽  
Morten Hvenegaard ◽  
Anne Bryde Christensen ◽  
Anita Eskildsen ◽  
Carsten Hjorthøj ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Major Depressive ◽  
Outpatient Mental Health ◽  
End Of Treatment

<b><i>Introduction:</i></b> The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments. <b><i>Objective:</i></b> This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services. <b><i>Methods:</i></b> In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. A modified per-protocol analysis was performed. <b><i>Results:</i></b> At end-of-treatment, WHO-5 mean scores for patients in UP (<i>n</i> = 148) were non-inferior to those of patients in dCBT (<i>n</i> = 143; mean difference –2.94; 95% CI –8.10 to 2.21). Results were inconclusive for the WHO-5 at the 6-month follow-up. Results for secondary outcomes were non-inferior at end-of-treatment and the 6-month follow-up. Client satisfaction and rates of attrition, response, remission, and deterioration were similar across conditions. <b><i>Conclusions:</i></b> This RCT demonstrated non-inferior acute-phase outcomes of group-delivered UP compared with dCBT for major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.

scholarly journals The Translation and Cross-Cultural Adaptation of an Arabic Version of the Reminiscence Functions Scale

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 343-343
Author(s):  
Abdallah Abu Khait ◽  
Juliette Shellman
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Positive Impact ◽  
Well Being ◽  
Arab Countries ◽  
Lessons Learned ◽  
Arabic Version ◽  
Harmonization Process ◽  
Back Translation ◽  
Target Culture

Abstract The Reminiscence Functions Scale (RFS), a 43 item reliable and valid scale, measures eight specific reasons as to why individuals reminisce: (a) identity (b) death preparation; (c) problem-solving; (d) bitterness revival; (e) boredom reduction; (f) intimacy maintenance; (g) conversation; and (h) teach/Inform others. Research indicates that certain reminiscence functions have a positive impact on the mental-health and well-being of older adults. However, no known studies have been conducted in Arab countries examining the relationship between reminiscence functions and mental health outcomes due to the lack of an Arabic version of the RFS. The purpose of this study was to translate the RFS from English to Arabic (Modern Standard Arabic), back-translate from Arabic to English, and compare the two English versions for equivalence and accuracy through a multi-step translation method. A team of bilingual, bicultural, Arabic speaking experts assembled to conduct the forward, back translation and harmonization process. In the next step, professionals with expertise in linguistics communication sciences and disorders, Arabic literature, geriatric nursing, and medicine reviewed the translated documents to assess the content (relevant to the target culture) and semantic equivalencies (similarity of meaning in the target culture). Challenges that occurred during the study included finding nuanced translation equivalences for Likert scale responses, translation of idioms such as “when time is heavy on my hands”, and logistical issues such as coordinating virtual meetings for the team of experts. Lessons learned during the translation process and implications for use of the RFS-Arabic version with Jordanian older adults will be presented.

Effect of yoga on cardiovascular functions and psychological aspects of people on public service-related work: an exploratory study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Y. Deepa ◽  
A. Mooventhan ◽  
Edmin Christa ◽  
C. A. Kayelarasi
Keyword(s):  
Blood Pressure ◽  
Public Service ◽  
Tamil Nadu ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Well Being ◽  
Anxiety And Depression ◽  
Rate Pressure Product ◽  
Clinical Difference ◽  
Cardiovascular Functions

Abstract Objectives Yoga is increasingly being introduced in workplace settings to improve health and well-being. However, there is a lack of studies reporting the effect of yoga in people on public service-related work, who are at high risk for various health-related problems. Thus, the objective of this study was to find the effect of yoga on cardiovascular functions and psychological (stress, anxiety, and depression) aspects of people on public service-related work. Methods A single-group pre-test and post-test experimental study design was adopted. Eighty-two participants aged 41.52 ± 7.44 years who are working in the Tamil Nadu Public Service Commission were undergone 1-h of yoga (under the supervision of a yoga & naturopathy doctor) a day, 5-days a week for a period of 1-month at their office. Cardiovascular functions such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were measured using an automatic BP monitor. Psychological variables such as stress, anxiety, and depression were measured using Depression Anxiety and Stress Scales (DASS) before and after the intervention. Results Results of this study showed a significant reduction in body mass index, SBP, DBP, PR, mean arterial pressure, rate pressure product, and double product. Though results showed insignificant (just missed the statistical significance [p=0.056]) reduction in anxiety, it showed clinical improvement (i.e. the mean anxiety score has reduced from moderate category to mild category). However, there is neither statistically significant nor clinical difference in stress and depression. None of the participants reported any untoward events during the study period. Conclusions Results suggest that yoga might improve the cardiovascular functions and anxiety of people in public service-related work. However, no such significant improvement was noted in their stress and depression levels. However, a randomized controlled trial is required to warrant the results of this study.

scholarly journals WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial

2017 ◽  
Vol 4 ◽  
Author(s):  
S. U. Hamdani ◽  
P. Akhtar ◽  
Zill-e-Huma ◽  
H. Nazir ◽  
F. A. Minhas ◽  
...  
Keyword(s):  
Mental Health ◽  
Developmental Disorders ◽  
Controlled Trial ◽  
Public Mental Health ◽  
Skills Training ◽  
Well Being ◽  
Evidence Based ◽  
Post Intervention ◽  
Hybrid Cluster ◽  
Rural Pakistan

Background.Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.Methods.The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).Discussion.This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.Trial registration.Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

scholarly journals SEPARATED KIN: RURAL-URBAN MIGRATION AND MENTAL HEALTH TRAJECTORIES OF OLDER ADULTS LEFT BEHIND IN RURAL CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S880-S880
Author(s):  
Zhiyong Lin
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Rural China ◽  
Well Being ◽  
Migrant Children ◽  
Urban Migration ◽  
Left Behind ◽  
Rate Of Increase ◽  
The Impact

Abstract As the processes of urbanization and globalization have intensified across the world, a burgeoning literature has documented the impact of emigration on the health of family members left behind in emigrant communities. Although the association between children’s migration and parental well-being is well documented, few have examined the health implications of children’s migration in the milieu of multiple children and further differentiated between children’s short-term and long-term migration. Therefore, I argue that it is not the geographic locality of a single child but the composition of all children’s location that matters. I further suggest that the impact of children’s migration on parental wellbeing is conditioned on the duration of children’s migration. Using a six waves longitudinal data (2001-2015) collected in rural China, this paper compares mental health (measured as depressive symptoms) trajectories of old adults (aged 60 and older) across different compositions of local and migrant children over a 14-year span. Results from growth curve models show that parents having more migrant children relative to local children experience a more rapid increase in depressive symptoms. In addition, older adults who have their most children migrate away for three or more waves of data have experienced the steepest rate of increase in depressive symptoms. These findings provide new evidence to support the life course processes of mental health disparities among older adults from the perspective of intergenerational proximity.

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