scholarly journals Repeated Digitized Assessment of Risk and Symptom Profiles During Inpatient Treatment of Affective Disorder: Observational Study (Preprint)

2020 ◽  
Author(s):  
Maike Frederike Richter ◽  
Michael Storck ◽  
Rogério Blitz ◽  
Janik Goltermann ◽  
Juliana Seipp ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Inpatient Treatment ◽  
Data Entry ◽  
Self Report ◽  
Individual Risk ◽  
Depression Severity ◽  
Symptom Profiles ◽  
Longitudinal Data Collection ◽  
Digital Collection

BACKGROUND Predictive models have revealed promising results for the individual prognosis of treatment response and relapse risk as well as for differential diagnosis in affective disorders. Yet, in order to translate personalized predictive modeling from research contexts to psychiatric clinical routine, standardized collection of information of sufficient detail and temporal resolution in day-to-day clinical care is needed. Digital collection of self-report measures by patients is a time- and cost-efficient approach to gain such data throughout treatment. OBJECTIVE The objective of this study was to investigate whether patients with severe affective disorders were willing and able to participate in such efforts, whether the feasibility of such systems might vary depending on individual patient characteristics, and if digitally acquired assessments were of sufficient diagnostic validity. METHODS We implemented a system for longitudinal digital collection of risk and symptom profiles based on repeated self-reports via tablet computers throughout inpatient treatment of affective disorders at the Department of Psychiatry at the University of Münster. Tablet-handling competency and the speed of data entry were assessed. Depression severity was additionally assessed by a clinical interviewer at baseline and before discharge. RESULTS Of 364 affective disorder patients who were approached, 242 (66.5%) participated in the study; 88.8% of participants (215/242) were diagnosed with major depressive disorder, and 27 (11.2%) had bipolar disorder. During the duration of inpatient treatment, 79% of expected assessments were completed, with an average of 4 completed assessments per participant; 4 participants (4/242, 1.6%) dropped out of the study prematurely. During data entry, 89.3% of participants (216/242) did not require additional support. Needing support with tablet handling and slower data entry pace were predicted by older age, whereas depression severity at baseline did not influence these measures. Patient self-reporting of depression severity showed high agreement with standardized external assessments by a clinical interviewer. CONCLUSIONS Our results indicate that digital collection of self-report measures is a feasible, accessible, and valid method for longitudinal data collection in psychiatric routine, which will eventually facilitate the identification of individual risk and resilience factors for affective disorders and pave the way toward personalized psychiatric care.

scholarly journals Repeated Digitized Assessment of Risk and Symptom Profiles During Inpatient Treatment of Affective Disorder: Observational Study

10.2196/24066 ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. e24066
Author(s):  
Maike Frederike Richter ◽  
Michael Storck ◽  
Rogério Blitz ◽  
Janik Goltermann ◽  
Juliana Seipp ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Inpatient Treatment ◽  
Data Entry ◽  
Self Report ◽  
Individual Risk ◽  
Depression Severity ◽  
Symptom Profiles ◽  
Longitudinal Data Collection ◽  
Digital Collection

Background Predictive models have revealed promising results for the individual prognosis of treatment response and relapse risk as well as for differential diagnosis in affective disorders. Yet, in order to translate personalized predictive modeling from research contexts to psychiatric clinical routine, standardized collection of information of sufficient detail and temporal resolution in day-to-day clinical care is needed. Digital collection of self-report measures by patients is a time- and cost-efficient approach to gain such data throughout treatment. Objective The objective of this study was to investigate whether patients with severe affective disorders were willing and able to participate in such efforts, whether the feasibility of such systems might vary depending on individual patient characteristics, and if digitally acquired assessments were of sufficient diagnostic validity. Methods We implemented a system for longitudinal digital collection of risk and symptom profiles based on repeated self-reports via tablet computers throughout inpatient treatment of affective disorders at the Department of Psychiatry at the University of Münster. Tablet-handling competency and the speed of data entry were assessed. Depression severity was additionally assessed by a clinical interviewer at baseline and before discharge. Results Of 364 affective disorder patients who were approached, 242 (66.5%) participated in the study; 88.8% of participants (215/242) were diagnosed with major depressive disorder, and 27 (11.2%) had bipolar disorder. During the duration of inpatient treatment, 79% of expected assessments were completed, with an average of 4 completed assessments per participant; 4 participants (4/242, 1.6%) dropped out of the study prematurely. During data entry, 89.3% of participants (216/242) did not require additional support. Needing support with tablet handling and slower data entry pace were predicted by older age, whereas depression severity at baseline did not influence these measures. Patient self-reporting of depression severity showed high agreement with standardized external assessments by a clinical interviewer. Conclusions Our results indicate that digital collection of self-report measures is a feasible, accessible, and valid method for longitudinal data collection in psychiatric routine, which will eventually facilitate the identification of individual risk and resilience factors for affective disorders and pave the way toward personalized psychiatric care.

scholarly journals Continuous digital collection of patient-reported outcomes during inpatient treatment for affective disorders - implementation and feasibility

2020 ◽  
Author(s):  
Maike Richter ◽  
Michael Storck ◽  
Rogerio Blitz ◽  
Janik Goltermann ◽  
Juliana Seipp ◽  
...  
Keyword(s):  
Affective Disorders ◽  
Inpatient Treatment ◽  
Patient Reported Outcomes ◽  
Data Entry ◽  
Machine Learning Algorithms ◽  
Individual Risk ◽  
Depression Severity ◽  
Patient Reported ◽  
Longitudinal Data Collection ◽  
Digital Collection

Multivariate predictive models have revealed promising results for the individual prediction of treatment response, relapse risk as well as for the differential diagnosis in affective disorders. Yet, in order to translate personalized predictive modelling from the research context to psychiatric clinical routine, standardized collection of information of sufficient detail and temporal resolution in day-to-day clinical care is needed, based on which machine learning algorithms can be trained. Digital collection of patient-reported outcomes (PROs) is a time- and cost-efficient approach to gain such data throughout the treatment course. However, it remains unclear whether patients with severe affective disorders are willing and able to participate in such efforts, whether the feasibility of such systems might vary depending on individual patient characteristics and if digitally acquired patient-reported outcomes are of sufficient diagnostic validity. To address these questions, we implemented a system for continuous digital collection of patient-reported outcomes via tablet computers throughout inpatient treatment for affective disorders at the Department of Psychiatry at the University of Muenster. 364 affective disorder patients were approached, 66.5% of which could be recruited to participate in the study. An average of four assessments were completed during the treatment course, none of the participants dropped out of the study prematurely. 89.3% of participants did not require additional support during data entry. Need of support with tablet handling and slower data entry pace was predicted by older age, whereas depression severity at baseline did not influence these measures. Patient-reported outcomes of depression severity showed high agreement with standardized external assessments by a clinical interviewer. Our results indicate that continuous digital collection of patient-reported outcomes is a feasible, accessible and valid method for longitudinal data collection in psychiatric routine, which will eventually facilitate the identification of individual risk and resilience factors for affective disorders and pave the way towards personalized psychiatric care.

scholarly journals Symptom Monitoring based on Digital Data Collection During Inpatient Treatment of Schizophrenia Spectrum Disorders - a Feasibility Study

2021 ◽  
Author(s):  
Julian Herpertz ◽  
Maike F Richter ◽  
Carlotta Barkhau ◽  
Michael Storck ◽  
Rogerio Blitz ◽  
...  
Keyword(s):  
Data Collection ◽  
Affective Disorder ◽  
Inpatient Treatment ◽  
Data Entry ◽  
Spectrum Disorder ◽  
Digital Data ◽  
Schizophrenia Spectrum Disorder ◽  
Symptom Profiles ◽  
Schizophrenia Spectrum ◽  
Self Reports

Background: Digital acquisition of risk factors and symptoms based on patients self-reports represents a promising, cost-efficient and increasingly prevalent approach for standardized data collection in psychiatric clinical routine. While the feasibility of digital data collection has been demonstrated across a range of psychiatric disorders, studies investigating digital data collection in schizophrenia spectrum disorder patients are scarce. Hence, up to now our knowledge about the acceptability and feasibility of digital data collection in patients with a schizophrenia spectrum disorder remains critically limited. Objective: The objective of this study was to explore the acceptance towards and performance with digitally acquired assessments of risk and symptom profiles in patients with a schizophrenia spectrum disorder in comparison with patients with an affective disorder. Methods: We investigated the acceptance, the required support and the data entry pace of patients during a longitudinal digital data collection system of risk and symptom profiles using self-reports on tablet computers throughout inpatient treatment in patients with a schizophrenia spectrum disorder. As a benchmark comparison, findings in patients with schizophrenia spectrum disorder were evaluated in direct comparison with findings in affective disorder patients. The influence of sociodemographic data and clinical characteristics on the assessment was explored. The study was performed at the Department of Psychiatry at the University of Muenster between February 2020 and February 2021. Results: Of 82 patients diagnosed with a schizophrenia spectrum disorder who were eligible for inclusion 59.8% (n=49) agreed to participate in the study of whom 54.2% (n=26) could enter data without any assistance. Inclusion rates, drop-out rates and subjective experience ratings did not differ between patients with a schizophrenia spectrum disorder and patients with an affective disorder. Out of all participating patients, 98% reported high satisfaction with the digital assessment. Patients with a schizophrenia spectrum disorder needed more support and more time for the assessment compared to patients with an affective disorder. The extent of support of patients with a schizophrenia spectrum disorder was predicted by age, whereas the feeling of self-efficacy predicted data entry pace. Conclusion: Our results indicate that, although patients with a schizophrenia spectrum disorder need more support and more time for data entry than patients with an affective disorder, digital data collection using patients self-reports is a feasible and well-received method. Future clinical and research efforts on digitized assessments in psychiatry should include patients with a schizophrenia spectrum disorder and offer adequate support to reduce digital exclusion of these patients.

Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis

2019 ◽  
Vol 24 (6) ◽  
pp. 722-727
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Megan Lee ◽  
Adam J. Kundishora ◽  
Christopher S. Hong ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Idiopathic Scoliosis ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Complication Rates ◽  
Total Cost ◽  
Adolescent Patients ◽  
Perioperative Complication ◽  
The Impact

OBJECTIVEIn the past decade, a gradual transition of health policy to value-based healthcare has brought increased attention to measuring the quality of care delivered. In spine surgery, adolescents with scoliosis are a population particularly at risk for depression, anxious feelings, and impaired quality of life related to back pain and cosmetic appearance of the deformity. With the rising prevalence of mental health ailments, it is necessary to evaluate the impact of concurrent affective disorders on patient care after spinal surgery in adolescents. The aim of this study was to investigate the impact that affective disorders have on perioperative complication rates, length of stay (LOS), and total costs in adolescents undergoing elective posterior spinal fusion (PSF) (≥ 4 levels) for idiopathic scoliosis.METHODSA retrospective study of the Kids’ Inpatient Database for the year 2012 was performed. Adolescent patients (age range 10–17 years old) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Patients were categorized into 2 groups at discharge: affective disorder or no affective disorder. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were assessed. The primary outcomes were perioperative complication rates, LOS, total cost, and discharge dispositions.RESULTSThere were 3759 adolescents included in this study, of whom 164 (4.4%) were identified with an affective disorder (no affective disorder: n = 3595). Adolescents with affective disorders were significantly older than adolescents with no affective disorders (affective disorder: 14.4 ± 1.9 years vs no affective disorder: 13.9 ± 1.8 years, p = 0.001), and had significantly different proportions of race (p = 0.005). Aside from hospital region (p = 0.016), no other patient- or hospital-level factors differed between the cohorts. Patient comorbidities did not differ significantly between cohorts. The number of vertebral levels involved was similar between the cohorts, with the majority of patients having 9 or more levels involved (affective disorder: 76.8% vs no affective disorder: 79.5%, p = 0.403). Postoperative complications were similar between the cohorts, with no significant difference in the proportion of patients experiencing a postoperative complication (p = 0.079) or number of complications (p = 0.124). The mean length of stay and mean total cost were similar between the cohorts. Moreover, the routine and nonroutine discharge dispositions were also similar between the cohorts, with the majority of patients having routine discharges (affective disorder: 93.9% vs no affective disorder: 94.9%, p = 0.591).CONCLUSIONSThis study suggests that affective disorders may not have a significant impact on surgical outcomes in adolescent patients undergoing surgery for scoliosis in comparison with adults. Further studies are necessary to elucidate how affective disorders affect adolescent patients with idiopathic scoliosis, which may improve provider approach in managing these patients perioperatively and at follow-up in hopes to better the overall patient satisfaction and quality of care delivered.

A High Prevalence of Affective Disorder Discovered in a ‘Schizophrenia Clinic’

1977 ◽  
Vol 22 (4) ◽  
pp. 181-183 ◽  
Author(s):  
Morton S. Rapp ◽  
Peggy Edwards
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Correct Diagnosis ◽  
Lithium Carbonate ◽  
Case Histories ◽  
Clinical Notes ◽  
The Past ◽  
High Prevalence ◽  
Incorrect Diagnosis

Fifty outpatients in a ‘schizophrenia clinic’ were examined, and sixteen were found to be suffering from periodic affective disorders. Nine of these were given lithium carbonate, and eight responded well. Case histories illustrate three separate reasons for incorrect diagnosis. Examination of extensive old clinical notes of five of these patients suggests that the problems of diagnosis which have been described in the literature in the past, continue to represent obstacles to correct diagnosis. Suggestions for improvement are offered.

Genetic Models of Affective Disorder: Application to Twin Data

1980 ◽  
Vol 29 (4) ◽  
pp. 289-294 ◽  
Author(s):  
Miron Baron
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Monozygotic Twins ◽  
Threshold Models ◽  
Twin Data ◽  
Bipolar Illness ◽  
Major Locus ◽  
Unipolar Disorder ◽  
Locus Model ◽  
Multiple Threshold

Twin data on bipolar and unipolar affective disorders are analyzed by multiple threshold models of inheritance. The two illness types are represented in the models on a continuum of genetic–environmental liability in which bipolar illness has a higher liability threshold than unipolar disorder. Autosomal single major locus model provides an acceptable fit to observed concordance rates in monozygotic twins. The multifactorial-polygenic model is rejected.

Prospective evaluation of specialist inpatient treatment for refractory affective disorders

2011 ◽  
Vol 131 (1-3) ◽  
pp. 92-103 ◽  
Author(s):  
Sarah C. Wooderson ◽  
Mario F. Juruena ◽  
Abebaw Fekadu ◽  
Clodagh Commane ◽  
Catherine Donaldson ◽  
...  
Keyword(s):  
Affective Disorders ◽  
Inpatient Treatment ◽  
Prospective Evaluation

Prediction of major affective disorders in adolescents by self-report measures

2009 ◽  
Vol 115 (1-2) ◽  
pp. 140-149 ◽  
Author(s):  
Marcel Aebi ◽  
Christa Winkler Metzke ◽  
Hans-Christoph Steinhausen
Keyword(s):  
Affective Disorders ◽  
Self Report

scholarly journals Analysis of 200,000 exome-sequenced UK Biobank subjects fails to identify genes influencing probability of developing a mood disorder resulting in psychiatric referral

2021 ◽  
Author(s):  
David Curtis
Keyword(s):  
Affective Disorder ◽  
Multiple Testing ◽  
Major Effect ◽  
Self Report ◽  
Uk Biobank ◽  
Recurrent Depression ◽  
Functional Variants ◽  
Gene Sets ◽  
Or Gene ◽  
Genetic Contributions

AbstractBackgroundDepression is moderately heritable but there is no common genetic variant which has a major effect on susceptibility. A previous analysis of 50,000 subjects failed to implicate any genes or sets of genes associated with risk of affective disorder requiring specialist treatment. A large exome-sequenced dataset is now available.MethodsData from 200,632 exome-sequenced UK Biobank participants was analysed. Subjects were treated as cases if they had reported having seen a psychiatrist for “nerves, anxiety, tension or depression”. Gene-wise weighted burden analysis was performed to see if there were any genes or sets of genes for which there was an excess of rare, functional variants in cases.ResultsThere were 22,886 cases and 176,486 controls. There were 22,642 informative genes but no gene or gene set produced a statistically significant result after correction for multiple testing. None of the genes or gene sets with the lowest p values appeared to be a biologically plausible candidate.LimitationsThe phenotype is based on self-report and the cases are likely to somewhat heterogeneous. Likewise, it is expected that some of the subjects classed as controls will in fact have suffered from depression or some other psychiatric diagnosis.ConclusionsThe results conform exactly with the expectation under the null hypothesis. It seems unlikely that the use of common, poorly defined phenotypes will produce useful advances in understanding genetic contributions to affective disorder and it might be preferable to focus instead on obtaining large exome-sequenced samples of conditions such as bipolar 1 disorder and severe, recurrent depression.

scholarly journals Depressive symptoms in patients with epilepsy and clinically associated features in a single tertiary center

2021 ◽  
Author(s):  
Mariacarolina Vacca ◽  
Mariana Fernandes ◽  
Matteo Spanetta ◽  
Fabio Placidi ◽  
Francesca Izzi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Clinical Features ◽  
Item Analysis ◽  
Well Being ◽  
Adult Patients ◽  
Self Report ◽  
Depression Severity ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Patients With Epilepsy

AbstractAlthough depressive symptoms are the most common psychiatric comorbidity in epilepsy, they remain underestimated and untreated in a large proportion of patients. The purpose of this study was to evaluate depression severity and related clinical features in people with epilepsy using a well-reliable self-report index of mood, the Beck Depression Inventory-II (BDI-II). One-hundred seventeen adult patients with epilepsy were recruited from a tertiary epilepsy center and completed the BDI-II. A single-item analysis of the 21 questions of the BDI-II was computed and differences between women and men in each depressive symptom were evaluated. Correlation and regression analyses were used to identify clinical features associated with the severity of depression. Results showed gender differences in some items, with women reporting overall higher depression severity than men. The most common symptoms regarded domains of sleeping patterns, tiredness, and loss of energy. Regression evidence suggested that being female, having an epilepsy duration < 10 years, as well as being treated with psychotropic drugs and reporting generalized seizure, were associated with higher depression severity. Despite its cross-sectional nature, this study reinforces the importance of investigating and possibly treating depressive symptoms in adult patients with epilepsy, since they negatively impact well-being, daytime activities, and sleep. Further studies identifying pharmacological and non-pharmacological treatments for depression in epilepsy need to be planned.

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