scholarly journals Monitoring the effects of therapeutic interventions in depression through self-assessments

Author(s):  
Ines Moragrega ◽  
René Bridler ◽  
Christine Mohr ◽  
Michela Possenti ◽  
Deborah Rochat ◽  
...  

The treatment of major psychiatric disorders is an arduous and thorny path for the patients concerned, characterized by polypharmacy, massive adverse side effects, modest prospects of success, and constantly declining response rates. The more important is the early detection of psychiatric disorders prior to the development of clinically relevant symptoms, so that people can benefit from early interventions. A well-proven approach to monitoring mental health relies on voice analysis. This method has been successfully used with psychiatric patients to ‘objectively’ document the progress of improvement or the onset of relapse. The studies with psychiatric patients over 2-4 weeks demonstrated that daily voice assessments have a notable therapeutic effect in themselves. Therefore, daily voice assessments appear to be a lowthreshold form of therapeutic means that may be realized through self-assessments. To evaluate performance and reliability of this approach, we have carried out a longitudinal study on 82 university students in 3 different countries with daily assessments over 2 weeks. The sample included 41 males (mean age 24.2±3.83 years) and 41 females (mean age 21.6±2.05 years). Unlike other research in the field, this study was not concerned with the classification of individuals in terms of diagnostic categories. The focus lay on the monitoring aspect and the extent to which the effects of therapeutic interventions or of behavioural changes are visible in the results of self-assessment voice analyses. The test persons showed an over-proportionally good adherence to the daily voice analysis scheme. The accumulated data were of generally high quality: sufficiently high signal levels, a very limited number of movement artifacts, and little to no interfering background noise. The method was sufficiently sensitive to detect: i) habituation effects when test persons became used to the daily procedure; and ii) short-term fluctuations that exceeded prespecified thresholds and reached significance. Results are directly interpretable and provide information about what is going well, what is going less well, and where there is a need for action. The proposed self-assessment approach was found to be well-suited to serve as a health-monitoring tool for subjects with an elevated vulnerability to psychiatric disorders or to stress-induced mental health problems. Daily voice assessments are in fact a low-threshold form of therapeutic means that can be realized through selfassessments, that requires only little effort, can be carried out in the test person’s own home, and has the potential to strengthen resilience and to induce positive behavioural changes.

2020 ◽  
Author(s):  
Patrizia Zeppegno ◽  
Carla Gramaglia ◽  
Chiara Guerriero ◽  
Fabio Madeddu ◽  
Raffaella Calati

Background: The World Health Organization declared the Corona Virus Disease 19 (Covid-19) a pandemic in March 2020. Psychological impact of Covid-19 can be consisent and should be prevented with adequate measures. Methods: We performed a literature mini review searching for studies in PubMed focusing on the psychological/psychiatric impact of Covid-19.Results: The selection process yielded 34 papers focusing on the relation between Covid-19 and mental health: 9 correspondence, 8 letters to the editor, 7 commentaries, 3 editorials, 4 original studies, 2 brief reports, and 1 a rapid review. The majority of the articles were performed in China. They focused on the general population and particular categories considered more fragile, e.g., psychiatric patients, older adults, international migrant workers, homeless people. Authors are unanimous in believing that Covid-19 will likely increase the risk of mental health problems and worsen existing psychiatric disorders/symptoms in patients, exposed subjects, and staff. Together with the negative emotionality related to the unpredictability of the situation, uncertainty concerning the risk, excessive fear, fear of death, loneliness, guilt, stigma, denial, anger, frustration, boredome, some symptoms might appear such as insomnia until patophobia (specifically, coronaphobia), depressive and anxiety disorders, post-traumatic stress disorder, and suicidal risk.Limitations: Literature is rapidly increasing and present results are only partial. Conclusions: Mental health care should not be overlooked in this moment. The experience of China should be of help for all the countries facing with Covid-19, among them Italy.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
H. M. Bjorgaas ◽  
I. Elgen ◽  
T. Boe ◽  
M. Hysing

Introduction. Children with cerebral palsy (CP), one of the most common childhood neurological disorders, often have associated medical and psychological symptoms. This study assesses mental health problems compared to population controls and the ability of a mental health screening tool to predict psychiatric disorders and to capture the complexity of coexisting symptoms.Methods. Children with CP (N=47) were assessed according to DSM-IV criteria using a psychiatric diagnostic instrument (Kiddie-SADS) and a mental health screening questionnaire (SDQ). Participants from the Bergen Child Study, a large epidemiological study, served as controls.Results. Children with CP had significantly higher means on all problem scores including impact scores. Two in three children scored above 90th percentile cutoff on Total Difficulties Score (TDS), and 57% met criteria for a psychiatric disorder, yielding a sensitivity of 0.85 and a specificity of 0.55. Mental health problems coexisted across symptom scales, and peer problems were highly prevalent in all groups of psychiatric disorders.Conclusion. A high prevalence of mental health problems and cooccurrence of symptoms were found in children with CP compared to controls. Screening with SDQ detects mental health problems, but does not predict specific disorders in children with CP. ADHD is common, but difficult to diagnose due to complexity of symptoms. Mental health services integrated in regular followup of children with CP are recommended due to high prevalence and considerable overlap of mental health symptoms.


2014 ◽  
Vol 4 (1) ◽  
pp. 306-315
Author(s):  
Indrajit Banerjee ◽  
Indraneel Banerjee ◽  
Bedanta Roy ◽  
Brijesh Sathian ◽  
Shovit Kadkha ◽  
...  

Background: The causes of mental health problems and ethnic variation are poorlyunderstood. The main objective of the study was to find out about psychiatricdiseases which frequently occur in Western Nepal for which hospitalization isrequired. The specific objective was to research about theeconomic condition ofthe psychiatric patients and the prevalence of common psychiatric disorderwitnessed among hospitalized patients who belong to diverse ethnic and culturalgroups in Western Nepal. Materials and Methods: It was a cross sectional studywhich was conducted in between 1st October 2009 and 31th March 2010 between at Manipalteaching hospital, Pokhara, Nepal. Odds ratios and adjusted odds ratio andtheir 95% confidence intervals (95% CI) were calculated. p < 0.05 wasconsidered as statistically significant. Results: Out of 240 cases the commonestcases of psychiatric disorders include Schizophrenia, Schizotypal and DelusionDisorders 36.3%, Mood Disorders 27.9%, Neurotic, stress-related and somatoformdisorders 15.8%. Study based on ethnicity revealed that the majority ofpatients were Dalit [n= 72] followed by Brahmin [n = 66], Chettri [n = 46],Newar [n = 19], Gurung [n = 17], others [n = 13] and Magar and Pun [n = 7].Most of the patients were <40yrs [n=191] unemployed [n=199], monthly familyincome <10000 NPR/month [n= 187], students [n = 102] housewives [n = 74,], job holders [n= 17]. Study showed that Mental and Behavioural disorder due toPsychoactive Substance abuse, Schizophrenia, Schizotypal and Delusion DisordersMood (Affective) Disorders, Neurotic, stress-related and somatoform disorderswere prevalent among unemployed patients [OR 8.170(CI 1.062, 62.853)], [OR3.033(CI 1.334, 6.897)], [OR 0.413(CI 0.199, 0.856)[OR 0.228(CI 0.089,0.583)]as compared to employed patients(p=0.001). Conclusion: Schizophrenia was the commonestpsychiatric disorder among the low socio-economic class of like Dalits. The study showed that culture based differences concerning mental health is furthermediated by poverty, unemployment and dearth of family income which leads tohigh prevalence of psychiatric illness among Nepalese population. Based on thefinding of the study, interventions should target these factors to minimise theload of various psychiatric illness among poor Dalit Nepalese population.DOI: http://dx.doi.org/10.3126/nje.v4i1.10132Nepal Journal of Epidemiology 2014;4 (1): 306-315Keywords:Culture, Ethnicity,Nepal, Psychiatry


Author(s):  
Hans Oh ◽  
Ai Koyanagi ◽  
Jordan DeVylder ◽  
Andrew Stickley

Seasonal allergies have been associated with mental health problems, though the evidence is still emergent, particularly in the United States. We analyzed data from the National Comorbidity Survey Replication and the National Latino and Asian American Survey (years 2001–2003). Multivariable logistic regression models were used to examine the relations between lifetime allergies and lifetime psychiatric disorders (each disorder in a separate model), adjusting for socio-demographic variables (including region of residence) and tobacco use. Analyses were also stratified to test for effect modification by race and sex. A history of seasonal allergies was associated with greater odds of mood disorders, anxiety disorders, and eating disorders, but not alcohol or substance use disorders, after adjusting for socio-demographic characteristics and tobacco use. The associations between seasonal allergies and mood disorders, substance use disorders, and alcohol use disorders were particularly strong for Latino Americans. The association between seasonal allergies and eating disorders was stronger for men than women. Seasonal allergies are a risk factor for psychiatric disorders. Individuals complaining of seasonal allergies should be screened for early signs of mental health problems and referred to specialized services accordingly.


2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Kazeem Ayinde Ayanda ◽  
Dauda Sulyman ◽  
Mahmud Yinka Mahmud ◽  
Joy Pius ◽  
Simeon Yinka Ategbese

Psychiatric disorders are common sequelae of diabetes mellitus and can further worsen the clinical state and quality of life of patients. The aims of this study were to determine the prevalence and pattern of psychological illnesses in patients with diabetes mellitus and to assess factors that predict these psychiatric disorders. The mental health of 114 eligible consenting adult patients with diabetes mellitus attending the diabetic clinic of Abubakar Tafawa Balewa University Teaching Hospital was assessed using Mini International Neuropsychiatric Interview (MINI). The prevalence of psychiatric disorders in the study respondents was 39.5% and the pattern of diagnoses found were Major Depressive Disorder (31.6%), Generalized Anxiety Disorder (6.1%) and Post-Traumatic Stress Disorder (1.8%). None of the sociodemographic variables was significantly associated with the presence of psychiatric disorders. The presence of diabetic complications (OR=2.519; 95% CI=1.056-6.001; P-value=0.037) was predictive of psychiatric disorders while good sugar control (OR=0.372; 95% CI=0.162-0.854; P-value=0.020) was a significant protective factor. A notable proportion of patients with diabetes mellitus develop mental health problems which can worsen the clinical outcome and further increase the burden of this illness. Efforts to promptly identify and manage these comorbid psychological problems can improve the prognosis of these patients.


2018 ◽  
Vol 42 (1) ◽  
pp. 22-37 ◽  
Author(s):  
Nick Midgley ◽  
Adriana Alayza ◽  
Hannah Lawrence ◽  
Rebecca Bellew

Children placed for adoption often face unique challenges and are at higher risk of mental health problems compared to the general population. Yet despite some important clinical developments, there is still a lack of evidence related to effective therapeutic interventions for this population. This study reports on the preliminary evaluation of a mentalization-based family therapy service, Adopting Minds, offered as part of a post-adoption support service. Thirty-six families who had adopted 42 children were referred to the service between September 2015 and December 2016. Demographic information was collected and assessments undertaken on the families at baseline and at the end of therapy, using a range of validated measures. Five families who had completed therapy were also interviewed about their experience of the approach. For those families on which data were available, positive outcomes in mental health and parental self-efficacy were identified, and adoptive parents reported high levels of satisfaction with the mentalization-based family therapy service. Analysis of the interviews revealed that the families found it a containing space that was supportive and non-judgemental. They felt able to express their fears and worries to a therapist who was friendly and knowledgeable and reported that the service helped them to deal with and link struggles they were facing to their own as well as their child's past experiences. However, some adoptive families felt that this short-term, six-session service alone was not enough to address all the difficulties that had brought the family to seek help, and would have preferred a longer-term intervention or therapy in combination with other types of support.


2020 ◽  
Vol 13 (4) ◽  
pp. e229120
Author(s):  
Rita Goncalves ◽  
Mafalda Marques ◽  
Teresa Cartaxo ◽  
Vera Santos

Worldwide, millions of children and adolescents are suffering due to a lack of efficient mental healthcare. Although some progress has been made to address the mental health problems in this age group, currently, even developed countries fail in providing psychiatric patients with the best practice care. We present a case of a Portuguese adolescent with a first episode of psychosis in whom multiple social and environmental risk factors were identified as triggers to his clinical presentation, as well as fundamental determinants of prognosis in the short and long term. In this case, we demonstrate how social determinants, including poverty, family dysfunction and difficulties in accessing appropriate mental healthcare, strongly influence the development, maintenance and prognosis in early psychosis during adolescence. Furthermore, we consider the implications of an absence of community-based mental healthcare and rehabilitation services and reasons for why this may complicate the management and limit opportunities to this patient population.


2017 ◽  
Vol 41 (S1) ◽  
pp. S133-S133
Author(s):  
S. Coli ◽  
D. Scuticchio ◽  
M. Bertelli

IntroductionAdults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.Objectives/aimsThis study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.MethodsA systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.ResultsMany studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.ConclusionsAlthough low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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