Pub Date : 2024-08-26DOI: 10.1101/2024.08.24.24312532
Saskia Delray, Sube Banerjee, Sedigheh Zabihi, Madeline Walpert, Karen Harrison-Dening, Charlotte Kenten, Yvonne Birks, Clarissa Marie Giebel, Mohammed Akhlak Rauf, Sally Reynolds, Claudia Cooper
Background: Very many social care clients have dementia, but few social care workers receive dementia-specific training. Objective: To systematically review dementia training interventions for social care, review past policies and hold stakeholder workshops considering how future policy can support quality dementia training in social care. Methods: We searched electronic databases, November 2015 to February 2024, including studies describing dementia training and support interventions for social care workers, assessing risk of bias with the Mixed Methods Appraisal Tool. We reviewed English policies January 2015 to April 2024 to identify social and policy contexts relevant to dementia training. We consulted home care and care home stakeholders regarding how findings could inform future policy. Results: We included 56 studies (50 in care homes, 6 in home care). There was good quality evidence that dementia training interventions in care homes that engaged staff champions to integrate practice-based learning reduced agitation, neuropsychiatric symptoms and antipsychotic prescribing and improved life quality of residents with dementia. One study found this approach was cost-effective. In home care, evidence was limited; group training was valued, and improved staff sense of dementia care competence in one study. We identified 27 policies and related documents; and consulted 18 stakeholders. Stakeholders supported mandatory dementia training but considered implementation very challenging in current economic contexts. Conclusions: We found strong evidence for dementia training in care homes, but a relative lack of research in home care. Policy options identified to implement evidence require investment, which could deliver substantial savings across health and social care.
{"title":"Systematic policy and evidence review to consider how dementia education and training is best delivered in the social care workforce, and how policy does or can enable its implementation in England","authors":"Saskia Delray, Sube Banerjee, Sedigheh Zabihi, Madeline Walpert, Karen Harrison-Dening, Charlotte Kenten, Yvonne Birks, Clarissa Marie Giebel, Mohammed Akhlak Rauf, Sally Reynolds, Claudia Cooper","doi":"10.1101/2024.08.24.24312532","DOIUrl":"https://doi.org/10.1101/2024.08.24.24312532","url":null,"abstract":"Background: Very many social care clients have dementia, but few social care workers receive dementia-specific training. Objective: To systematically review dementia training interventions for social care, review past policies and hold stakeholder workshops considering how future policy can support quality dementia training in social care. Methods: We searched electronic databases, November 2015 to February 2024, including studies describing dementia training and support interventions for social care workers, assessing risk of bias with the Mixed Methods Appraisal Tool. We reviewed English policies January 2015 to April 2024 to identify social and policy contexts relevant to dementia training. We consulted home care and care home stakeholders regarding how findings could inform future policy. Results: We included 56 studies (50 in care homes, 6 in home care). There was good quality evidence that dementia training interventions in care homes that engaged staff champions to integrate practice-based learning reduced agitation, neuropsychiatric symptoms and antipsychotic prescribing and improved life quality of residents with dementia. One study found this approach was cost-effective. In home care, evidence was limited; group training was valued, and improved staff sense of dementia care competence in one study. We identified 27 policies and related documents; and consulted 18 stakeholders. Stakeholders supported mandatory dementia training but considered implementation very challenging in current economic contexts.\u0000Conclusions: We found strong evidence for dementia training in care homes, but a relative lack of research in home care. Policy options identified to implement evidence require investment, which could deliver substantial savings across health and social care.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"192 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1101/2024.08.25.24312468
Nicole Shu En Goh, Christian Morgenstern, Alex Jie Wei Yap, Stanford Chun Yin Wong, Mythily Subramaniam, Edimansyah Bin Abdin, David Chien Boon Lye, Kelvin Bryan Tan, Sharon Hui Xuan Tan
Background In the sphere of mental health, little population wide-scale research has been done in Asia on the pandemic's differential impacts on different sociodemographic groups over time. Methods This study evaluates symptoms of anxiety and depression within different age groups in Singapore across different pandemic phases. Symptoms of depression and anxiety were measured using the Patient Health Questionnaire-4 (PHQ-4), in which higher scores indicate more symptoms and lower scores indicate less. Cross-sectional data from 34,429 individuals aged 18 years and above in Singapore between 27 April 2020 and 27 September 2021 were analyzed. Multivariable logistic and linear regression were performed on PHQ-4 scores over pandemic phases and by age. Findings Overall symptoms of depression and anxiety did not vary significantly across pandemic phases in Singapore. However, compared to Circuit Breaker, younger age groups reported higher PHQ-4 scores as restrictions lifted (ages 18-29: beta (β)=0.59, 95% CI [0.22, 0.97]; ages 30-39: β=0.44, 95% CI [0.08, 0.80]), while older adults reported lower scores (ages 50-59: β=-0.45, 95% CI [-0.80, -0.10]; ages 60 and above: β=-0.38, 95% CI [-0.73, -0.02]). This was associated with more symptoms of anxiety among younger adults, and less symptoms of depression and anxiety among older adults. Interpretation In Singapore, psychological responses to pandemic restrictions may be heterogenous across different age groups and across time. The study can inform policymakers' decisions in distributing mental health resources during a crisis. Funding The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
背景在心理健康领域，亚洲几乎没有针对大流行病在不同时期对不同社会人口群体造成的不同影响进行过大规模的研究。本研究评估了新加坡不同年龄段人群在不同大流行阶段的焦虑和抑郁症状。抑郁和焦虑症状采用病人健康问卷-4（PHQ-4）进行测量，得分越高表示症状越多，得分越低表示症状越少。分析了 2020 年 4 月 27 日至 2021 年 9 月 27 日期间新加坡 34,429 名 18 岁及以上人士的横断面数据。对不同流行阶段和不同年龄段的 PHQ-4 分数进行了多变量逻辑回归和线性回归。研究结果在新加坡，不同大流行阶段的抑郁和焦虑症状没有明显差异。然而，与 "断路器 "阶段相比，随着限制的解除，年轻年龄组的 PHQ-4 分数更高（18-29 岁：β (β)=0.59, 95% CI [0.22, 0.97]；30-39 岁：β=0.44，95% CI [0.08，0.80]），而老年人的得分较低（50-59 岁：β=-0.45，95% CI [-0.80，-0.10]；60 岁及以上：β=-0.38，95% CI [-0.73，-0.02]）。这与年轻人焦虑症状较多、老年人抑郁和焦虑症状较少有关。解释在新加坡，不同年龄组和不同时间段对大流行病限制的心理反应可能是不同的。这项研究可为决策者在危机期间分配心理健康资源的决策提供参考。经费资助资助方未参与研究设计、数据收集、数据分析、数据解释或报告撰写。
{"title":"Inequalities in Mental Health: Age-related Trends Across Pandemic Phases in Singapore","authors":"Nicole Shu En Goh, Christian Morgenstern, Alex Jie Wei Yap, Stanford Chun Yin Wong, Mythily Subramaniam, Edimansyah Bin Abdin, David Chien Boon Lye, Kelvin Bryan Tan, Sharon Hui Xuan Tan","doi":"10.1101/2024.08.25.24312468","DOIUrl":"https://doi.org/10.1101/2024.08.25.24312468","url":null,"abstract":"<em>Background</em>\u0000In the sphere of mental health, little population wide-scale research has been done in Asia on the pandemic's differential impacts on different sociodemographic groups over time. <em>Methods</em>\u0000This study evaluates symptoms of anxiety and depression within different age groups in Singapore across different pandemic phases. Symptoms of depression and anxiety were measured using the Patient Health Questionnaire-4 (PHQ-4), in which higher scores indicate more symptoms and lower scores indicate less. Cross-sectional data from 34,429 individuals aged 18 years and above in Singapore between 27 April 2020 and 27 September 2021 were analyzed. Multivariable logistic and linear regression were performed on PHQ-4 scores over pandemic phases and by age. <em>Findings</em>\u0000Overall symptoms of depression and anxiety did not vary significantly across pandemic phases in Singapore. However, compared to Circuit Breaker, younger age groups reported higher PHQ-4 scores as restrictions lifted <em>(ages 18-29: beta (β)=0.59, 95% CI [0.22, 0.97]; ages 30-39: β=0.44, 95% CI [0.08, 0.80])</em>, while older adults reported lower scores <em>(ages 50-59: β=-0.45, 95% CI [-0.80, -0.10]; ages 60 and above: β=-0.38, 95% CI [-0.73, -0.02])</em>. This was associated with more symptoms of anxiety among younger adults, and less symptoms of depression and anxiety among older adults. <em>Interpretation</em>\u0000In Singapore, psychological responses to pandemic restrictions may be heterogenous across different age groups and across time. The study can inform policymakers' decisions in distributing mental health resources during a crisis. <em>Funding</em>\u0000The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bangladesh is experiencing rapid urbanization and an increasing elderly population, particularly in urban areas. Cognitive decline is a common issue among elderly populations worldwide. This study aims to investigate the current state of cognitive decline among urban-dwelling older adults in Bangladesh to inform effective healthcare plans and programs. This cross-sectional study employed systematic random sampling among 150 participants at the outpatient department of NITOR in Dhaka, Bangladesh. Data were collected using a pretested structured standard questionnaire, and cognitive function was assessed with the Rowland Universal Dementia Assessment Scale (RUDAS). The study revealed a linear association between cognitive function and factors such as level of educational status, and history of eye sight problem. Conversely, age and diabetes showed an adverse correlation with cognitive function. Moreover, factors such as age, educational level and diabetes remained significant predictors of cognitive function in multivariate analysis. Cognitive impairment is significantly more common among the elderly in Bangladesh, with cognitive abilities being affected by a range of factors such as age, education level, diabetes, and vision issues.
{"title":"Level of Cognitive Functioning among Elderly Patients in Urban area of Bangladesh: A Cross-Sectional Study","authors":"Joynal Abedin Imran, Pradip Kumar Saha, Marzana Afrooj Ria, Syeda Saika Sarwar, Jannatul Ferdous Konok","doi":"10.1101/2024.08.22.24312384","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312384","url":null,"abstract":"Bangladesh is experiencing rapid urbanization and an increasing elderly population, particularly in urban areas. Cognitive decline is a common issue among elderly populations worldwide. This study aims to investigate the current state of cognitive decline among urban-dwelling older adults in Bangladesh to inform effective healthcare plans and programs. This cross-sectional study employed systematic random sampling among 150 participants at the outpatient department of NITOR in Dhaka, Bangladesh. Data were collected using a pretested structured standard questionnaire, and cognitive function was assessed with the Rowland Universal Dementia Assessment Scale (RUDAS). The study revealed a linear association between cognitive function and factors such as level of educational status, and history of eye sight problem. Conversely, age and diabetes showed an adverse correlation with cognitive function. Moreover, factors such as age, educational level and diabetes remained significant predictors of cognitive function in multivariate analysis. Cognitive impairment is significantly more common among the elderly in Bangladesh, with cognitive abilities being affected by a range of factors such as age, education level, diabetes, and vision issues.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1101/2024.08.21.24312402
Siyuan Zhang, Shuting Yu, Xiaobing Cui, Xuebing Li
The current study examined resting-state and event-related neural oscillations associated with ADHD symptoms in children aged 6-12. 77 children were assessed using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) and EEG during resting-state. A group of these children also completed a classic visual oddball task. Key findings include increased relative delta activity at left parietal electrodes during eyes-open and decreased relative theta activity at left posterior electrodes during eyes-closed, both associated with poor attention. Increased beta activity at right parieto-occipital electrodes during eyes-open and increased alpha activity at bilateral posterior electrodes during eyes-closed were associated with poor response control. In addition, the power of the P3 component was negatively correlated with attention across most frequency bands and conditions, except for delta power in the standard condition. Furthermore, combining multiple metrics, especially resting-state EEG oscillations, event-related oscillations, and parental ratings, provided a more robust prediction. The current study identified important brain regions and frequency bands related to ADHD symptoms, offering new insights for multi-metric prediction and clinical guidance.
{"title":"Neural Oscillation Features of ADHD Symptoms in Children: EEG Evidence from Resting State and Oddball Task","authors":"Siyuan Zhang, Shuting Yu, Xiaobing Cui, Xuebing Li","doi":"10.1101/2024.08.21.24312402","DOIUrl":"https://doi.org/10.1101/2024.08.21.24312402","url":null,"abstract":"The current study examined resting-state and event-related neural oscillations associated with ADHD symptoms in children aged 6-12. 77 children were assessed using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) and EEG during resting-state. A group of these children also completed a classic visual oddball task. Key findings include increased relative delta activity at left parietal electrodes during eyes-open and decreased relative theta activity at left posterior electrodes during eyes-closed, both associated with poor attention. Increased beta activity at right parieto-occipital electrodes during eyes-open and increased alpha activity at bilateral posterior electrodes during eyes-closed were associated with poor response control. In addition, the power of the P3 component was negatively correlated with attention across most frequency bands and conditions, except for delta power in the standard condition. Furthermore, combining multiple metrics, especially resting-state EEG oscillations, event-related oscillations, and parental ratings, provided a more robust prediction. The current study identified important brain regions and frequency bands related to ADHD symptoms, offering new insights for multi-metric prediction and clinical guidance.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1101/2024.08.22.24312419
Deepan Singh, Theresa Jacob, Michael Silver
Introduction: Prader-Willi Syndrome (PWS), a rare genetic disorder, affects development and behavior, frequently resulting in self-injury, aggression, hyperphagia, oppositional behavior, impulsivity and over-activity causing significant morbidity. Currently, limited therapeutic options are available to manage these neuropsychiatric manifestations. The aim of this clinical trial was to assess the efficacy of guanfacine-extended release (GXR) in reducing aggression and self-injury in individuals with PWS. Trial Design: Randomized, double-blind, placebo-controlled trial conducted under IRB approval. Methods: Subjects with a diagnosis of PWS, 6-35 years of age, with moderate to severe aggressive and/or self-injurious behavior as determined by the Clinical Global Impression (CGI)-Severity scale, were included in an 8-week double-blind, placebo-controlled, fixed-flexible dose clinical trial of GXR, that was followed by an 8-week open-label extension phase. Validated behavioral instruments and physician assessments measured the efficacy of GXR treatment, its safety and tolerability. Results: GXR was effective in reducing aggression/agitation and hyperactivity/noncompliance as measured by the Aberrant Behavior Checklist (ABC) scales (p=0.03). Overall aberrant behavior scores significantly reduced in the GXR arm. Aggression as measured by the Modified Overt Aggression Scale (MOAS) also showed a significant reduction. Skin-picking lesions as measured by the Self Injury Trauma (SIT) scale decreased in response to GXR. No serious adverse events were experienced by any of the study participants. Fatigue /sedation was the only adverse event significantly associated with GXR. The GXR group demonstrated significant overall clinical improvement as measured by the CGI-Improvement (CGI-I) scale. (p<0.01). Conclusion: Findings of this pragmatic trial strongly support the use of GXR for treatment of aggression, skin picking, and hyperactivity in children, adolescents, and adults with PWS. Trial Registration: ClinicalTrials.gov Identifier - NCT05657860
{"title":"A randomized double-blind placebo-controlled clinical trial of Guanfacine Extended Release for aggression and self-injurious behavior associated with Prader-Willi Syndrome","authors":"Deepan Singh, Theresa Jacob, Michael Silver","doi":"10.1101/2024.08.22.24312419","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312419","url":null,"abstract":"Introduction: Prader-Willi Syndrome (PWS), a rare genetic disorder, affects development and behavior, frequently resulting in self-injury, aggression, hyperphagia, oppositional behavior, impulsivity and over-activity causing significant morbidity. Currently, limited therapeutic options are available to manage these neuropsychiatric manifestations. The aim of this clinical trial was to assess the efficacy of guanfacine-extended release (GXR) in reducing aggression and self-injury in individuals with PWS. Trial Design: Randomized, double-blind, placebo-controlled trial conducted under IRB approval. Methods: Subjects with a diagnosis of PWS, 6-35 years of age, with moderate to severe aggressive and/or self-injurious behavior as determined by the Clinical Global Impression (CGI)-Severity scale, were included in an 8-week double-blind, placebo-controlled, fixed-flexible dose clinical trial of GXR, that was followed by an 8-week open-label extension phase. Validated behavioral instruments and physician assessments measured the efficacy of GXR treatment, its safety and tolerability. Results: GXR was effective in reducing aggression/agitation and hyperactivity/noncompliance as measured by the Aberrant Behavior Checklist (ABC) scales (p=0.03). Overall aberrant behavior scores significantly reduced in the GXR arm. Aggression as measured by the Modified Overt Aggression Scale (MOAS) also showed a significant reduction. Skin-picking lesions as measured by the Self Injury Trauma (SIT) scale decreased in response to GXR. No serious adverse events were experienced by any of the study participants. Fatigue /sedation was the only adverse event significantly associated with GXR. The GXR group demonstrated significant overall clinical improvement as measured by the CGI-Improvement (CGI-I) scale. (p<0.01). Conclusion: Findings of this pragmatic trial strongly support the use of GXR for treatment of aggression, skin picking, and hyperactivity in children, adolescents, and adults with PWS.\u0000Trial Registration: ClinicalTrials.gov Identifier - NCT05657860","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1101/2024.08.21.24312389
Lauren Ng, Emily Adams, David Henderson, Eddie Donaghy, Stewart Mercer
Background Homelessness staff often experience high job demands, limited resources, and significant emotional strains; with high levels of burnout, stress, and trauma being common within the workforce. Despite growing recognition of these issues, limited information exists regarding interventions to address this. Aim To conduct a systematic scoping review of interventions aimed at improving well-being and reducing burnout among homelessness staff. Methods All eligible studies needed to include an intervention addressing burnout and/or well-being in homelessness staff, published in English with primary data. Evidence sources were left open with no data restrictions. Following a registered protocol (available at osf.io/jp5yx), a systematic search of five electronic databases (Medline, APA PsychInfo, Global Health, ASSIA, CINAHL) and Google Scholar was conducted. Studies were double-screened for inclusion. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Results Out of 5,775 screened studies, six met the inclusion criteria: two peer-reviewed and four non-peer-reviewed publications. No studies were retrieved from Google Scholar. The included studies comprised four quantitative non-randomised designs, one randomised controlled trial, and one mixed-methods study, with four being complex interventions. Three were therapy-based, two included supervision, and two comprised one-time educational sessions. Most were conducted in the United States (n=4), with two in the United Kingdom. The total pooled sample was 347 participants, though four studies were missing demographic data (age and gender). The studies used heterogenous measures and outcomes. Limitations included restrictions to English-only publications, potential gaps in capturing well-being measures, and a limited grey literature scope. Conclusion There is a lack of research on well-being and burnout interventions in frontline homelessness staff. Identified studies were generally of low quality with a heterogeneity of measures and outcomes used to assess well-being and burnout, limiting generalisability of findings. More robust study designs, along with standardised measures and outcomes, are needed going forwards.
{"title":"Interventions for burnout and well-being in homelessness staff: a systematic scoping review","authors":"Lauren Ng, Emily Adams, David Henderson, Eddie Donaghy, Stewart Mercer","doi":"10.1101/2024.08.21.24312389","DOIUrl":"https://doi.org/10.1101/2024.08.21.24312389","url":null,"abstract":"Background\u0000Homelessness staff often experience high job demands, limited resources, and significant emotional strains; with high levels of burnout, stress, and trauma being common within the workforce. Despite growing recognition of these issues, limited information exists regarding interventions to address this. Aim\u0000To conduct a systematic scoping review of interventions aimed at improving well-being and reducing burnout among homelessness staff. Methods\u0000All eligible studies needed to include an intervention addressing burnout and/or well-being in homelessness staff, published in English with primary data. Evidence sources were left open with no data restrictions. Following a registered protocol (available at osf.io/jp5yx), a systematic search of five electronic databases (Medline, APA PsychInfo, Global Health, ASSIA, CINAHL) and Google Scholar was conducted. Studies were double-screened for inclusion. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Results\u0000Out of 5,775 screened studies, six met the inclusion criteria: two peer-reviewed and four non-peer-reviewed publications. No studies were retrieved from Google Scholar. The included studies comprised four quantitative non-randomised designs, one randomised controlled trial, and one mixed-methods study, with four being complex interventions. Three were therapy-based, two included supervision, and two comprised one-time educational sessions. Most were conducted in the United States (n=4), with two in the United Kingdom. The total pooled sample was 347 participants, though four studies were missing demographic data (age and gender). The studies used heterogenous measures and outcomes. Limitations included restrictions to English-only publications, potential gaps in capturing well-being measures, and a limited grey literature scope. Conclusion\u0000There is a lack of research on well-being and burnout interventions in frontline homelessness staff. Identified studies were generally of low quality with a heterogeneity of measures and outcomes used to assess well-being and burnout, limiting generalisability of findings. More robust study designs, along with standardised measures and outcomes, are needed going forwards.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"699 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1101/2024.08.22.24312398
Daniel McDuff, Isaac Galatzer-Levy, Seamus Thomson Thomson, Andrew Barakat, Conor Heneghan, Samy Abdel-Ghaffar, Jake Sunshine, Ming-Zher Poh, Lindsey Sunden, John Hernandez, Allen Jiang, Xin Liu, Ari Winbush, Benjamin Nelson, Nicholas B Allen
Electrodermal activity (EDA) is a measure of sympathetic arousal that has been linked to depression in laboratory experiments. However, the inability to measure EDA passively over time and in the real-world has limited conclusions that can be drawn about EDA as an indicator of mental health status outside of controlled settings. Recent smartwatches have begun to incorporate wrist-worn continuous EDA sensors that enable longitudinal measurement of sympathetic arousal in every-day life. This work (N=237, 4-week observation period) examines the association between passively collected, diurnal variations in EDA and symptoms of depression, anxiety and perceived stress in a large community sample. Subjects who exhibited elevated depressive and anxiety symptoms had higher tonic EDA, skin temperature, and heart rate, despite not engaging in greater physical activity, compared to those that were not depressed or anxious. In contrast, subjects who exhibited elevated stress only exhibited higher skin temperature. Most strikingly, differences in EDA between those with high versus low symptoms were most prominent during the early morning. We did not observe amplitude or phase differences in the diurnal patterns. Our work suggests that electrodermal sensors may be practical and useful in measuring the physiological correlates of mental health symptoms in free-living contexts and that recent consumer smartwatches might be a tool for doing so.
{"title":"Evidence of Differences in Diurnal Electrodermal, Temperature, and Heart Rate Patterns by Mental Health Status in Free-Living Data","authors":"Daniel McDuff, Isaac Galatzer-Levy, Seamus Thomson Thomson, Andrew Barakat, Conor Heneghan, Samy Abdel-Ghaffar, Jake Sunshine, Ming-Zher Poh, Lindsey Sunden, John Hernandez, Allen Jiang, Xin Liu, Ari Winbush, Benjamin Nelson, Nicholas B Allen","doi":"10.1101/2024.08.22.24312398","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312398","url":null,"abstract":"Electrodermal activity (EDA) is a measure of sympathetic arousal that has been linked to depression in laboratory experiments. However, the inability to measure EDA passively over time and in the real-world has limited conclusions that can be drawn about EDA as an indicator of mental health status outside of controlled settings. Recent smartwatches have begun to incorporate wrist-worn continuous EDA sensors that enable longitudinal measurement of sympathetic arousal in every-day life. This work (N=237, 4-week observation period) examines the association between passively collected, diurnal variations in EDA and symptoms of depression, anxiety and perceived stress in a large community sample. Subjects who exhibited elevated depressive and anxiety symptoms had higher tonic EDA, skin temperature, and heart rate, despite not engaging in greater physical activity, compared to those that were not depressed or anxious. In contrast, subjects who exhibited elevated stress only exhibited higher skin temperature. Most strikingly, differences in EDA between those with high versus low symptoms were most prominent during the early morning. We did not observe amplitude or phase differences in the diurnal patterns. Our work suggests that electrodermal sensors may be practical and useful in measuring the physiological correlates of mental health symptoms in free-living contexts and that recent consumer smartwatches might be a tool for doing so.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-07DOI: 10.1101/2024.08.07.24311602
Mohammad Mahmud, Narayan Kuleindiren, Steph Suddell, Raphael Paul Rifkin-Zybutz, Parivrudh Sharma, Temidayo Osunronbi, Olivia Pounds, Hamzah Selim, Anushka Patchava, Aaron Lin, Ali Alim-Marvasti
Background: Digital health technologies are increasingly being used to monitor, assess, and treat depressive symptoms in the community. However, many such technologies rely on screening tools which were originally designed for use in primary care clinics, such as the Patient Health Questionnaire (PHQ-9). These scales are symptom-focused and do not capture the wider experiences of the patient. We developed a new screen for assessing depressive symptoms in a digital setting. Named the Mindstep Mood and Cause Examination (MMCE), it was designed to replicate the predictive capabilities of the PHQ-9, while improving user experience and capturing broader determinants of mental health. Method: This was a cross-sectional study, conducted fully remotely on Prolific. Participants (n=367) completed both the PHQ-9 and the MMCE, in a randomised order. Responses on the MMCE were examined for a range of psychometric properties, including: internal consistency, item selectivity, and convergence with PHQ-9 scores. User experience was assessed with a theory-led acceptability scale and compared across both mental health measures. Thematic analysis was used to analyse participants' free text responses, describing their experience of completing the scales. Results: The MMCE displayed good internal consistency and strong convergence with the PHQ-9 (r = 0.70), accounting for 49% of the variance in PHQ-9 scores. The MMCE also demonstrated robust predictive capability for the PHQ-9 using a moderate depression symptom cut-off of 10, with an Area Under Curve (AUC) of 0.84. In direct comparisons between the scales, 259 of 367 users (70.1%) preferred the MMCE and the MMCE outperformed the PHQ-9 in 8 out of 12 user experience categories. Conclusions: The MMCE has demonstrated validity in predicting PHQ-9 scores and offers an improved user experience, while additionally encouraging the user to examine the underlying causes of their depressive symptoms. However, additional research is necessary to evaluate the MMCE in terms of repeated assessments for effective depression monitoring.
{"title":"Mindstep Mood and Cause Examination (MMCE): The Preferred Tool for Remote Digital Depression Screening","authors":"Mohammad Mahmud, Narayan Kuleindiren, Steph Suddell, Raphael Paul Rifkin-Zybutz, Parivrudh Sharma, Temidayo Osunronbi, Olivia Pounds, Hamzah Selim, Anushka Patchava, Aaron Lin, Ali Alim-Marvasti","doi":"10.1101/2024.08.07.24311602","DOIUrl":"https://doi.org/10.1101/2024.08.07.24311602","url":null,"abstract":"Background: Digital health technologies are increasingly being used to monitor, assess, and treat depressive symptoms in the community. However, many such technologies rely on screening tools which were originally designed for use in primary care clinics, such as the Patient Health Questionnaire (PHQ-9). These scales are symptom-focused and do not capture the wider experiences of the patient. We developed a new screen for assessing depressive symptoms in a digital setting. Named the Mindstep Mood and Cause Examination (MMCE), it was designed to replicate the predictive capabilities of the PHQ-9, while improving user experience and capturing broader determinants of mental health. Method: This was a cross-sectional study, conducted fully remotely on Prolific. Participants (n=367) completed both the PHQ-9 and the MMCE, in a randomised order. Responses on the MMCE were examined for a range of psychometric properties, including: internal consistency, item selectivity, and convergence with PHQ-9 scores. User experience was assessed with a theory-led acceptability scale and compared across both mental health measures. Thematic analysis was used to analyse participants' free text responses, describing their experience of completing the scales. Results: The MMCE displayed good internal consistency and strong convergence with the PHQ-9 (r = 0.70), accounting for 49% of the variance in PHQ-9 scores. The MMCE also demonstrated robust predictive capability for the PHQ-9 using a moderate depression symptom cut-off of 10, with an Area Under Curve (AUC) of 0.84. In direct comparisons between the scales, 259 of 367 users (70.1%) preferred the MMCE and the MMCE outperformed the PHQ-9 in 8 out of 12 user experience categories. Conclusions: The MMCE has demonstrated validity in predicting PHQ-9 scores and offers an improved user experience, while additionally encouraging the user to examine the underlying causes of their depressive symptoms. However, additional research is necessary to evaluate the MMCE in terms of repeated assessments for effective depression monitoring.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141936742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: For young patients with depression, electroconvulsive therapy (ECT) is highly effective but causes acute cognitive side effects. We designed a new i-HECT therapy combines ECT with low-charge electrotherapy (LCE) and individual symptom monitoring to reduce cognitive impairments. Methods: i-HECT comprised two treatments: ECT and LCE. ECT utilized an energy set of 1.5 times the seizure threshold (ST), while LCE was set at 0.5 ST. The initial session employed ECT. Subsequent sessions involved ECT or LCE, depending on whether meeting the ECT-LCE transition criteria (MADRS total score < 22 or ≥ 50% reduction), assessed after each session. Results: The intention-to-treat analysis revealed an 80.4% response rate and a 58.7% remission rate (Hedges' g = 3.29). Notably, both subjective and objective cognitive functions significantly improved post-i-HECT treatments and during the 3-month follow-up periods. Conclusion: The i-HECT protocol may provide a rapid antidepressant treatment option with cognitive benefits for young depression patients.
{"title":"Individualized Hybrid Electroconvulsive Therapy (i-HECT) Shows Rapid Anti-Depressant Effect and Improved Cognition in Young Patients with Depression","authors":"Jing-ya Zhang, Lun Zeng, Jia Li, Mian-mian Chen, Shu-xian Xu, Baijian Tan, Xin-hui Xie","doi":"10.1101/2024.08.01.24311339","DOIUrl":"https://doi.org/10.1101/2024.08.01.24311339","url":null,"abstract":"Background: For young patients with depression, electroconvulsive therapy (ECT) is highly effective but causes acute cognitive side effects. We designed a new i-HECT therapy combines ECT with low-charge electrotherapy (LCE) and individual symptom monitoring to reduce cognitive impairments.\u0000Methods: i-HECT comprised two treatments: ECT and LCE. ECT utilized an energy set of 1.5 times the seizure threshold (ST), while LCE was set at 0.5 ST. The initial session employed ECT. Subsequent sessions involved ECT or LCE, depending on whether meeting the ECT-LCE transition criteria (MADRS total score < 22 or ≥ 50% reduction), assessed after each session. Results: The intention-to-treat analysis revealed an 80.4% response rate and a 58.7% remission rate (Hedges' g = 3.29). Notably, both subjective and objective cognitive functions significantly improved post-i-HECT treatments and during the 3-month follow-up periods. Conclusion: The i-HECT protocol may provide a rapid antidepressant treatment option with cognitive benefits for young depression patients.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141936846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-07DOI: 10.1101/2024.08.06.24311524
Konstantinos Kotsis, Graham Thornicroft, Julia Luiza Schafer, Aspasia Serdari, Maria Basta, Caio Borba Casella, Lauro Estivalete Marchionatti, Mauricio Scopel Hoffmann, Alexandra Tzotzi, Andromachi Mitropoulou, Andre Rafael Simioni, Katerina Papanikolaou, Anastasia Koumoula, Giovanni Abrahao Salum
Background: To improve access to mental health care for children and adolescents, it is necessary to identify the barriers faced by their caregivers. The aim of this study is to identify these barriers in Greece and to investigate the reliability and validity of the modified version of the Barriers to Access to Care Evaluation scale (BACE) - the BACE Proxy Report (BACE-PR). Methods: A total of 265 caregivers completed the BACE-PR. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate the factor structure of the instrument. Item parameters were assessed via Item Response Theory. Interpretability was assessed by linking summed scores to IRT-based scores. Results: Caregivers reported care costs as the major barrier to access. Obsessive compulsive symptoms and self-harm were the conditions for which caregivers reported the highest level of barriers. EFA and CFA suggested that a one-factor solution fit the data well (RMSEA = 0.048, CFI = 0.991, TLI = 0.990). Internal consistency was found to be high (ω=0.96). Average z-scores provided five meaningful levels of caregivers perceived barriers compared to the national average. Conclusions: Caregivers face a variety of barriers to access mental health care for their children and this could partly explain the treatment gap in the Greek mental health sector. Our study provides evidence for the reliability and validity of the BACE-PR scale, which can aid to identify caregiver-perceived barriers and to design interventions to improve access to mental health care.
{"title":"Barriers to Access to Care Evaluation Scale - Proxy Report (BACE-PR): evidence of reliability and validity for caregivers reporting on children and adolescents with mental health concerns in Greece.","authors":"Konstantinos Kotsis, Graham Thornicroft, Julia Luiza Schafer, Aspasia Serdari, Maria Basta, Caio Borba Casella, Lauro Estivalete Marchionatti, Mauricio Scopel Hoffmann, Alexandra Tzotzi, Andromachi Mitropoulou, Andre Rafael Simioni, Katerina Papanikolaou, Anastasia Koumoula, Giovanni Abrahao Salum","doi":"10.1101/2024.08.06.24311524","DOIUrl":"https://doi.org/10.1101/2024.08.06.24311524","url":null,"abstract":"Background: To improve access to mental health care for children and adolescents, it is necessary to identify the barriers faced by their caregivers. The aim of this study is to identify these barriers in Greece and to investigate the reliability and validity of the modified version of the Barriers to Access to Care Evaluation scale (BACE) - the BACE Proxy Report (BACE-PR).\u0000Methods: A total of 265 caregivers completed the BACE-PR. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate the factor structure of the instrument. Item parameters were assessed via Item Response Theory. Interpretability was assessed by linking summed scores to IRT-based scores.\u0000Results: Caregivers reported care costs as the major barrier to access. Obsessive compulsive symptoms and self-harm were the conditions for which caregivers reported the highest level of barriers. EFA and CFA suggested that a one-factor solution fit the data well (RMSEA = 0.048, CFI = 0.991, TLI = 0.990). Internal consistency was found to be high (ω=0.96). Average z-scores provided five meaningful levels of caregivers perceived barriers compared to the national average.\u0000Conclusions: Caregivers face a variety of barriers to access mental health care for their children and this could partly explain the treatment gap in the Greek mental health sector. Our study provides evidence for the reliability and validity of the BACE-PR scale, which can aid to identify caregiver-perceived barriers and to design interventions to improve access to mental health care.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"132 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141936740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：