The acceptability and feasibility of an online pathway for depression treatment via decision support: a cross-sectional survey. (Preprint)

2020 ◽  
Author(s):  
Paul J Barr ◽  
Michelle D Dannenberg ◽  
Shama S Alam ◽  
Karen L Fortuna ◽  
Theresa Nguyen ◽  
...  

BACKGROUND Individuals often turn to the internet seeking answers to their mental health problems. In 2014, Mental Health America (MHA) began the online program MHA Screening, including the PHQ-9, and since then has collected data from nearly 2.5 million people. Among those who complete a depression screening online, 83% report moderate to severe depression. Despite a range of evidence-based treatments for depression, 60% of these individuals do not seek care. A lack of both knowledge of and access to treatment are major barriers to help-seeking. Decision aids (DAs) are tools that can increase treatment knowledge, yet it is unclear if individuals with depression symptoms would use such a tool online. OBJECTIVE The objective of this project was to determine the views of individuals with depression toward an online DA for depression, and to determine the characteristics those most likely to review a DA and are willing to seek care online. METHODS MHA offers web-based depression screening using the Patient Health Questionnaire (PHQ-9). For this pilot, MHA made a link to a depression DA available to all individuals completing PHQ-9 screening from October – November 2017. The DA consisted of information on frequently asked questions pertaining to three treatment approaches: watchful waiting, talk therapy and antidepressants. Respondents viewing the DA could complete a short survey assessing the perceived helpfulness of the DA, and whether they would be “willing to consult a doctor online” about symptoms. Descriptive statistics were calculated, while a multiple logistic regression model identified characteristics associated with viewing the DA. RESULTS Of 74,936 PHQ-9 screens completed, 599 (8%) proceeded to review the depression DA; 92% of these respondents screened positive for moderate to severe depression and 86% had never sought prior treatment. Of the 599, 527 (88%) completed the DA survey: 46% found the DA to be helpful, 45% were unsure, while only 8% said the DA was not helpful. Higher levels of depression severity, female sex and older age were associated with increased likelihood of viewing the DA, while higher income levels and Black/African Americans were less likely to view the DA. A majority of respondents (72%) stated they would be willing to discuss their symptoms with a doctor online. CONCLUSIONS Screening for depression and providing DA outside of traditional settings is viewed positively and holds significant potential for those seeking care online. This knowledge is timely given the rising interest in the use online therapies, and the detrimental impact on psychological health of social isolation measures in response to the Coronavirus pandemic. Future work will determine the best placement of such decision support tools to maximize DA access, and assess the potential for an online pathway to treatment facilitated by screening and decision support.

2020 ◽  
Author(s):  
Hady Naal ◽  
Dana Nabulsi ◽  
Nour El Arnaout ◽  
Lina Abdouni ◽  
Hani Dimassi ◽  
...  

Abstract Background: Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking. Aims: We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates.Methods: A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9). Results: A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, only 51.6% (n=1678) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. The PHQ-9 analysis revealed high prevalence (25%) of moderate to severe depression in the total sample, suggestive of high probability for major depression disorder (MDD). Further analyses indicate that being ≥45 years of age (OR 1.70, 95% CI 1.22-2.36), a woman (OR 1.35, 95% CI 1.07-1.69), divorced/separated (OR 3.32, 95% CI 1.57-7.01), reporting a neurological (OR 1.77, 95% CI 1.20-2.61) or a mental health condition (OR 5.30, 95% CI 2.40-11.66) are major risk factors for MDD.Conclusion: Our study suggests that one in four Syrian refugees in Lebanon have probable MDD, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.


Author(s):  
Bo Zhao ◽  
Fanlei Kong ◽  
Myo Nyein Aung ◽  
Motoyuki Yuasa ◽  
Eun Woo Nam

This study assessed university students’ knowledge and precaution practices of Novel Coronavirus (COVID-19) in South Korea, China, and Japan, and investigated their depressive states during the pandemic. This cross-sectional survey collected data from 821 respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from 23 March to 20 April 2020, which included socio-demographic questions, knowledge and perceptions of COVID-19, preventative practices, and the Patient Health Questionnaire-9 (PHQ-9) scale to assess mental health. High proportions of respondents showed good knowledge of the transmission pathways and information related to COVID-19. Contact history as well as concerns about family members and the disease showed statistically significant distinctions by nationality and gender. On the whole, all participants reported good levels of preventative practices. The Chinese group reported the highest preventative practice scores; and females scored higher than males. Moreover, the Japanese group showed the most severe depressive states; overall, females experienced more severe depression than males. Thus, authorities should especially emphasize the importance of COVID-19 precautions to males. Educational departments and health authorities should observe the mental health of university adults during the pandemic and plan interventions to improve it.


2021 ◽  
Author(s):  
Hady Naal ◽  
Dana Nabulsi ◽  
Nour El Arnaout ◽  
Lina Abdouni ◽  
Hani Dimassi ◽  
...  

Abstract Background: Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking.Aims: We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates.Methods: A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9).Results: A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, 46.73% (n=1521) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. In the entire sample (n=3255), the prevalence of moderate to severe depression symptoms (PHQ-2 ≥2 and then PHQ-9 ≥10) was 22% (n=706). Further analyses indicate that being ≥45 years of age (OR 1.61, 95% CI 1.13-2.30), a woman (OR 1.34, 95% CI 1.06-1.70), widowed (OR 2.88, 95% CI 1.31-6.32), reporting a neurological (OR 1.73, 95% CI 1.15-2.60) or a mental health condition (OR 3.98, 95% CI 1.76-8.97) are major risk factors for depression.Conclusion: Our study suggests that an estimated one in four Syrian refugees in Lebanon shows moderate to severe depression symptoms, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.


2020 ◽  
pp. 1-6
Author(s):  
Pragati Kaurani ◽  
Kavita Batra ◽  
Himangini Rathore Hooja

COVID-19 has caused unprecedented disruption of all spheres of life, including health, financial, and socio behavioral. Given the rampant nature of the pandemic, several nations, including India has instituted stringent public health measures, with one being nationwide lockdown, to mitigate COVID-19 transmission. Previous studies reported increased stress and anxiety levels among general population during phase 1 (complete) lockdown, however, the effect of extended lockdown (phase 2) on mental health outcomes remains the subject of investigation till today. Therefore, this cross-sectional study endeavors to assess the psychological outcomes among general population during phase 2 lockdown. The online questionnaire surveyed 627 individuals from the general population using a non-probability snowball sampling technique. Descriptive statistics, including the frequency distribution, mean and standard deviations were generated. Mean differences across groups were analyzed through independent-samples- t and analysis of variance tests. Consistent with previous studies, our results indicated a higher mean score of anxiety and stress among females compared to males. Young adults aged between 21-39 years had the highest mean stress and anxiety scores compared to other categories. The mean anxiety score increased from retired (M=3.96, SD=4.76, to students (M=7.04, SD=7.11), to unemployed (M=9.0, SD=6.53) occupation groups. The findings of this study highlight the need for designing psychosocial regulatory frameworks and suitable interventions to address the needs of those being mentally traumatized by the pandemic and associated lockdowns. The study also advocates for establishing psychological health monitoring and telepsychiatry systems for identifying and treating mental health problems.


2020 ◽  
Author(s):  
Hady Naal ◽  
Dana Nabulsi ◽  
Nour El Arnaout ◽  
Lina Abdouni ◽  
Hani Dimassi ◽  
...  

Abstract Background: Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking.Aims: We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates.Methods: A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9).Results: A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, only 46.73% (n=1521) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. The PHQ-9 analysis revealed high prevalence (22%) of moderate to severe depression in the total sample, suggestive of high probability for Major Depression Disorder (MDD). Further analyses indicate that being ≥45 years of age (OR 1.61, 95% CI 1.13-2.30), a woman (OR 1.34, 95% CI 1.06-1.70), widowed (OR 2.88, 95% CI 1.31-6.32), reporting a neurological (OR 1.73, 95% CI 1.15-2.60) or a mental health condition (OR 3.98, 95% CI 1.76-8.97) are major risk factors for depression.Conclusion: Our study suggests that an estimated one in four Syrian refugees in Lebanon have probable MDD, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hady Naal ◽  
Dana Nabulsi ◽  
Nour El Arnaout ◽  
Lina Abdouni ◽  
Hani Dimassi ◽  
...  

Abstract Background Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking. We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates. Methods A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9). Results A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, 46.73% (n = 1521) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. In the entire sample (n = 3255), the prevalence of moderate to severe depression symptoms (PHQ-2 ≥ 2 and then PHQ-9 ≥ 10) was 22% (n = 706). Further analyses indicate that being ≥45 years of age (OR 1.61, 95% CI 1.13–2.30), a woman (OR 1.34, 95% CI 1.06–1.70), widowed (OR 2.88, 95% CI 1.31–6.32), reporting a neurological (OR 1.73, 95% CI 1.15–2.60) or a mental health condition (OR 3.98, 95% CI 1.76–8.97) are major risk factors for depression. Conclusion Our study suggests that an estimated one in four Syrian refugees in Lebanon shows moderate to severe depression symptoms, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sylvia Xiaohua Chen ◽  
Jacky C. K. Ng ◽  
Bryant P. H. Hui ◽  
Algae K. Y. Au ◽  
Wesley C. H. Wu ◽  
...  

AbstractThe spread of coronavirus disease 2019 (COVID-19) has affected both physical health and mental well-being around the world. Stress-related reactions, if prolonged, may result in mental health problems. We examined the consequences of the COVID-19 pandemic on mental health in a multinational study and explored the effects of government responses to the outbreak. We sampled 18,171 community adults from 35 countries/societies, stratified by age, gender, and region of residence. Across the 35 societies, 26.6% of participants reported moderate to extremely severe depression symptoms, 28.2% moderate to extremely severe anxiety symptoms, and 18.3% moderate to extremely severe stress symptoms. Coronavirus anxiety comprises two factors, namely Perceived Vulnerability and Threat Response. After controlling for age, gender, and education level, perceived vulnerability predicted higher levels of negative emotional symptoms and psychological distress, whereas threat response predicted higher levels of self-rated health and subjective well-being. People in societies with more stringent control policies had more threat response and reported better subjective health. Coronavirus anxiety exerts detrimental effects on subjective health and well-being, but also has the adaptive function in mobilizing safety behaviors, providing support for an evolutionary perspective on psychological adaptation.


2021 ◽  
Vol 15 (9) ◽  
pp. 2333-2336
Author(s):  
Anum Arif ◽  
Minahil Iram ◽  
Sabih Nofal ◽  
Aima Sohail ◽  
Bismah Riaz ◽  
...  

Aim: To assess prevalence of Depression, Anxiety, Stress in medical students, interns, and residents in Pakistan Study design: Cross-sectional Survey (Questionnaire) based study. Place and duration of study: This study was conducted at Combined Military Hospital Lahore Medical College from March 2020 to May 2020. Results: 104 participants were included in the study. There was female predominance 58(55.8%), and the mean age was 23.55±1.42. The overall mean score of depression and anxiety was 21.2±12.67 and 15.7±10.67 respectively and most prevalent in third and fourth-year residents. The mean stress score was 13.7, 10. 27. Twenty-eight (26.9%) of the overall participants had extremely severe depression, 36 (34.6 %) had extremely severe anxiety and 13(12.5%) had severe stress. Doctors studying and practicing in the private sector have a higher DASS21 score (p = < 0.006) Conclusion: Multiple factors have been found to contribute to the poor mental health of health care workers, including financial trouble, sleep deprivation, abuse from colleagues, high expectations, female gender, broken relationships, and substance misuse. Keywords: Anxiety Disorders, Depression, Medical, Mental Health Problem Solving, Psychological Distress,


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Annika McGivern ◽  
Stephen Shannon ◽  
Gavin Breslin

Purpose This paper aims to conduct the first cross-sectional survey on depression, Resilience, well-being, depression symptoms and concussion levels in equestrian athletes and to assess whether past concussion rates were associated with depression, resilience and well-being. Design/methodology/approach In total, 511 participants from Canada, Republic of Ireland, UK, Australia and USA took part in an international cross-sectional, online survey evaluating concussion history, depression symptoms, resilience and well-being. Findings In total, 27.1% of athletes met clinically relevant symptoms of major depressive disorder. Significant differences were shown in the well-being and resilience scores between countries. Significant relationships were observed between reported history of concussion and both high depression scores and low well-being scores. Practical implications Findings highlight the need for mental health promotion and support in equestrian sport. Social implications Results support previous research suggesting a need for enhanced mental health support for equestrians. There is reason to believe that mental illness could still be present in riders with normal levels of resilience and well-being. Originality/value This study examined an understudied athlete group: equestrian athletes and presents important findings with implications for the physical and mental health of this population.


2021 ◽  
Vol 15 (9) ◽  
pp. 2215-2218
Author(s):  
Anum Arif ◽  
Minahil Iram ◽  
Sabih Nofal ◽  
Aima Sohail ◽  
Bismah Riaz ◽  
...  

Aim: To assess prevalence of depression, anxiety, stress in medical students, interns and residents in Pakistan Study design: Cross-sectional Survey (Questionnaire) based study. Place and duration of study: This study was conducted at Combined Military Hospital Lahore Medical College from March 2020 to May 2020. Results: 104 participants were included in the study. There was female predominance 58(55.8%), and the mean age was 23.55±1.42. The overall mean score of depression and anxiety was 21.2±12.67 and 15.7±10.67 respectively and most prevalent in third and fourth-year residents. The mean stress score was 13.7, 10. 27. Twenty-eight (26.9%) of the overall participants had extremely severe depression, 36 (34.6 %) had extremely severe anxiety and 13(12.5%) had severe stress. Conclusion: Multiple factors have been found to contribute to the poor mental health of health care workers, including financial trouble, sleep deprivation, abuse from colleagues, high expectations, female gender, broken relationships, and substance misuse. The prevalence of depression, anxiety, and stress in common in medical students. This calls for the development of strategies, workshops, and programs to identify modifiable stressors, encourage students to reach out to their family members and their teachers to verbalize their issues, and make psychiatric consultation accessible to them. Keywords: Anxiety Disorders, Depression, Medical, Mental Health Problem Solving, Psychological Distress,


Sign in / Sign up

Export Citation Format

Share Document