A fully automated self-help biopsychosocial transdiagnostic digital intervention to reduce anxiety and/or depression and improve emotional regulation and well-being: pre-follow-up single-arm feasibility trial
- Klein, Britt, Nguyen, Huy, McLaren, Suzanne, Andrews, Brooke, Shandley, Kerrie
- Authors: Klein, Britt , Nguyen, Huy , McLaren, Suzanne , Andrews, Brooke , Shandley, Kerrie
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Formative Research Vol. 7, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety disorders and depression are prevalent disorders with high comorbidity, leading to greater chronicity and severity of symptoms. Given the accessibility to treatment issues, more evaluation is needed to assess the potential benefits of fully automated self-help transdiagnostic digital interventions. Innovating beyond the current transdiagnostic one-size-fits-all shared mechanistic approach may also lead to further improvements. Objective: The primary objective of this study was to explore the preliminary effectiveness and acceptability of a new fully automated self-help biopsychosocial transdiagnostic digital intervention (Life Flex) aimed at treating anxiety and/or depression, as well as improving emotional regulation; emotional, social, and psychological well-being; optimism; and health-related quality of life. Methods: This was a real-world pre-during-post-follow-up feasibility trial design evaluation of Life Flex. Participants were assessed at the preintervention time point (week 0), during intervention (weeks 3 and 5), at the postintervention time point (week 8), and at 1- and 3-month follow-ups (weeks 12 and 20, respectively). Results: The results provided early support for the Life Flex program in reducing anxiety (Generalized Anxiety Disorder 7), depression (Patient Health Questionnaire 9), psychological distress (Kessler 6), and emotional dysregulation (Difficulties in Emotional Regulation 36) and increasing emotional, social, and psychological well-being (Mental Health Continuum-Short Form); optimism (Revised Life Orientation Test); and health-related quality of life (EQ-5D-3L Utility Index and Health Rating; all false discovery rate [FDR] < .001). Large within-group treatment effect sizes (range |d|=0.82 to 1.33) were found for most variables from pre- to postintervention assessments and at the 1- and 3-month follow-up. The exceptions were medium treatment effect sizes for EQ-5D-3L Utility Index (range Cohen d=
- Authors: Klein, Britt , Nguyen, Huy , McLaren, Suzanne , Andrews, Brooke , Shandley, Kerrie
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Formative Research Vol. 7, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety disorders and depression are prevalent disorders with high comorbidity, leading to greater chronicity and severity of symptoms. Given the accessibility to treatment issues, more evaluation is needed to assess the potential benefits of fully automated self-help transdiagnostic digital interventions. Innovating beyond the current transdiagnostic one-size-fits-all shared mechanistic approach may also lead to further improvements. Objective: The primary objective of this study was to explore the preliminary effectiveness and acceptability of a new fully automated self-help biopsychosocial transdiagnostic digital intervention (Life Flex) aimed at treating anxiety and/or depression, as well as improving emotional regulation; emotional, social, and psychological well-being; optimism; and health-related quality of life. Methods: This was a real-world pre-during-post-follow-up feasibility trial design evaluation of Life Flex. Participants were assessed at the preintervention time point (week 0), during intervention (weeks 3 and 5), at the postintervention time point (week 8), and at 1- and 3-month follow-ups (weeks 12 and 20, respectively). Results: The results provided early support for the Life Flex program in reducing anxiety (Generalized Anxiety Disorder 7), depression (Patient Health Questionnaire 9), psychological distress (Kessler 6), and emotional dysregulation (Difficulties in Emotional Regulation 36) and increasing emotional, social, and psychological well-being (Mental Health Continuum-Short Form); optimism (Revised Life Orientation Test); and health-related quality of life (EQ-5D-3L Utility Index and Health Rating; all false discovery rate [FDR] < .001). Large within-group treatment effect sizes (range |d|=0.82 to 1.33) were found for most variables from pre- to postintervention assessments and at the 1- and 3-month follow-up. The exceptions were medium treatment effect sizes for EQ-5D-3L Utility Index (range Cohen d=
Acupuncture for comorbid depression and insomnia in perimenopause : a feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial
- Zhao, Fei, Zheng, Zhen, Fu, Qiang-Qiang, Conduit, Russell, Xu, Hong, Wang, Hui-ru, Huang, Yu-Ling, Jiang, Ting, Zhang, Wen-Jing, Kennedy, Gerard
- Authors: Zhao, Fei , Zheng, Zhen , Fu, Qiang-Qiang , Conduit, Russell , Xu, Hong , Wang, Hui-ru , Huang, Yu-Ling , Jiang, Ting , Zhang, Wen-Jing , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background and objective: Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Methods: Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfaction with the acupuncture treatment. Blood samples were taken to measure reproductive hormone levels. Intention-To-Treat and Per-Protocol analyses were conducted with linear mixed-effects models. The James' and Bang's blinding indices were used to assess the adequacy of blinding. Results: Sixty-five participants completed all treatment sessions, and 54 and 41 participants completed the eight- and 16-week follow-ups, respectively. At post-treatment and 8-week follow-up, the RA group showed a significantly greater reduction in PSQI scores than the SA group did; although the reduction of HAM-D17 scores in RA group was significant, the change was not statistically different from that of SA. There were no significant mean differences between baseline and 16-week follow-up in either HAM-D17 or PSQI in either group. There were no significant between-group differences in serum reproductive hormone levels. All treatments were tolerable and no serious adverse events were reported, and the blinding was successful. Conclusion: Acupuncture is safe and can contribute to clinically relevant improvements in comorbid PMD and PMI, with satisfactory short-and medium-term effects. Whether the anti-depressive benefit of acupuncture is specific or non-specific remains to be determined. No evidence was found for any longer-term benefit of acupuncture compared to sham at 16 weeks. Further research is required to elucidate mechanisms underlying the short to medium term effects of acupuncture. Copyright © 2023 Zhao, Zheng, Fu, Conduit, Xu, Wang, Huang, Jiang, Zhang and Kennedy.
- Authors: Zhao, Fei , Zheng, Zhen , Fu, Qiang-Qiang , Conduit, Russell , Xu, Hong , Wang, Hui-ru , Huang, Yu-Ling , Jiang, Ting , Zhang, Wen-Jing , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background and objective: Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Methods: Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfaction with the acupuncture treatment. Blood samples were taken to measure reproductive hormone levels. Intention-To-Treat and Per-Protocol analyses were conducted with linear mixed-effects models. The James' and Bang's blinding indices were used to assess the adequacy of blinding. Results: Sixty-five participants completed all treatment sessions, and 54 and 41 participants completed the eight- and 16-week follow-ups, respectively. At post-treatment and 8-week follow-up, the RA group showed a significantly greater reduction in PSQI scores than the SA group did; although the reduction of HAM-D17 scores in RA group was significant, the change was not statistically different from that of SA. There were no significant mean differences between baseline and 16-week follow-up in either HAM-D17 or PSQI in either group. There were no significant between-group differences in serum reproductive hormone levels. All treatments were tolerable and no serious adverse events were reported, and the blinding was successful. Conclusion: Acupuncture is safe and can contribute to clinically relevant improvements in comorbid PMD and PMI, with satisfactory short-and medium-term effects. Whether the anti-depressive benefit of acupuncture is specific or non-specific remains to be determined. No evidence was found for any longer-term benefit of acupuncture compared to sham at 16 weeks. Further research is required to elucidate mechanisms underlying the short to medium term effects of acupuncture. Copyright © 2023 Zhao, Zheng, Fu, Conduit, Xu, Wang, Huang, Jiang, Zhang and Kennedy.
An evaluation of low and high intensity digital mental health treatment models for anxiety and depression : an adaptive treatment randomized clinical trial
- Authors: Andrews, Brooke
- Date: 2023
- Type: Text , Thesis , PhD
- Full Text:
- Description: Doctor of Philsophy
- Authors: Andrews, Brooke
- Date: 2023
- Type: Text , Thesis , PhD
- Full Text:
- Description: Doctor of Philsophy
Associations between smartphone keystroke metadata and mental health symptoms in adolescents: findings from the future proofing study
- Braund, Taylor, O'Dea, Bridianne, Bal, Debopriyo, Maston, Kate, Larsen, Mark, Werner-Seidler, Aliza, Tillman, Gabriel, Christensen, Helen
- Authors: Braund, Taylor , O'Dea, Bridianne , Bal, Debopriyo , Maston, Kate , Larsen, Mark , Werner-Seidler, Aliza , Tillman, Gabriel , Christensen, Helen
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Mental Health Vol. 10, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Mental disorders are prevalent during adolescence. Among the digital phenotypes currently being developed to monitor mental health symptoms, typing behavior is one promising candidate. However, few studies have directly assessed associations between typing behavior and mental health symptom severity, and whether these relationships differs between genders. Objective: In a cross-sectional analysis of a large cohort, we tested whether various features of typing behavior derived from keystroke metadata were associated with mental health symptoms and whether these relationships differed between genders. Methods: A total of 934 adolescents from the Future Proofing study undertook 2 typing tasks on their smartphones through the Future Proofing app. Common keystroke timing and frequency features were extracted across tasks. Mental health symptoms were assessed using the Patient Health Questionnaire-Adolescent version, the Children's Anxiety Scale-Short Form, the Distress Questionnaire 5, and the Insomnia Severity Index. Bivariate correlations were used to test whether keystroke features were associated with mental health symptoms. The false discovery rates of P values were adjusted to q values. Machine learning models were trained and tested using independent samples (ie, 80% train 20% test) to identify whether keystroke features could be combined to predict mental health symptoms. Results: Keystroke timing features showed a weak negative association with mental health symptoms across participants. When split by gender, females showed weak negative relationships between keystroke timing features and mental health symptoms, and weak positive relationships between keystroke frequency features and mental health symptoms. The opposite relationships were found for males (except for dwell). Machine learning models using keystroke features alone did not predict mental health symptoms. Conclusions: Increased mental health symptoms are weakly associated with faster typing, with important gender differences. Keystroke metadata should be collected longitudinally and combined with other digital phenotypes to enhance their clinical relevance. ©Taylor A Braund, Bridianne O'Dea, Debopriyo Bal, Kate Maston, Mark Larsen, Aliza Werner-Seidler, Gabriel Tillman, Helen Christensen.
- Authors: Braund, Taylor , O'Dea, Bridianne , Bal, Debopriyo , Maston, Kate , Larsen, Mark , Werner-Seidler, Aliza , Tillman, Gabriel , Christensen, Helen
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Mental Health Vol. 10, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Mental disorders are prevalent during adolescence. Among the digital phenotypes currently being developed to monitor mental health symptoms, typing behavior is one promising candidate. However, few studies have directly assessed associations between typing behavior and mental health symptom severity, and whether these relationships differs between genders. Objective: In a cross-sectional analysis of a large cohort, we tested whether various features of typing behavior derived from keystroke metadata were associated with mental health symptoms and whether these relationships differed between genders. Methods: A total of 934 adolescents from the Future Proofing study undertook 2 typing tasks on their smartphones through the Future Proofing app. Common keystroke timing and frequency features were extracted across tasks. Mental health symptoms were assessed using the Patient Health Questionnaire-Adolescent version, the Children's Anxiety Scale-Short Form, the Distress Questionnaire 5, and the Insomnia Severity Index. Bivariate correlations were used to test whether keystroke features were associated with mental health symptoms. The false discovery rates of P values were adjusted to q values. Machine learning models were trained and tested using independent samples (ie, 80% train 20% test) to identify whether keystroke features could be combined to predict mental health symptoms. Results: Keystroke timing features showed a weak negative association with mental health symptoms across participants. When split by gender, females showed weak negative relationships between keystroke timing features and mental health symptoms, and weak positive relationships between keystroke frequency features and mental health symptoms. The opposite relationships were found for males (except for dwell). Machine learning models using keystroke features alone did not predict mental health symptoms. Conclusions: Increased mental health symptoms are weakly associated with faster typing, with important gender differences. Keystroke metadata should be collected longitudinally and combined with other digital phenotypes to enhance their clinical relevance. ©Taylor A Braund, Bridianne O'Dea, Debopriyo Bal, Kate Maston, Mark Larsen, Aliza Werner-Seidler, Gabriel Tillman, Helen Christensen.
Disordered social media use during COVID-19 predicts perceived stress and depression through indirect effects via fear of COVID-19
- Tillman, Gabriel, March, Evita, Lavender, Andrew, Braund, Taylor, Mesagno, Christopher
- Authors: Tillman, Gabriel , March, Evita , Lavender, Andrew , Braund, Taylor , Mesagno, Christopher
- Date: 2023
- Type: Text , Journal article
- Relation: Behavioral Sciences Vol. 13, no. 9 (2023), p.
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- Reviewed:
- Description: The 2019 novel coronavirus disease (COVID-19) is a global threat that can have an adverse effect on an individuals’ physical and mental health. Here, we investigate if disordered social media use predicts user stress and depression symptoms indirectly via fear of COVID-19. A total of 359 (timepoint 1 = 171, timepoint 2 = 188) participants were recruited via social media and snowball sampling. They completed an online survey that measured disordered social media use, fear of COVID-19, perceived stress, and depression symptomatology at two cross-sectional timepoints. We found that disordered social media use predicts depression indirectly through fear of COVID-19 at both timepoints. We also found that disordered social media use predicts perceived stress indirectly through fear of COVID-19, but only at timepoint 1. Taken together with previous research, our findings indicate that disordered social media use may lead to increased fear of COVID-19, which in turn may lead to poorer psychological wellbeing outcomes. Overall, there is evidence that the impact of the COVID-19 pandemic is affecting the physical, psychological, and emotional health of individuals worldwide. Moreover, this impact may be exacerbated by disordered use of social media. © 2023 by the authors.
- Authors: Tillman, Gabriel , March, Evita , Lavender, Andrew , Braund, Taylor , Mesagno, Christopher
- Date: 2023
- Type: Text , Journal article
- Relation: Behavioral Sciences Vol. 13, no. 9 (2023), p.
- Full Text:
- Reviewed:
- Description: The 2019 novel coronavirus disease (COVID-19) is a global threat that can have an adverse effect on an individuals’ physical and mental health. Here, we investigate if disordered social media use predicts user stress and depression symptoms indirectly via fear of COVID-19. A total of 359 (timepoint 1 = 171, timepoint 2 = 188) participants were recruited via social media and snowball sampling. They completed an online survey that measured disordered social media use, fear of COVID-19, perceived stress, and depression symptomatology at two cross-sectional timepoints. We found that disordered social media use predicts depression indirectly through fear of COVID-19 at both timepoints. We also found that disordered social media use predicts perceived stress indirectly through fear of COVID-19, but only at timepoint 1. Taken together with previous research, our findings indicate that disordered social media use may lead to increased fear of COVID-19, which in turn may lead to poorer psychological wellbeing outcomes. Overall, there is evidence that the impact of the COVID-19 pandemic is affecting the physical, psychological, and emotional health of individuals worldwide. Moreover, this impact may be exacerbated by disordered use of social media. © 2023 by the authors.
Efficacy of a digital mental health biopsychosocial transdiagnostic intervention with or without therapist assistance for adults with anxiety and depression : adaptive randomized controlled trial
- Andrews, Brooke, Klein, Britt, Nguyen, Huy, Corboy, Denise, McLaren, Suzanne, Watson, Shaun
- Authors: Andrews, Brooke , Klein, Britt , Nguyen, Huy , Corboy, Denise , McLaren, Suzanne , Watson, Shaun
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. Objective: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. Methods: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. Results: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program–only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. Conclusions: The findings highlight that early detection of low engagement and non–treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. ©Brooke Andrews, Britt Klein, Huy Van Nguyen, Denise Corboy, Suzanne McLaren, Shaun Watson.
- Authors: Andrews, Brooke , Klein, Britt , Nguyen, Huy , Corboy, Denise , McLaren, Suzanne , Watson, Shaun
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. Objective: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. Methods: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. Results: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program–only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. Conclusions: The findings highlight that early detection of low engagement and non–treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. ©Brooke Andrews, Britt Klein, Huy Van Nguyen, Denise Corboy, Suzanne McLaren, Shaun Watson.
Evaluation of various support intensities of digital mental health treatment for reducing anxiety and depression in adults : protocol for a mixed methods, adaptive, randomized clinical trial
- Andrews, Brooke, Klein, Britt, McLaren, Suzanne, Watson, Shaun, Corboy, Denise
- Authors: Andrews, Brooke , Klein, Britt , McLaren, Suzanne , Watson, Shaun , Corboy, Denise
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 12, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. Objective: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. Methods: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). Results: The primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. Conclusions: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. © Brooke Andrews, Britt Klein, Suzanne McLaren, Shaun Watson, Denise Corboy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.04.2023.
- Authors: Andrews, Brooke , Klein, Britt , McLaren, Suzanne , Watson, Shaun , Corboy, Denise
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 12, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. Objective: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. Methods: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). Results: The primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. Conclusions: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. © Brooke Andrews, Britt Klein, Suzanne McLaren, Shaun Watson, Denise Corboy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.04.2023.
Managing depression with complementary and alternative medicine therapies: a scientometric analysis and visualization of research activities
- Zhao, Fei-Yi, Xu, Peijie, Zheng, Zhen, Conduit, Russell, Xu, Yan, Yue, Li-Ping, Wang, Hui-Ru, Wang, Yan-Mei, Li, Yuan-Xin, Li, Chun-Yan, Zhang, Wen-Jing, Fu, Qiang-Qiang, Kennedy, Gerard
- Authors: Zhao, Fei-Yi , Xu, Peijie , Zheng, Zhen , Conduit, Russell , Xu, Yan , Yue, Li-Ping , Wang, Hui-Ru , Wang, Yan-Mei , Li, Yuan-Xin , Li, Chun-Yan , Zhang, Wen-Jing , Fu, Qiang-Qiang , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 14, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body–mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. “Inflammation,” “rating scale” and “psychological stress” were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body–mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced. Copyright © 2023 Zhao, Xu, Zheng, Conduit, Xu, Yue, Wang, Wang, Li, Li, Zhang, Fu and Kennedy.
- Authors: Zhao, Fei-Yi , Xu, Peijie , Zheng, Zhen , Conduit, Russell , Xu, Yan , Yue, Li-Ping , Wang, Hui-Ru , Wang, Yan-Mei , Li, Yuan-Xin , Li, Chun-Yan , Zhang, Wen-Jing , Fu, Qiang-Qiang , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 14, no. (2023), p.
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- Description: Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body–mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. “Inflammation,” “rating scale” and “psychological stress” were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body–mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced. Copyright © 2023 Zhao, Xu, Zheng, Conduit, Xu, Yue, Wang, Wang, Li, Li, Zhang, Fu and Kennedy.
Maternal attachment state of mind and perinatal emotional wellbeing : findings from a pregnancy cohort study
- Galbally, Megan, Watson, Stuart, Lewis, Andrew, Power, Josephine, Buus, Niels, van Ijzendoorn, Marinus
- Authors: Galbally, Megan , Watson, Stuart , Lewis, Andrew , Power, Josephine , Buus, Niels , van Ijzendoorn, Marinus
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 333, no. (2023), p. 297-304
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- Description: Objectives: Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. Methods: This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). Limitations: Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. Conclusions: This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing. © 2023 The Author(s)
- Authors: Galbally, Megan , Watson, Stuart , Lewis, Andrew , Power, Josephine , Buus, Niels , van Ijzendoorn, Marinus
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 333, no. (2023), p. 297-304
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- Description: Objectives: Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. Methods: This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). Limitations: Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. Conclusions: This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing. © 2023 The Author(s)
Rurality as a predictor of perinatal mental health and well-being in an Australian cohort
- Galbally, Megan, Watson, Stuart, Coleman, Mathew, Worley, Paul, Verrier, Leanda, Padmanabhan, Vineet, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Coleman, Mathew , Worley, Paul , Verrier, Leanda , Padmanabhan, Vineet , Lewis, Andrew
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 182-195
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- Description: Objective: Perinatal emotional well-being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well-being. This study compares perinatal well-being between women living in metropolitan and rural regions. Design: Prospective, longitudinal cohort. Participants/setting: Eight hundred and six women from Victoria and Western Australia recruited before 20 weeks of pregnancy and followed up to 12 months postpartum. Main outcome measures: Rurality was assessed using the Modified Monash Model (MM Model) with 578 in metropolitan cities MM1, 185 in regional and large rural towns MM2-MM3 and 43 in rural to remote MM4-MM7. The Structured Clinical Interview for DSM-IV (SCID-IV) was administered at recruitment to assess depression, and symptoms of depression and anxiety were measured using the Edinburgh Post-natal Depression Scale and the State and Trait Anxiety Scale, respectively. Other measures included stressful events, diet, exercise, partner support, parenting and sleep. Results: The prevalence of depressive disorders did not differ across rurality. There was also no difference in breastfeeding cessation, exercise, sleep or partner support. Women living in rural communities and who also had depression reported significantly higher parenting stress than metropolitan women and lower access to parenting activities. Conclusions: Our study suggests while many of the challenges of the perinatal period were shared between women in all areas, there were important differences in parenting stress and access to activities. Furthermore, these findings suggest that guidelines and interventions designed for perinatal mental health should consider rurality. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
- Authors: Galbally, Megan , Watson, Stuart , Coleman, Mathew , Worley, Paul , Verrier, Leanda , Padmanabhan, Vineet , Lewis, Andrew
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 182-195
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- Description: Objective: Perinatal emotional well-being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well-being. This study compares perinatal well-being between women living in metropolitan and rural regions. Design: Prospective, longitudinal cohort. Participants/setting: Eight hundred and six women from Victoria and Western Australia recruited before 20 weeks of pregnancy and followed up to 12 months postpartum. Main outcome measures: Rurality was assessed using the Modified Monash Model (MM Model) with 578 in metropolitan cities MM1, 185 in regional and large rural towns MM2-MM3 and 43 in rural to remote MM4-MM7. The Structured Clinical Interview for DSM-IV (SCID-IV) was administered at recruitment to assess depression, and symptoms of depression and anxiety were measured using the Edinburgh Post-natal Depression Scale and the State and Trait Anxiety Scale, respectively. Other measures included stressful events, diet, exercise, partner support, parenting and sleep. Results: The prevalence of depressive disorders did not differ across rurality. There was also no difference in breastfeeding cessation, exercise, sleep or partner support. Women living in rural communities and who also had depression reported significantly higher parenting stress than metropolitan women and lower access to parenting activities. Conclusions: Our study suggests while many of the challenges of the perinatal period were shared between women in all areas, there were important differences in parenting stress and access to activities. Furthermore, these findings suggest that guidelines and interventions designed for perinatal mental health should consider rurality. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
The roles of depression, life control and affective distress on treatment attendance and perceived disability in chronic back pain sufferers throughout the duration of the condition
- Oraison, Humberto, Loton, Daniel, Kennedy, Gerard
- Authors: Oraison, Humberto , Loton, Daniel , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 19 (2023), p.
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- Description: The aims of this study were to examine psychological factors that predict treatment seeking and disability over the total duration of experiencing back pain. A sample of 201 adults experiencing chronic back pain was recruited through health professionals and completed the Depression, Anxiety and Stress Scale (DASS), the Oswestry Back Pain Disability Questionnaire (ODQ), the McGill Pain Questionnaire (MPQ) and the life control and affective distress variables of the West Haven–Yale Multidimensional Pain Inventory (WHYMP), and participants disclosed the number of treatment sessions attended over the course of the illness. Depression, life control and affective distress were tested as indirect predictors of disability severity that were mediated by treatment attendance. Each unit increase in life control predicted attending nearly 30 more treatment sessions, each unit increase in affective distress predicted attending 16 fewer treatments and each unit increase in depression predicted 4 fewer treatments, together explaining 44% of variance in treatment seeking. The effects of life control and affective distress on disability were explained by treatment attendance, whereas depression retained a direct effect on disability. Treatment attendance had an effect on disability. The findings show that participants with lower life control and higher affective distress and depression had higher levels of pain and disability, in part due to due to their treatment-seeking behaviour. © 2023 by the authors.
- Authors: Oraison, Humberto , Loton, Daniel , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 19 (2023), p.
- Full Text:
- Reviewed:
- Description: The aims of this study were to examine psychological factors that predict treatment seeking and disability over the total duration of experiencing back pain. A sample of 201 adults experiencing chronic back pain was recruited through health professionals and completed the Depression, Anxiety and Stress Scale (DASS), the Oswestry Back Pain Disability Questionnaire (ODQ), the McGill Pain Questionnaire (MPQ) and the life control and affective distress variables of the West Haven–Yale Multidimensional Pain Inventory (WHYMP), and participants disclosed the number of treatment sessions attended over the course of the illness. Depression, life control and affective distress were tested as indirect predictors of disability severity that were mediated by treatment attendance. Each unit increase in life control predicted attending nearly 30 more treatment sessions, each unit increase in affective distress predicted attending 16 fewer treatments and each unit increase in depression predicted 4 fewer treatments, together explaining 44% of variance in treatment seeking. The effects of life control and affective distress on disability were explained by treatment attendance, whereas depression retained a direct effect on disability. Treatment attendance had an effect on disability. The findings show that participants with lower life control and higher affective distress and depression had higher levels of pain and disability, in part due to due to their treatment-seeking behaviour. © 2023 by the authors.
Anhedonia and anergia predict mortality in older Australians living in residential aged care
- Greenfield, L., Mathews, Stephanie, Toukhsati, Samia
- Authors: Greenfield, L. , Mathews, Stephanie , Toukhsati, Samia
- Date: 2022
- Type: Text , Journal article
- Relation: Aging and Mental Health Vol. 26, no. 3 (2022), p. 614-622
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- Description: Objectives: Depression is common in older adults and is linked to morbidity and mortality. The aim of this study was to investigate whether specific symptoms of depression (dysphoria, anhedonia and anergia) predicted mortality in older Australian Aged Care residents. Methods: Eighty older adults (M = 83.16 ± 7.14) without cognitive impairment residing in 14 Residential Aged Care facilities located in Melbourne, Australia, completed the 15-item Geriatric Depression Scale—Short Form (GDS-15) and the Standardized Mini Mental State Examination. Residential Aged Care facilities provided the primary end-point of all-cause mortality at follow-up (M = 5.4 years ± 0.1). Results: Univariate Kaplan-Meier survival curves and Cox Proportional Hazards regression analyses were used to evaluate whether symptoms of depression predicted all-cause mortality, with known prognostic factors controlled. The results indicated that anhedonia (Hazard Ratio = 2.931 [95% CI 1.278–6.722], p =.011) and anergia (Hazard Ratio = 2.783 [95% CI 1.065–7.276], p =.037) were associated with almost a threefold increased risk of mortality in older adults living in RAC in adjusted analyses. Dysphoria did not predict mortality. Conclusions: These findings advance understanding of the mortality risks of anhedonia and anergia in an understudied population. Symptoms of anhedonia and anergia should be targeted for screening in older adults living in Aged Care to increase the detection and potential for referral to treatment for depressive presentation. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
Buffering the fear of COVID-19 : social connectedness mediates the relationship between fear of COVID-19 and psychological wellbeing
- Humphrey, Ashley, March, Evita, Lavender, Andrew, Miller, Kyle, Alvarenga, Marlies, Mesagno, Christopher
- Authors: Humphrey, Ashley , March, Evita , Lavender, Andrew , Miller, Kyle , Alvarenga, Marlies , Mesagno, Christopher
- Date: 2022
- Type: Text , Journal article
- Relation: Behavioral Sciences Vol. 12, no. 3 (2022), p.
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- Description: Social connections are crucial for an individual’s health, wellbeing, and overall effective functioning. During the COVID-19 pandemic, one major preventative effort for reducing the spread of COVID-19 involved restricting people’s typical social interactions through physical distancing and isolation. The current cross-sectional study, conducted during the COVID-19 pandemic, explored the relationship among fear of COVID-19, social connectedness, resilience, depressive symptomologies, and self-perceived stress. Participants (N = 174) completed an anonymous, online questionnaire, and results indicated that social connectedness mediated the relationship between fear of COVID-19 and psychological wellbeing. In contrast, the relationship between fear of COVID-19 and psychological wellbeing was not mediated by resilience. These findings highlight the important role that social connections and resilience play in buffering against negative psychological wellbeing outcomes, especially during a pandemic. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Humphrey, Ashley , March, Evita , Lavender, Andrew , Miller, Kyle , Alvarenga, Marlies , Mesagno, Christopher
- Date: 2022
- Type: Text , Journal article
- Relation: Behavioral Sciences Vol. 12, no. 3 (2022), p.
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- Description: Social connections are crucial for an individual’s health, wellbeing, and overall effective functioning. During the COVID-19 pandemic, one major preventative effort for reducing the spread of COVID-19 involved restricting people’s typical social interactions through physical distancing and isolation. The current cross-sectional study, conducted during the COVID-19 pandemic, explored the relationship among fear of COVID-19, social connectedness, resilience, depressive symptomologies, and self-perceived stress. Participants (N = 174) completed an anonymous, online questionnaire, and results indicated that social connectedness mediated the relationship between fear of COVID-19 and psychological wellbeing. In contrast, the relationship between fear of COVID-19 and psychological wellbeing was not mediated by resilience. These findings highlight the important role that social connections and resilience play in buffering against negative psychological wellbeing outcomes, especially during a pandemic. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Constructions of athlete mental health post-retirement: a discursive analysis of stigmatising and legitimising versions of transition distress in the Australian broadcast media
- Cosh, Suzanne, Crabb, Shona, McNeil, Dominic, Tully, Phillip
- Authors: Cosh, Suzanne , Crabb, Shona , McNeil, Dominic , Tully, Phillip
- Date: 2022
- Type: Text , Journal article
- Relation: Qualitative Research in Sport, Exercise and Health Vol. 14, no. 7 (2022), p. 1045-1069
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- Description: Athletes are vulnerable to experiencing mental health disorders, yet, disclosure and help-seeking around mental health remains low, with stigma the most widely reported barrier. However, the ways in which stigma around mental health may be produced (or resisted) in dominant constructions of athlete mental health remain under examined. This study explores constructions of athlete mental health into retirement in an example of Australian broadcast media, with consideration of the ways in which these representations might function to reproduce and perpetuate (or not) stigmatising versions of athlete mental health. Data from a two-part special of a current affairs programme focusing on transition difficulties and poor mental health of nine retired athletes were analysed using Discursive Psychology. Analysis focused on identifying the constructions of mental health and recovery produced in this broadcast, with consideration as to how these depictions might function to perpetuate and/or resist stigma. Mental health was constructed in two key ways–biomedical and life-stress–which externalised mental health. Recovery was, conversely, located as solely the individual’s responsibility and was depicted as achieved through self-awareness and engaging in new pursuits. Thus, individual experiences of mental health disorders were partially legitimised through externalising blame and presenting a plurality of depictions, yet did not redress stigma around transition distress more broadly by overlooking contextual factors. Depictions trivialised recovery, potentially functioning to stigmatise long-term or chronic mental health experiences as well as help-seeking. These results inform ways in which stigma around athlete mental health may be challenged, and implications for practice are discussed. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Cosh, Suzanne , Crabb, Shona , McNeil, Dominic , Tully, Phillip
- Date: 2022
- Type: Text , Journal article
- Relation: Qualitative Research in Sport, Exercise and Health Vol. 14, no. 7 (2022), p. 1045-1069
- Full Text:
- Reviewed:
- Description: Athletes are vulnerable to experiencing mental health disorders, yet, disclosure and help-seeking around mental health remains low, with stigma the most widely reported barrier. However, the ways in which stigma around mental health may be produced (or resisted) in dominant constructions of athlete mental health remain under examined. This study explores constructions of athlete mental health into retirement in an example of Australian broadcast media, with consideration of the ways in which these representations might function to reproduce and perpetuate (or not) stigmatising versions of athlete mental health. Data from a two-part special of a current affairs programme focusing on transition difficulties and poor mental health of nine retired athletes were analysed using Discursive Psychology. Analysis focused on identifying the constructions of mental health and recovery produced in this broadcast, with consideration as to how these depictions might function to perpetuate and/or resist stigma. Mental health was constructed in two key ways–biomedical and life-stress–which externalised mental health. Recovery was, conversely, located as solely the individual’s responsibility and was depicted as achieved through self-awareness and engaging in new pursuits. Thus, individual experiences of mental health disorders were partially legitimised through externalising blame and presenting a plurality of depictions, yet did not redress stigma around transition distress more broadly by overlooking contextual factors. Depictions trivialised recovery, potentially functioning to stigmatise long-term or chronic mental health experiences as well as help-seeking. These results inform ways in which stigma around athlete mental health may be challenged, and implications for practice are discussed. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
- Galbally, Megan, Watson, Stuart, Spigset, Olav, Lappas, Martha, Walker, Susan, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Spigset, Olav , Lappas, Martha , Walker, Susan , Lewis, Andrew
- Date: 2022
- Type: Text , Journal article
- Relation: Placenta Vol. 119, no. (2022), p. 44-51
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- Description: Placental dysfunction and inefficiency, is important in understanding fetal growth restriction and low birth weight. Two recent studies have examined the relationship between antidepressant use in pregnancy and placental weight ratios one found lower placental weight ratio associated with antidepressant use and the other found a higher ratio. This study examined 342 women recruited in early pregnancy, including 75 taking antidepressants, 29 with current depression and 238 controls. Antidepressant use was measured through self-report in early and late pregnancy, hospital records at delivery and drug concentrations in umbilical cord and maternal blood obtained at delivery. Maternal depression was measured using the Structured Clinical Interview for the DSM IV (SCID) at recruitment. Placentas were collected at delivery and weighed, and infant birth weight recorded. Placental efficiency was measured using standardised placental weight residuals and included as the outcome in general linear models (ANOVA/ANCOVA) to test hypotheses. While placental weight was higher for those on antidepressants compared to controls (z=.30 c.f. Z=-0.08, p=.012), there were no significant differences between the three groups after adjusting for maternal body mass index at recruitment. When comparing antidepressant groups separately there were small-to-moderate positive associations between (SSRI) concentrations and placental weight (rho's > 0.20, p's > 0.05), which did not reach significance. Antidepressant use in pregnancy was not associated with significant changes in placental efficiency after adjustment for confounding variables. Future research should expand on this to examine other aspects of placental function and include a wide range of potential confounding variables to draw clinically meaningful conclusions. •Birth weight to placental weight ratio is often used as a proxy for placental dysfunction.•Placental dysfunction may underlie the association between antenatal antidepressant use and low infant birth weight.•Two studies found the opposite relationship between antidepressants and placental weight but did not adjust for confounders.•We found placental weight, when adjusted for confounders, was not significantly different for those on antidepressants.
Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID-19 pandemic
- Galbally, Megan, Watson, Stuart, Lewis, Andrew, van Ijzendoorn, Marinus
- Authors: Galbally, Megan , Watson, Stuart , Lewis, Andrew , van Ijzendoorn, Marinus
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Paediatrics and Child Health Vol. 58, no. 11 (2022), p. 2051-2057
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- Description: Aim: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia – a city exposed to one of the longest lockdowns world-wide in response to the pandemic. Methods: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3–4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic. Results: When compared to mothers followed up at 3–4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. Conclusions: Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient. © 2022 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
- Authors: Galbally, Megan , Watson, Stuart , Lewis, Andrew , van Ijzendoorn, Marinus
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Paediatrics and Child Health Vol. 58, no. 11 (2022), p. 2051-2057
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- Description: Aim: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia – a city exposed to one of the longest lockdowns world-wide in response to the pandemic. Methods: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3–4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic. Results: When compared to mothers followed up at 3–4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. Conclusions: Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient. © 2022 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Smartphone sensor data for identifying and monitoring symptoms of mood disorders : a longitudinal observational study
- Braund, Taylor, Zin, May, Boonstra, Tjeerd, Wong, Quincy, Larsen, Mark, Christensen, Helen, Tillman, Gabriel, O'Dea, Bridianne
- Authors: Braund, Taylor , Zin, May , Boonstra, Tjeerd , Wong, Quincy , Larsen, Mark , Christensen, Helen , Tillman, Gabriel , O'Dea, Bridianne
- Date: 2022
- Type: Text , Journal article
- Relation: JMIR Mental Health Vol. 9, no. 5 (2022), p.
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- Description: Background: Mood disorders are burdensome illnesses that often go undetected and untreated. Sensor technologies within smartphones may provide an opportunity for identifying the early changes in circadian rhythm and social support/connectedness that signify the onset of a depressive or manic episode. Objective: Using smartphone sensor data, this study investigated the relationship between circadian rhythm, which was determined by GPS data, and symptoms of mental health among a clinical sample of adults diagnosed with major depressive disorder or bipolar disorder. Methods: A total of 121 participants were recruited from a clinical setting to take part in a 10-week observational study. Self-report questionnaires for mental health outcomes, social support, social connectedness, and quality of life were assessed at 6 time points throughout the study period. Participants consented to passively sharing their smartphone GPS data for the duration of the study. Circadian rhythm (ie, regularity of location changes in a 24-hour rhythm) was extracted from GPS mobility patterns at baseline. Results: Although we found no association between circadian rhythm and mental health functioning at baseline, there was a positive association between circadian rhythm and the size of participants' social support networks at baseline (r=0.22; P = .03; R2=0.049). In participants with bipolar disorder, circadian rhythm was associated with a change in anxiety from baseline; a higher circadian rhythm was associated with an increase in anxiety and a lower circadian rhythm was associated with a decrease in anxiety at time point 5. Conclusions: Circadian rhythm, which was extracted from smartphone GPS data, was associated with social support and predicted changes in anxiety in a clinical sample of adults with mood disorders. Larger studies are required for further validations. However, smartphone sensing may have the potential to monitor early symptoms of mood disorders. © Taylor A Braund, May The Zin, Tjeerd W Boonstra, Quincy J J Wong, Mark E Larsen, Helen Christensen, Gabriel Tillman, Bridianne O'Dea.
- Authors: Braund, Taylor , Zin, May , Boonstra, Tjeerd , Wong, Quincy , Larsen, Mark , Christensen, Helen , Tillman, Gabriel , O'Dea, Bridianne
- Date: 2022
- Type: Text , Journal article
- Relation: JMIR Mental Health Vol. 9, no. 5 (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Mood disorders are burdensome illnesses that often go undetected and untreated. Sensor technologies within smartphones may provide an opportunity for identifying the early changes in circadian rhythm and social support/connectedness that signify the onset of a depressive or manic episode. Objective: Using smartphone sensor data, this study investigated the relationship between circadian rhythm, which was determined by GPS data, and symptoms of mental health among a clinical sample of adults diagnosed with major depressive disorder or bipolar disorder. Methods: A total of 121 participants were recruited from a clinical setting to take part in a 10-week observational study. Self-report questionnaires for mental health outcomes, social support, social connectedness, and quality of life were assessed at 6 time points throughout the study period. Participants consented to passively sharing their smartphone GPS data for the duration of the study. Circadian rhythm (ie, regularity of location changes in a 24-hour rhythm) was extracted from GPS mobility patterns at baseline. Results: Although we found no association between circadian rhythm and mental health functioning at baseline, there was a positive association between circadian rhythm and the size of participants' social support networks at baseline (r=0.22; P = .03; R2=0.049). In participants with bipolar disorder, circadian rhythm was associated with a change in anxiety from baseline; a higher circadian rhythm was associated with an increase in anxiety and a lower circadian rhythm was associated with a decrease in anxiety at time point 5. Conclusions: Circadian rhythm, which was extracted from smartphone GPS data, was associated with social support and predicted changes in anxiety in a clinical sample of adults with mood disorders. Larger studies are required for further validations. However, smartphone sensing may have the potential to monitor early symptoms of mood disorders. © Taylor A Braund, May The Zin, Tjeerd W Boonstra, Quincy J J Wong, Mark E Larsen, Helen Christensen, Gabriel Tillman, Bridianne O'Dea.
The role of acupuncture in the management of insomnia as a major or residual symptom among patients with active or previous depression : a systematic review and meta-analysis
- Zhao, Fei-Yi, Kennedy, Gerard, Spencer, Sarah, Conduit, Russell, Zhang, Wen-Jing, Fu, Qiang-Qiang, Zheng, Zhen
- Authors: Zhao, Fei-Yi , Kennedy, Gerard , Spencer, Sarah , Conduit, Russell , Zhang, Wen-Jing , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Due to concerns about risks associated with antidepressants and/or hypnotics, complementary therapies such as acupuncture have been sought by patients with active or previous depression to manage insomnia. This systematic review aimed to clarify if acupuncture is effective and safe enough to be recommended as an alternative or adjuvant therapy to standard care in ameliorating concomitant or residual insomnia, two types of insomnia associated with depression. Methods: Randomized controlled trials (RCTs) of depression-related insomnia (DI) treatment via acupuncture vs. waitlist-control or placebo-/sham-acupuncture and RCTs of DI treatment via acupuncture alone or combined with standard care [Western pharmacotherapy and/or cognitive-behavioral therapy (CBT)] vs. standard care alone were searched for from seven databases from inception to December 2021. Cochrane criteria were followed. Results: Twenty-one studies involving 1,571 participants were analyzed. For insomnia as a major symptom of active depression, meta-analyses suggested that acupuncture significantly reduced the global scores of both the Pittsburg Sleep Quality Index (PSQI) [MD = −3.12, 95% CI (−5.16, −1.08), p < 0.01] and Hamilton Depression Scale (HAMD) [SMD = −2.67, 95% CI (−3.51, −1.84), p < 0.01], in comparison with placebo-acupuncture. When compared with conventional pharmacotherapy (antidepressants and/or hypnotics), the results favored acupuncture in decreasing PSQI [MD = −1.17, 95% CI (−2.26, −0.08), p = 0.03] and HAMD [SMD = −0.47, 95% CI (−0.91, −0.02), p = 0.04]. Acupuncture was comparable to conventional pharmacotherapy in reducing scores of each domain of PSQI. For insomnia as a residual symptom of previous or partially remitted depression, acupuncture conferred a very limited, non-significant therapeutic advantage against sham-/placebo-acupuncture. Whether acupuncture has an add-on effect to conventional pharmacotherapy in this type of insomnia has not been investigated. Also, no study was available to address the efficacy differences between acupuncture and CBT or the synergistic effect of these two therapies. Conclusions: There is a low to moderate level of evidence supporting acupuncture as a safe and effective remedy alternative to or adjuvant to conventional pharmacotherapy (antidepressant and/or hypnotic) in improving insomnia and other depression symptoms among patients with active depression. Furthermore, the patients' complaint of disrupted sleep continuity is most likely to benefit from acupuncture. The benefit of acupuncture on residual insomnia associated with previous or partially remitted depression is limited. Future acupuncture studies need to consider applying optimal dosage and addressing deficiencies in trial quality. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021269880, PROSPERO, identifier: CRD42021269880. Copyright © 2022 Zhao, Kennedy, Spencer, Conduit, Zhang, Fu and Zheng.
- Authors: Zhao, Fei-Yi , Kennedy, Gerard , Spencer, Sarah , Conduit, Russell , Zhang, Wen-Jing , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Due to concerns about risks associated with antidepressants and/or hypnotics, complementary therapies such as acupuncture have been sought by patients with active or previous depression to manage insomnia. This systematic review aimed to clarify if acupuncture is effective and safe enough to be recommended as an alternative or adjuvant therapy to standard care in ameliorating concomitant or residual insomnia, two types of insomnia associated with depression. Methods: Randomized controlled trials (RCTs) of depression-related insomnia (DI) treatment via acupuncture vs. waitlist-control or placebo-/sham-acupuncture and RCTs of DI treatment via acupuncture alone or combined with standard care [Western pharmacotherapy and/or cognitive-behavioral therapy (CBT)] vs. standard care alone were searched for from seven databases from inception to December 2021. Cochrane criteria were followed. Results: Twenty-one studies involving 1,571 participants were analyzed. For insomnia as a major symptom of active depression, meta-analyses suggested that acupuncture significantly reduced the global scores of both the Pittsburg Sleep Quality Index (PSQI) [MD = −3.12, 95% CI (−5.16, −1.08), p < 0.01] and Hamilton Depression Scale (HAMD) [SMD = −2.67, 95% CI (−3.51, −1.84), p < 0.01], in comparison with placebo-acupuncture. When compared with conventional pharmacotherapy (antidepressants and/or hypnotics), the results favored acupuncture in decreasing PSQI [MD = −1.17, 95% CI (−2.26, −0.08), p = 0.03] and HAMD [SMD = −0.47, 95% CI (−0.91, −0.02), p = 0.04]. Acupuncture was comparable to conventional pharmacotherapy in reducing scores of each domain of PSQI. For insomnia as a residual symptom of previous or partially remitted depression, acupuncture conferred a very limited, non-significant therapeutic advantage against sham-/placebo-acupuncture. Whether acupuncture has an add-on effect to conventional pharmacotherapy in this type of insomnia has not been investigated. Also, no study was available to address the efficacy differences between acupuncture and CBT or the synergistic effect of these two therapies. Conclusions: There is a low to moderate level of evidence supporting acupuncture as a safe and effective remedy alternative to or adjuvant to conventional pharmacotherapy (antidepressant and/or hypnotic) in improving insomnia and other depression symptoms among patients with active depression. Furthermore, the patients' complaint of disrupted sleep continuity is most likely to benefit from acupuncture. The benefit of acupuncture on residual insomnia associated with previous or partially remitted depression is limited. Future acupuncture studies need to consider applying optimal dosage and addressing deficiencies in trial quality. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021269880, PROSPERO, identifier: CRD42021269880. Copyright © 2022 Zhao, Kennedy, Spencer, Conduit, Zhang, Fu and Zheng.
- Stavropoulos, Vasileios, Vassallo, Jeremy, Burleigh, Tyrone, Gomez, Rapson, Colder Carras, Michelle
- Authors: Stavropoulos, Vasileios , Vassallo, Jeremy , Burleigh, Tyrone , Gomez, Rapson , Colder Carras, Michelle
- Date: 2022
- Type: Text , Journal article
- Relation: Asia-Pacific Psychiatry Vol. 14, no. 2 (2022), p.
- Full Text: false
- Reviewed:
- Description: Background: Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression. Methods: A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21). Results: Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms. Conclusion: Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction. © 2021 John Wiley & Sons Australia, Ltd.
Unraveling the complexity of cardiac distress : a study of prevalence and severity
- Jackson, Alun, Rogerson, Michelle, Amerena, John, Smith, Julian, Hoover, Valerie, Alvarenga, Marlies, Higgins, Rosemary, Grande, Michael, Ski, Chantal, Thompson, David, Murphy, Barbara
- Authors: Jackson, Alun , Rogerson, Michelle , Amerena, John , Smith, Julian , Hoover, Valerie , Alvarenga, Marlies , Higgins, Rosemary , Grande, Michael , Ski, Chantal , Thompson, David , Murphy, Barbara
- Date: 2022
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Introduction: While much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way. Method: A sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress. Results: Across the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were “being physically restricted” (66%), “lacking energy” (60%), “being short of breath” (60%), “thinking I will never be the same again” (57%), and “not sleeping well” (51%). While less prevalent, “not having access to the health care I need,” “being concerned about my capacity for sexual activity,” and “being unsupported by family and friends” were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress. Conclusion and Implications: Specific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery. Copyright © 2022 Jackson, Rogerson, Amerena, Smith, Hoover, Alvarenga, Higgins, Grande, Ski, Thompson and Murphy.
- Authors: Jackson, Alun , Rogerson, Michelle , Amerena, John , Smith, Julian , Hoover, Valerie , Alvarenga, Marlies , Higgins, Rosemary , Grande, Michael , Ski, Chantal , Thompson, David , Murphy, Barbara
- Date: 2022
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Introduction: While much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way. Method: A sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress. Results: Across the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were “being physically restricted” (66%), “lacking energy” (60%), “being short of breath” (60%), “thinking I will never be the same again” (57%), and “not sleeping well” (51%). While less prevalent, “not having access to the health care I need,” “being concerned about my capacity for sexual activity,” and “being unsupported by family and friends” were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress. Conclusion and Implications: Specific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery. Copyright © 2022 Jackson, Rogerson, Amerena, Smith, Hoover, Alvarenga, Higgins, Grande, Ski, Thompson and Murphy.