Pub Date : 2022-01-01Epub Date: 2021-12-21DOI: 10.1080/00332747.2021.1991200
Allison Engstrom, Kathleen Moloney, Jefferson Nguyen, Lea Parker, Michelle Roberts, Rddhi Moodliar, Joan Russo, Jin Wang, Hannah Scheuer, Douglas Zatzick
Objective: Few investigations have comprehensively described methods for assessing and monitoring suicidal ideation in pragmatic clinical trials of mental health services interventions. This investigation's goal was to assess a collaborative care intervention's effectiveness in reducing suicidal ideation and describe suicide monitoring implementation in a nationwide protocol.
Method: The investigation was a secondary analysis of a stepped wedge cluster randomized trial at 25-Level I trauma centers. Injury survivors (N = 635) were randomized to control (n = 370) and intervention (n = 265) conditions and assessed at baseline hospitalization and follow-up at 3-, 6- and 12-months post-injury. The Patient Health Questionnaire (PHQ-9) item-9 was used to evaluate patients for suicidal ideation. Mixed model regression was used to assess intervention versus control group changes in PHQ-9 item-9 scores over time and associations between baseline characteristics and development of suicidal ideation longitudinally. As part of the study implementation process assessment, suicide outreach call logs were also reviewed.
Results: Over 50% of patients endorsed suicidal ideation at ≥1 assessment. Intervention patients relative to control patients demonstrated reductions in endorsements of suicidal ideation that did not achieve statistical significance (F[3,1461] = 0.74, P = .53). The study team completed outreach phone calls, texts or voice messages to 268 patients with PHQ-9 item-9 scores ≥1 (n = 161 control, n = 107 intervention).
Conclusions: Suicide assessment and monitoring can be feasibly implemented in large-scale pragmatic clinical trials. Intervention patients demonstrated less suicidal ideation over time; however, these comparisons did not achieve statistical significance. Intensive pragmatic trial monitoring may mask treatment effects by providing control patients a supportive intervention.
{"title":"A Pragmatic Clinical Trial Approach to Assessing and Monitoring Suicidal Ideation: Results from A National US Trauma Care System Study.","authors":"Allison Engstrom, Kathleen Moloney, Jefferson Nguyen, Lea Parker, Michelle Roberts, Rddhi Moodliar, Joan Russo, Jin Wang, Hannah Scheuer, Douglas Zatzick","doi":"10.1080/00332747.2021.1991200","DOIUrl":"10.1080/00332747.2021.1991200","url":null,"abstract":"<p><strong>Objective: </strong>Few investigations have comprehensively described methods for assessing and monitoring suicidal ideation in pragmatic clinical trials of mental health services interventions. This investigation's goal was to assess a collaborative care intervention's effectiveness in reducing suicidal ideation and describe suicide monitoring implementation in a nationwide protocol.</p><p><strong>Method: </strong>The investigation was a secondary analysis of a stepped wedge cluster randomized trial at 25-Level I trauma centers. Injury survivors (N = 635) were randomized to control (n = 370) and intervention (n = 265) conditions and assessed at baseline hospitalization and follow-up at 3-, 6- and 12-months post-injury. The Patient Health Questionnaire (PHQ-9) item-9 was used to evaluate patients for suicidal ideation. Mixed model regression was used to assess intervention versus control group changes in PHQ-9 item-9 scores over time and associations between baseline characteristics and development of suicidal ideation longitudinally. As part of the study implementation process assessment, suicide outreach call logs were also reviewed.</p><p><strong>Results: </strong>Over 50% of patients endorsed suicidal ideation at ≥1 assessment. Intervention patients relative to control patients demonstrated reductions in endorsements of suicidal ideation that did not achieve statistical significance (F[3,1461] = 0.74, <i>P</i> = .53). The study team completed outreach phone calls, texts or voice messages to 268 patients with PHQ-9 item-9 scores ≥1 (n = 161 control, n = 107 intervention).</p><p><strong>Conclusions: </strong>Suicide assessment and monitoring can be feasibly implemented in large-scale pragmatic clinical trials. Intervention patients demonstrated less suicidal ideation over time; however, these comparisons did not achieve statistical significance. Intensive pragmatic trial monitoring may mask treatment effects by providing control patients a supportive intervention.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02655354.</p>","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 1","pages":"13-29"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916972/pdf/nihms-1751704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9579320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2022.2132775
Craig J Bryan, Heather Wastler, Nicholas Allan, Lauren R Khazem, M David Rudd
on suicide prevention intervention development and refinement. on understanding the mechanisms for suicide risk individuals recently diagnosed with a psychotic disorder, and her long-term goal is to develop and test just-in-time interventions for this high risk population. is on identifying unique drivers of suicide risk in the disability community, Veterans, and military personnel and improving the efficacy, accessibility, and reach of suicide prevention assessments and interventions for these populations. in the assessment and treatment of suicide risk.
{"title":"Just-in-Time Adaptive Interventions (JITAIs) for Suicide Prevention: Tempering Expectations.","authors":"Craig J Bryan, Heather Wastler, Nicholas Allan, Lauren R Khazem, M David Rudd","doi":"10.1080/00332747.2022.2132775","DOIUrl":"https://doi.org/10.1080/00332747.2022.2132775","url":null,"abstract":"on suicide prevention intervention development and refinement. on understanding the mechanisms for suicide risk individuals recently diagnosed with a psychotic disorder, and her long-term goal is to develop and test just-in-time interventions for this high risk population. is on identifying unique drivers of suicide risk in the disability community, Veterans, and military personnel and improving the efficacy, accessibility, and reach of suicide prevention assessments and interventions for these populations. in the assessment and treatment of suicide risk.","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"341-346"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2022.2132777
Jonathan Lebolt
On March 19, 2022, the Center for the Study of Race, Ethnicity and Culture (CSREC) at the Washington School of Psychiatry presented Race, Gender and Sexuality: From the Ancient Mediterranean to Contemporary Intersectionality via Zoom. Addressing structural racism in the discipline of classics, the rhetorical question was asked, when did classics become White, indicating that today’s racial categories did not exist in the Greco-Roman world, where sexual orientation and gender identity were also more fluid than is commonly believed. Addressing America’s propensity for erasing the cultures White Europeans “found,” challenged the hegemony of the Greco-Roman in American mores, affirming the resilience of indigenous cultures by pointing to the resurgence of Mayan Quechua, now a lingua franca in Latin America. How did this hegemony evolve? The “discovery” of Pompeii, Herculaneum and the Apollo Belvedere ushered in the Enlightenment/neo-classical idealization of what were perceived to be classical forms–accurately, in the case of neo-classical buildings such as America’s capitol, but inaccurately in the case of Whitened sculptures that were originally polychromous. For example, Titian’s Andromeda is White, but she was actually from modern-day Ethiopia. Ironically, in light of contemporary racism and sexism, men in the art of the classical era, at a time and place when men were viewed as superior, were portrayed as darker than women. White Europeans constructed race by positing biological difference to serve ends of conquest and domination, whereas recent scientific scholarship evinces less than .01% variability attributable to “race.” We learned that classicist Frank Snowden’s revelation that dark-skinned Africans, generically labelled “Ethiops,” were valued in antiquity. Most slaves were what we would today call White, though xenophobia—viewing other cultures as “barbaric”—was rampant. Alluding to the whitewashing of Ancient Egypt— Elizabeth Taylor as Cleopatra, for example— Stark credited Fred Wilson’s busts of Nefertiti in various shades of darkness. Emphasizing the importance of more recent and accu-
{"title":"Race, Gender and Sexuality: Ancient to Present.","authors":"Jonathan Lebolt","doi":"10.1080/00332747.2022.2132777","DOIUrl":"https://doi.org/10.1080/00332747.2022.2132777","url":null,"abstract":"On March 19, 2022, the Center for the Study of Race, Ethnicity and Culture (CSREC) at the Washington School of Psychiatry presented Race, Gender and Sexuality: From the Ancient Mediterranean to Contemporary Intersectionality via Zoom. Addressing structural racism in the discipline of classics, the rhetorical question was asked, when did classics become White, indicating that today’s racial categories did not exist in the Greco-Roman world, where sexual orientation and gender identity were also more fluid than is commonly believed. Addressing America’s propensity for erasing the cultures White Europeans “found,” challenged the hegemony of the Greco-Roman in American mores, affirming the resilience of indigenous cultures by pointing to the resurgence of Mayan Quechua, now a lingua franca in Latin America. How did this hegemony evolve? The “discovery” of Pompeii, Herculaneum and the Apollo Belvedere ushered in the Enlightenment/neo-classical idealization of what were perceived to be classical forms–accurately, in the case of neo-classical buildings such as America’s capitol, but inaccurately in the case of Whitened sculptures that were originally polychromous. For example, Titian’s Andromeda is White, but she was actually from modern-day Ethiopia. Ironically, in light of contemporary racism and sexism, men in the art of the classical era, at a time and place when men were viewed as superior, were portrayed as darker than women. White Europeans constructed race by positing biological difference to serve ends of conquest and domination, whereas recent scientific scholarship evinces less than .01% variability attributable to “race.” We learned that classicist Frank Snowden’s revelation that dark-skinned Africans, generically labelled “Ethiops,” were valued in antiquity. Most slaves were what we would today call White, though xenophobia—viewing other cultures as “barbaric”—was rampant. Alluding to the whitewashing of Ancient Egypt— Elizabeth Taylor as Cleopatra, for example— Stark credited Fred Wilson’s busts of Nefertiti in various shades of darkness. Emphasizing the importance of more recent and accu-","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"435-437"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10710764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2021.1989855
Sudha Mishra, Sujita Kar
To the Editor, Since time immemorial, stigma is closely associated with mental illnesses. Due to stigma, misconceptions about mental illnesses as well as lack of awareness, a large proportion of patients with mental illnesses remain untreated or consult traditional healers, which attribute to a large treatment gap as found in the recent National Mental Health Survey 2015–16, sponsored by the Government of India Gururaj et al. (2016a). Due to stigma, in most parts of the world, non-psychiatrist practitioners treat patients with mental illness, and antidepressants are commonly over-prescribed medications Kar (2015). Over the past few decades, a new subspecialty has emerged which works at the interface of psychiatry and other medical disciplines. It is known as consultationliaison psychiatry, and it intends to deliver collaborative care for patients having medical illnesses with psychiatric co-morbidities Chen et al. (2016). Consultation-liaison service improves mental health care for up to three months; also improves client satisfaction and medication adherence Grover et al. (2014). A cross-sectional study was conducted on non-psychiatric practitioners in a city in North India. The study participants were general medical practitioners (nonpsychiatric medical practitioners). To be included in a study, the participant must be a medical practitioner (clinician) with a minimum MBBS degree. Written informed consent was taken from the participants. Study participants were evaluated on a semistructured questionnaire that intends to assess attitudes and practices about mental illnesses. Approximately 200 medical practitioners were approached during the survey, but only 61 (30%) were responded. Consented and completed in all respects. Most of the participants, 44 (72.14%), were male, and 17 (27.86%) were female. The specific difficulty reported for not giving consent by the practitioners is lack of time. Among participants, nearly 98% dealt with patients with psychiatric illness, out of which nearly 30% treated the patient. More than half (63.93%) of practitioners refer the patient to the psychiatric department, whereas 36.07% of practitioners had treated the patient with psychiatric problems by themselves. Particularly 88.52%practictioners referring the patient to psychiatrists, and more than 91.8%reported psychiatric problems are associated with medical illness. More than 42.62% prescribe psychotropic medication, out of which benzodiazepine is
{"title":"Patterns of Practice and Attitudes to Referral for Mental Health Needs among Practitioners in Northern India.","authors":"Sudha Mishra, Sujita Kar","doi":"10.1080/00332747.2021.1989855","DOIUrl":"https://doi.org/10.1080/00332747.2021.1989855","url":null,"abstract":"To the Editor, Since time immemorial, stigma is closely associated with mental illnesses. Due to stigma, misconceptions about mental illnesses as well as lack of awareness, a large proportion of patients with mental illnesses remain untreated or consult traditional healers, which attribute to a large treatment gap as found in the recent National Mental Health Survey 2015–16, sponsored by the Government of India Gururaj et al. (2016a). Due to stigma, in most parts of the world, non-psychiatrist practitioners treat patients with mental illness, and antidepressants are commonly over-prescribed medications Kar (2015). Over the past few decades, a new subspecialty has emerged which works at the interface of psychiatry and other medical disciplines. It is known as consultationliaison psychiatry, and it intends to deliver collaborative care for patients having medical illnesses with psychiatric co-morbidities Chen et al. (2016). Consultation-liaison service improves mental health care for up to three months; also improves client satisfaction and medication adherence Grover et al. (2014). A cross-sectional study was conducted on non-psychiatric practitioners in a city in North India. The study participants were general medical practitioners (nonpsychiatric medical practitioners). To be included in a study, the participant must be a medical practitioner (clinician) with a minimum MBBS degree. Written informed consent was taken from the participants. Study participants were evaluated on a semistructured questionnaire that intends to assess attitudes and practices about mental illnesses. Approximately 200 medical practitioners were approached during the survey, but only 61 (30%) were responded. Consented and completed in all respects. Most of the participants, 44 (72.14%), were male, and 17 (27.86%) were female. The specific difficulty reported for not giving consent by the practitioners is lack of time. Among participants, nearly 98% dealt with patients with psychiatric illness, out of which nearly 30% treated the patient. More than half (63.93%) of practitioners refer the patient to the psychiatric department, whereas 36.07% of practitioners had treated the patient with psychiatric problems by themselves. Particularly 88.52%practictioners referring the patient to psychiatrists, and more than 91.8%reported psychiatric problems are associated with medical illness. More than 42.62% prescribe psychotropic medication, out of which benzodiazepine is","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"433-434"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10358021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2022-02-09DOI: 10.1080/00332747.2021.2014383
Jone Bjornestad, Tore Tjora, Johannes H Langeveld, Inge Joa, Jan Olav Johannessen, Michelle Friedman-Yakoobian, Wenche Ten Velden Hegelstad
Objective: In this hypothesis-testing study, which is based on findings from a previous atheoretical machine-learning study, we test the predictive power of baseline "reduced expression of emotion" for psychosis.Method: Study participants (N = 96, mean age 16.55 years) were recruited from the Prevention of Psychosis Study in Rogaland, Norway. The Structured Interview for Prodromal Syndromes (SIPS) was conducted 13 times over two years. Reduced expression of emotion was added to positive symptoms at baseline (P1-P5) as a predictor of psychosis onset over a two-year period using logistic regression.Results: Participants with a score above zero on expression of emotion had over eight times the odds of conversion (OR = 8.69, p < .001). Data indicated a significant dose-response association. A model including reduced expression of emotion at baseline together with the positive symptoms of the SIPS rendered the latter statistically insignificant.Conclusions: The study findings confirm findings from the previous machine-learning study, indicating that observing reduced expression of emotion may serve two purposes: first, it may add predictive value to psychosis conversion, and second, it is readily observable. This may facilitate detection of those most at risk within the clinical high risk of psychosis population, as well as those at clinical high risk. A next step could be including this symptom within current high-risk criteria. Future research should consolidate these findings.
目的:在这项假设检验研究中，我们基于先前的一项理论机器学习研究的发现，测试了基线“情绪表达减少”对精神病的预测能力。方法:研究参与者(N = 96，平均年龄16.55岁)从挪威Rogaland的精神病预防研究中招募。前驱症状的结构化访谈(SIPS)在两年内进行了13次。在基线阳性症状(P1-P5)的基础上增加情绪表达减少，使用逻辑回归作为两年精神病发作的预测因子。结果:情绪表达得分在0分以上的参与者转换的几率超过8倍(OR = 8.69, p < .001)。数据显示有显著的剂量-反应关联。一个包括基线情绪表达减少和SIPS阳性症状的模型显示后者在统计上不显著。结论:研究结果证实了之前机器学习研究的结果，表明观察情绪表达减少可能有两个目的:首先，它可能增加精神病转换的预测价值，其次，它很容易观察到。这可能有助于在临床高危精神病人群中发现那些最危险的人，以及那些临床高危人群。下一步可能是将这种症状纳入目前的高风险标准。未来的研究应该巩固这些发现。
{"title":"Reduced Expression of Emotion: A Red Flag Signalling Conversion to Psychosis in Clinical High Risk for Psychosis (CHR-P) Populations.","authors":"Jone Bjornestad, Tore Tjora, Johannes H Langeveld, Inge Joa, Jan Olav Johannessen, Michelle Friedman-Yakoobian, Wenche Ten Velden Hegelstad","doi":"10.1080/00332747.2021.2014383","DOIUrl":"https://doi.org/10.1080/00332747.2021.2014383","url":null,"abstract":"<p><p><i>Objective</i>: In this hypothesis-testing study, which is based on findings from a previous atheoretical machine-learning study, we test the predictive power of baseline \"reduced expression of emotion\" for psychosis.<i>Method</i>: Study participants (N = 96, mean age 16.55 years) were recruited from the Prevention of Psychosis Study in Rogaland, Norway. The Structured Interview for Prodromal Syndromes (SIPS) was conducted 13 times over two years. Reduced expression of emotion was added to positive symptoms at baseline (P1-P5) as a predictor of psychosis onset over a two-year period using logistic regression.<i>Results</i>: Participants with a score above zero on expression of emotion had over eight times the odds of conversion (OR = 8.69, <i>p</i> < .001). Data indicated a significant dose-response association. A model including reduced expression of emotion at baseline together with the positive symptoms of the SIPS rendered the latter statistically insignificant.<i>Conclusions</i>: The study findings confirm findings from the previous machine-learning study, indicating that observing reduced expression of emotion may serve two purposes: first, it may add predictive value to psychosis conversion, and second, it is readily observable. This may facilitate detection of those most at risk within the clinical high risk of psychosis population, as well as those at clinical high risk. A next step could be including this symptom within current high-risk criteria. Future research should consolidate these findings.</p>","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 3","pages":"282-292"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39779464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2022.2062660
Yael Cohen-Chazani, Michal Lavidor, Eva Gilboa-Schechtman, David Roe, Ilanit Hasson-Ohayon
Objective: The current meta-analysis investigates the efficacy of psychotherapy during psychiatric hospitalization and examines the moderating role of diagnosis and therapeutic approach.
Methods: We conducted systematic searches in literature databases, including PubMed, PsycInfo, and Google Scholar. In total, 37 samples were included for the meta-analysis with a total of 4,443 patients. The primary outcome was the standardized mean differences in clinical status measured by symptomatic and functional measures.
Results: The meta-analysis of 22 samples without a control group resulted in the upper end of the medium effect size for the overall effect of treatment during psychiatric hospitalization that included psychotherapy (k = 22, Cohen's d = 0.70, and 95% Cl 0.36 to 1.04). The meta-analysis of 15 samples with a control group resulted in the upper end of the low effect size for the contribution of psychotherapy to the improvement of patients' clinical status measured by symptomatic and functional measures (k = 15, Cohen's d = 0.43, and 95% CI 0.06 to 0.81). No significant effects were uncovered for psychotherapy orientation. Diagnosis was found to moderate the contribution of psychotherapy in an inpatient setting to the improvement of patients' clinical condition.
Conclusion: Psychotherapy during psychiatric hospitalization may be an effective treatment. Across the various samples, psychotherapy has a moderate effect on the reduction of psychiatric symptoms beyond the overall effect of ward treatment.
目的:本荟萃分析探讨心理治疗在精神病住院期间的疗效，并探讨诊断和治疗方法的调节作用。方法:系统检索PubMed、PsycInfo、Google Scholar等文献数据库。总共有37个样本被纳入meta分析，共4443名患者。主要结果是通过症状和功能测量测量的临床状态的标准化平均差异。结果:在没有对照组的22个样本的荟萃分析中，包括心理治疗在内的精神科住院期间治疗的总体效果达到了中等效应量的上限(k = 22, Cohen’s d = 0.70, 95% Cl = 0.36至1.04)。对15个样本和对照组进行荟萃分析，结果显示心理治疗对通过症状和功能测量测量的患者临床状态改善的贡献达到低效应量的上限(k = 15, Cohen’s d = 0.43, 95% CI 0.06 ~ 0.81)。没有发现心理治疗取向的显著影响。诊断被发现缓和了住院患者的心理治疗对患者临床状况改善的贡献。结论:精神科住院期间的心理治疗可能是有效的治疗方法。在不同的样本中，心理治疗对精神病症状的减轻有中等效果，超出了病房治疗的总体效果。
{"title":"Meta-Analysis of the Effect of Psychotherapy in an Inpatient Setting: Examining the Moderating Role of Diagnosis and Therapeutic Approach.","authors":"Yael Cohen-Chazani, Michal Lavidor, Eva Gilboa-Schechtman, David Roe, Ilanit Hasson-Ohayon","doi":"10.1080/00332747.2022.2062660","DOIUrl":"https://doi.org/10.1080/00332747.2022.2062660","url":null,"abstract":"<p><strong>Objective: </strong>The current meta-analysis investigates the efficacy of psychotherapy during psychiatric hospitalization and examines the moderating role of diagnosis and therapeutic approach.</p><p><strong>Methods: </strong>We conducted systematic searches in literature databases, including PubMed, PsycInfo, and Google Scholar. In total, 37 samples were included for the meta-analysis with a total of 4,443 patients. The primary outcome was the standardized mean differences in clinical status measured by symptomatic and functional measures.</p><p><strong>Results: </strong>The meta-analysis of 22 samples without a control group resulted in the upper end of the medium effect size for the overall effect of treatment during psychiatric hospitalization that included psychotherapy (k = 22, Cohen's d = 0.70, and 95% Cl 0.36 to 1.04). The meta-analysis of 15 samples with a control group resulted in the upper end of the low effect size for the contribution of psychotherapy to the improvement of patients' clinical status measured by symptomatic and functional measures (k = 15, Cohen's d = 0.43, and 95% CI 0.06 to 0.81). No significant effects were uncovered for psychotherapy orientation. Diagnosis was found to moderate the contribution of psychotherapy in an inpatient setting to the improvement of patients' clinical condition.</p><p><strong>Conclusion: </strong>Psychotherapy during psychiatric hospitalization may be an effective treatment. Across the various samples, psychotherapy has a moderate effect on the reduction of psychiatric symptoms beyond the overall effect of ward treatment.</p>","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"399-417"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10727363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2022.2132774
Marjan Ghahramanlou-Holloway
Just-In-Time Adaptive Interventions (JITAIs) for suicide prevention, using mobile health (mHealth) technologies including wearables, are the focus of an article recently written by Coppersmith et al. (2022) in Psychiatry: Interpersonal and Biological Processes. As a clinical psychologist with nearly two decades of professional experience in treating individuals with suicidal thoughts and behaviors (STBs), training mental health providers in the delivery of evidence-informed and evidencebased suicide-focused care, and conducting research to advance suicide prevention and intervention science, I am eager to write this commentary to share some of my thoughts on the topic. Before doing so, I must commend my colleagues for offering an informative, comprehensive, and captivating seminal manuscript which I am confident will be well-cited and relied upon in the years to come. As we collectively enter the brave new world of JITAIs for suicide prevention and evolve our thinking and practices in the use of technology and its applications, several important considerations must be taken into account. These are highlighted below. “STAY HUNGRY. STAY FOOLISH.”
{"title":"Entering the Brave New World of Just-In-Time Adaptive Interventions for Suicide Prevention.","authors":"Marjan Ghahramanlou-Holloway","doi":"10.1080/00332747.2022.2132774","DOIUrl":"https://doi.org/10.1080/00332747.2022.2132774","url":null,"abstract":"Just-In-Time Adaptive Interventions (JITAIs) for suicide prevention, using mobile health (mHealth) technologies including wearables, are the focus of an article recently written by Coppersmith et al. (2022) in Psychiatry: Interpersonal and Biological Processes. As a clinical psychologist with nearly two decades of professional experience in treating individuals with suicidal thoughts and behaviors (STBs), training mental health providers in the delivery of evidence-informed and evidencebased suicide-focused care, and conducting research to advance suicide prevention and intervention science, I am eager to write this commentary to share some of my thoughts on the topic. Before doing so, I must commend my colleagues for offering an informative, comprehensive, and captivating seminal manuscript which I am confident will be well-cited and relied upon in the years to come. As we collectively enter the brave new world of JITAIs for suicide prevention and evolve our thinking and practices in the use of technology and its applications, several important considerations must be taken into account. These are highlighted below. “STAY HUNGRY. STAY FOOLISH.”","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"336-340"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2022.2132772
Peter M Gutierrez
This article by Coppersmith and colleagues tackles a vexing problem within the field of suicide prevention. Although suicide is a major public health concern, suicide-specific behaviors are difficult to predict, effective interventions are limited, few practitioners are trained in them, and many individuals at risk of suicide never receive any treatment. These are all issues the authors clearly explain in the introduction. The field also spent more time than was likely ideal focused on assessing risk and protective factors for suicide and too little time developing and testing suicide-specific interventions. This fact may be one reason why suicide rates within the United States have been stubbornly resistance to reduction over many decades. More recent attention has been paid to the many other factors contributing to the ongoing problem of suicide that must be addressed through means other than clinical interventions. If suicide is treated as the public health crisis that it is, through community-based interventions targeting a broad range of upstream distal contributors to suicide, then the capacity of clinicians to effectively treat those in crisis will not be exceeded. The impact of JITAIs, if effective, on overall suicide rates will likely never be large. But when combined with broad public health interventions they can be a vital component of the overall solution to the problem. And, as the authors clearly explain, there are many challenges which must be addressed before JITAIs can be tested with individuals at risk of suicide. The most significant one, or at least the one that must be tackled first, are the assessment methods used to create the tailoring variable. Currently there are no self-report measures of suicide-specific thoughts and behaviors with sufficient positive and negative predictive power to be used for this purpose. More frequent administration of self-report measures may partially mitigate this problem, but it seems unlikely that will be the ultimate solution. Passive monitoring of physiological correlates of suicide risk is an intriguing idea, and there are some candidate markers worth considering, but work in that area is either purely theoretical (e.g., eye blink rate) or very preliminary (e.g., geolocation of mobility and social contacts). It seems likely that multiple risk data sources will need to be combined and probably differentially weighted to generate a clinically useful risk stratification score used for the tailoring variable. Accomplishing that in real time and in a fully automated fashion will be no small feat.
{"title":"Promising New Directions in Addressing the Whole Problem of Suicide.","authors":"Peter M Gutierrez","doi":"10.1080/00332747.2022.2132772","DOIUrl":"https://doi.org/10.1080/00332747.2022.2132772","url":null,"abstract":"This article by Coppersmith and colleagues tackles a vexing problem within the field of suicide prevention. Although suicide is a major public health concern, suicide-specific behaviors are difficult to predict, effective interventions are limited, few practitioners are trained in them, and many individuals at risk of suicide never receive any treatment. These are all issues the authors clearly explain in the introduction. The field also spent more time than was likely ideal focused on assessing risk and protective factors for suicide and too little time developing and testing suicide-specific interventions. This fact may be one reason why suicide rates within the United States have been stubbornly resistance to reduction over many decades. More recent attention has been paid to the many other factors contributing to the ongoing problem of suicide that must be addressed through means other than clinical interventions. If suicide is treated as the public health crisis that it is, through community-based interventions targeting a broad range of upstream distal contributors to suicide, then the capacity of clinicians to effectively treat those in crisis will not be exceeded. The impact of JITAIs, if effective, on overall suicide rates will likely never be large. But when combined with broad public health interventions they can be a vital component of the overall solution to the problem. And, as the authors clearly explain, there are many challenges which must be addressed before JITAIs can be tested with individuals at risk of suicide. The most significant one, or at least the one that must be tackled first, are the assessment methods used to create the tailoring variable. Currently there are no self-report measures of suicide-specific thoughts and behaviors with sufficient positive and negative predictive power to be used for this purpose. More frequent administration of self-report measures may partially mitigate this problem, but it seems unlikely that will be the ultimate solution. Passive monitoring of physiological correlates of suicide risk is an intriguing idea, and there are some candidate markers worth considering, but work in that area is either purely theoretical (e.g., eye blink rate) or very preliminary (e.g., geolocation of mobility and social contacts). It seems likely that multiple risk data sources will need to be combined and probably differentially weighted to generate a clinically useful risk stratification score used for the tailoring variable. Accomplishing that in real time and in a fully automated fashion will be no small feat.","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"334-335"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1080/00332747.2022.2134681
James C West, Adam Walsh, Joshua C Morganstein
In the article “Just-in-Time Adaptive Interventions for Prevention: Promise, Challenges, and Future Directions,” Coppersmith and colleagues provide a theoretical framework for leveraging advanced digital technologies to improve suicide risk detection and intervention through just-in-time adaptive interventions (JITAIs; Coppersmith et al., 2022). In the following commentary, we will address several key issues the article raises and provide a holistic and pragmatic framework to further analyze the main tenets of the article. According to the Centers for Disease Control, Suicide claims a life in the US approximately every 11 minutes (Centers for Disease Control and Prevention, 2021). Over the last several decades, there has been growing interest and investment in developing strategies and interventions to drive down the number of suicide deaths (Action Alliance, 2012). Unfortunately, suicide is a vexing problem to solve, and many of the interventions and strategies deployed to prevent suicide have yet to produce significant declines in suicide rates. At the center of this vexing problem is not knowing precisely who is contemplating suicide, when the person is thinking of attempting suicide and how to best reach out and help the person who is considering suicide. Recent studies indicate that over half of clinical patients who attempt or die by suicide screen negative for suicide ideation (Bryan, Thomsen, et al., 2022), and 95% of individuals who think of suicide do not attempt or die by suicide (Bryan, 2022). Further complicating the identification of people who may be at risk for suicide is how quickly many individuals progress from thinking about suicide to acting on it. Study findings show that many individuals transition from thinking about suicide within 10 minutes (Deisenhammer et al., 2009; Simon et al., 2001). Therefore, novel approaches to swiftly identify individuals who are contemplating suicide that do not rely on self-report of suicide ideation are urgently needed. In the current article by Coppersmith and colleagues, the authors posit several novel “wearable” technology approaches that aim to formulate digital phenotypes and address the challenge of identifying individuals who may be at risk for suicide, in-real-time. Another main point of the article by Coppersmith and colleagues is how to best, in-situ, provide help to individuals who exhibit physical changes measured by wearable device or information reported via smartphone or web-based interactions that identify potential risk of suicide. Providing help to those in suicide crisis can be challenging. Often, individuals who are experiencing an acute suicidal crisis do not think about needing help (Bryan, Bryan, et al., 2022), cannot physically access mental health care due to
{"title":"Just-in-Time Adaptive Interventions for Suicide: the Right Idea at the Right Time.","authors":"James C West, Adam Walsh, Joshua C Morganstein","doi":"10.1080/00332747.2022.2134681","DOIUrl":"https://doi.org/10.1080/00332747.2022.2134681","url":null,"abstract":"In the article “Just-in-Time Adaptive Interventions for Prevention: Promise, Challenges, and Future Directions,” Coppersmith and colleagues provide a theoretical framework for leveraging advanced digital technologies to improve suicide risk detection and intervention through just-in-time adaptive interventions (JITAIs; Coppersmith et al., 2022). In the following commentary, we will address several key issues the article raises and provide a holistic and pragmatic framework to further analyze the main tenets of the article. According to the Centers for Disease Control, Suicide claims a life in the US approximately every 11 minutes (Centers for Disease Control and Prevention, 2021). Over the last several decades, there has been growing interest and investment in developing strategies and interventions to drive down the number of suicide deaths (Action Alliance, 2012). Unfortunately, suicide is a vexing problem to solve, and many of the interventions and strategies deployed to prevent suicide have yet to produce significant declines in suicide rates. At the center of this vexing problem is not knowing precisely who is contemplating suicide, when the person is thinking of attempting suicide and how to best reach out and help the person who is considering suicide. Recent studies indicate that over half of clinical patients who attempt or die by suicide screen negative for suicide ideation (Bryan, Thomsen, et al., 2022), and 95% of individuals who think of suicide do not attempt or die by suicide (Bryan, 2022). Further complicating the identification of people who may be at risk for suicide is how quickly many individuals progress from thinking about suicide to acting on it. Study findings show that many individuals transition from thinking about suicide within 10 minutes (Deisenhammer et al., 2009; Simon et al., 2001). Therefore, novel approaches to swiftly identify individuals who are contemplating suicide that do not rely on self-report of suicide ideation are urgently needed. In the current article by Coppersmith and colleagues, the authors posit several novel “wearable” technology approaches that aim to formulate digital phenotypes and address the challenge of identifying individuals who may be at risk for suicide, in-real-time. Another main point of the article by Coppersmith and colleagues is how to best, in-situ, provide help to individuals who exhibit physical changes measured by wearable device or information reported via smartphone or web-based interactions that identify potential risk of suicide. Providing help to those in suicide crisis can be challenging. Often, individuals who are experiencing an acute suicidal crisis do not think about needing help (Bryan, Bryan, et al., 2022), cannot physically access mental health care due to","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"85 4","pages":"347-353"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-09-18DOI: 10.1080/00332747.2020.1800291
Emily Weitzel, Caroline Hopper, Del Herridge
Objective: Adult gang members have higher substance misuse and Adverse Childhood Experiences (ACE) prevalence than non-gang involved individuals. The authors aimed to understand UK gang membership demographics and estimate substance misuse and ACE prevalence among a community-based sample of children and young people (CYP) contrasting three groups; gang members, periphery and non-gang involved.Method: The authors used the 2006 Offending, Crime and Justice Survey (OCJS) cross-sectional dataset, containing gang involvement, ACE exposure and substance misuse data, sampling 2,443 individuals aged 13-17 years. Gang membership was self-identified. Gang periphery was CYP identifying as gang involved according to the Eurogang Youth survey questionnaire, but not self-identifying as members. Other CYP were non-gang involved.Results: Gang periphery participants were significantly more likely to misuse all substance types than non-gang involved CYP. The substance misuse likelihood was greatest for gang peripherals, then members, then non-gang involved. Gang periphery and members were significantly more likely to have been a victim of serious assault, less serious assault, any assault, any violence and to have committed any violent act in the last year than non-gang involved.Conclusions: This is the first study comparing ACE exposure and substance misuse prevalence among the UK, community-based CYP sample. Current research highlights younger children with complex needs, including girls, risk gang involvement and requires tailored support to enable safe exit from gangs. Factors relating to gang involvement, ACEs and substance misuse are interlinked and complex, demanding a holistic approach to support across education, children's social services, health and criminal justice settings.
{"title":"Adolescent Gangs: Substance Misuse and Exposure to Adverse Childhood Experiences.","authors":"Emily Weitzel, Caroline Hopper, Del Herridge","doi":"10.1080/00332747.2020.1800291","DOIUrl":"https://doi.org/10.1080/00332747.2020.1800291","url":null,"abstract":"<p><p><i>Objective</i>: Adult gang members have higher substance misuse and Adverse Childhood Experiences (ACE) prevalence than non-gang involved individuals. The authors aimed to understand UK gang membership demographics and estimate substance misuse and ACE prevalence among a community-based sample of children and young people (CYP) contrasting three groups; gang members, periphery and non-gang involved.<i>Method</i>: The authors used the 2006 Offending, Crime and Justice Survey (OCJS) cross-sectional dataset, containing gang involvement, ACE exposure and substance misuse data, sampling 2,443 individuals aged 13-17 years. Gang membership was self-identified. Gang periphery was CYP identifying as gang involved according to the Eurogang Youth survey questionnaire, but not self-identifying as members. Other CYP were non-gang involved.<i>Results</i>: Gang periphery participants were significantly more likely to misuse all substance types than non-gang involved CYP. The substance misuse likelihood was greatest for gang peripherals, then members, then non-gang involved. Gang periphery and members were significantly more likely to have been a victim of serious assault, less serious assault, any assault, any violence and to have committed any violent act in the last year than non-gang involved.<i>Conclusions</i>: This is the first study comparing ACE exposure and substance misuse prevalence among the UK, community-based CYP sample. Current research highlights younger children with complex needs, including girls, risk gang involvement and requires tailored support to enable safe exit from gangs. Factors relating to gang involvement, ACEs and substance misuse are interlinked and complex, demanding a holistic approach to support across education, children's social services, health and criminal justice settings.</p>","PeriodicalId":49656,"journal":{"name":"Psychiatry-Interpersonal and Biological Processes","volume":"84 1","pages":"33-45"},"PeriodicalIF":2.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00332747.2020.1800291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38493929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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