39 results on '"van Marwijk, Harm W. J."'
Search Results
2. Patients’ and practice nurses’ perceptions of depression in patients with type 2 diabetes and/or coronary heart disease screened for subthreshold depression
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Pols, Alide D., Schipper, Karen, Overkamp, Debbie, van Marwijk, Harm W. J., van Tulder, Maurits W., and Adriaanse, Marcel C.
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- 2018
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3. Associations of financial strain and income with depressive and anxiety disorders
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Dijkstra-Kersten, Sandra M A, Biesheuvel-Leliefeld, Karolien E M, van der Wouden, Johannes C, Penninx, Brenda W J H, and van Marwijk, Harm W J
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- 2015
4. Management of patients with persistent medically unexplained symptoms: a descriptive study
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Sitnikova, Kate, Pret-Oskam, Rinske, Dijkstra-Kersten, Sandra M. A., Leone, Stephanie S., van Marwijk, Harm W. J., van der Horst, Henriëtte E., and van der Wouden, Johannes C.
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- 2018
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5. Assessing the Impact of EQ-5D Country-specific Value Sets on Cost-utility Outcomes
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van Dongen, Johanna M, Jornada Ben, Ângela, Finch, Aureliano P, Rossenaar, Milou M M, Biesheuvel-Leliefeld, Karolien E M, Apeldoorn, Adrie T, Ostelo, Raymond W J G, van Tulder, Maurits W, van Marwijk, Harm W J, Bosmans, Judith E, van Dongen, Johanna M, Jornada Ben, Ângela, Finch, Aureliano P, Rossenaar, Milou M M, Biesheuvel-Leliefeld, Karolien E M, Apeldoorn, Adrie T, Ostelo, Raymond W J G, van Tulder, Maurits W, van Marwijk, Harm W J, and Bosmans, Judith E
- Abstract
PURPOSE: To assess the impact of EQ-5D country-specific value sets on cost-utility outcomes.METHODS: Data from 2 randomized controlled trials on low back pain (LBP) and depression were used. 3L value sets were identified from the EuroQol Web site. A nonparametric crosswalk was employed for each tariff to obtain the likely 5L values. Differences in quality-adjusted life years (QALYs) between countries were tested using paired t tests, with United Kingdom as reference. Cost-utility outcomes were estimated for both studies and both EQ-5D versions, including differences in QALYs and cost-effectiveness acceptability curves.RESULTS: For the 3L, QALYs ranged between 0.650 (Taiwan) and 0.892 (United States) in the LBP study and between 0.619 (Taiwan) and 0.879 (United States) in the depression study. In both studies, most country-specific QALY estimates differed statistically significantly from that of the United Kingdom. Incremental cost-effectiveness ratios ranged between &OV0556;2044/QALY (Taiwan) and &OV0556;5897/QALY (Zimbabwe) in the LBP study and between &OV0556;38,287/QALY (Singapore) and &OV0556;96,550/QALY (Japan) in the depression study. At the NICE threshold of &OV0556;23,300/QALY (≈£20,000/QALY), the intervention's probability of being cost-effective versus control ranged between 0.751 (Zimbabwe) and 0.952 (Taiwan) and between 0.230 (Canada) and 0.396 (Singapore) in the LBP study and depression study, respectively. Similar results were found for the 5L, with extensive differences in ICERs and moderate differences in the probability of cost-effectiveness.CONCLUSIONS: This study indicates that the use of different EQ-5D country-specific value sets impacts on cost-utility outcomes. Therefore, to account for the fact that health state preferences are affected by sociocultural differences, relevant country-specific value sets should be used.
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- 2021
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6. Comparative effect of collaborative care, pain medication, and duloxetine in the treatment of depression and comorbid pain in outpatient care: results of a randomized, placebo-controlled, multi-center trial
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de Heer, Eric W, Dekker, Jack, Beekman, Aartjan T F, van Marwijk, Harm W J, Holwerda, Tjalling J, Bet, Pierre M, Roth, Joost, Timmerman, Lotte, and van der Feltz-Cornelis, Christina M
- Abstract
Objective: Evidence exists for efficacy of collaborative care (CC) against MDD, for efficacy of consequent use of pain medication against pain, and for efficacy of duloxetine against both MDD and neuropathic pain. However, their relative effectiveness in comorbid major depression (MDD) and pain has never been established so far. This study evaluates the effectiveness of CC, pain medication and duloxetine, and CC, pain medication and placebo, compared to duloxetine alone, on depressive and pain outcomes.\ud Methods:\ud Three armed cluster randomized multi-centre placebo controlled trial in consecutive patients presented at three specialized mental health outpatient clinics who screened positive for MDD. All interventions lasted 12 weeks. In the CC groups duloxetine or placebo was prescribed. Pain medication was administered according to an algorithm that avoids opiate prescription as much as possible as an alternative to the current WHO pain ladder, with paracetamol, COX inhibitors and pregabalin as steps before opiates are considered. Patients who did not show up for three or more sessions were registered as noncompliant. Explorative, intention-to-treat and per protocol, multilevel regression analyses were performed. The trial is listed in the trial registration (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1089; NTR number: NTR1089).\ud Results:\ud This study was prematurely terminated because of massive reorganisations and reimbursement changes for mental health care during the study. 60 patients completed the study. Patients in all treatment groups reported significant less depressive and pain symptoms after 12 weeks. CC with placebo condition showed the fastest decrease of depressive symptoms compared to the duloxetine alone group (b = -.78; p = .01), Noncompliant patients did not improve over the 12 weeks period. Pain outcomes did not differ between the three groups.\ud Conclusions: In MDD and pain, compliance of patients and placebo effects are more important than choice of one of the three treatments. Active pain management in CC with COX inhibitors and pregabalin as alternatives to Tramadol or other opiates might provide an attractive alternative to the current WHO pain ladder as it avoids opiate prescription as much as possible. The study was sufficiently powered to show an exploratory result, but the generalizability is limited due to the small sample size. Larger studies are needed.
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- 2018
7. A supported self-help for recurrent depression in primary care; An economic evaluation alongside a multi-center randomised controlled trial
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Biesheuvel-Leliefeld, Karolien E. M., primary, Bosmans, Judith E., additional, Dijkstra-Kersten, Sandra M. A., additional, Smit, Filip, additional, Bockting, Claudi L. H., additional, van Schaik, Digna J. F., additional, van Marwijk, Harm W. J., additional, and van der Horst, Henriette E., additional
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- 2018
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8. Predictors of Persistent Medically Unexplained Physical Symptoms: Findings From a General Population Study
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van Eck van der Sluijs, Jonna F., primary, ten Have, Margreet, additional, de Graaf, Ron, additional, Rijnders, Cees A. Th., additional, van Marwijk, Harm W. J., additional, and van der Feltz-Cornelis, Christina M., additional
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- 2018
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9. Effectiveness of supported self-help in recurrent depression: a randomized controlled trial in primary care
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Biesheuvel-Leliefeld, Karolien E M, Dijkstra-Kersten, Sandra M A, van Schaik, Digna J F, van Marwijk, Harm W J, Smit, Filip, van der Horst, Henriette E, Bockting, Claudi L H, Leerstoel Bockting, Clinical Psychology (onderzoeksprogramma), Leerstoel Bockting, Clinical Psychology (onderzoeksprogramma), General practice, EMGO - Mental health, Psychiatry, APH - Mental Health, Epidemiology and Data Science, APH - Aging & Later Life, Adult Psychiatry, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, and APH - Personalized Medicine
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Rate ratio ,Self-help ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Depressive Disorder, Major/therapy ,Quality of life ,Randomized controlled trial ,law ,Recurrence ,medicine ,History of depression ,Humans ,Psychiatry ,Applied Psychology ,Depressive Disorder, Major ,Depressive Disorder ,Cognitive Behavioral Therapy ,Primary Health Care ,business.industry ,Depression ,Prevention ,Absolute risk reduction ,General Medicine ,Major/therapy ,Middle Aged ,Primary care ,030227 psychiatry ,Cognitive behavioral therapy ,Self Care ,Psychotherapy ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Number needed to treat ,Cognitive therapy ,Physical therapy ,Female ,business ,030217 neurology & neurosurgery - Abstract
Background: The burden and economic consequences of depression are high, mostly due to its recurrent nature. Due to current budget and time restraints, a preventive, low- cost, accessible minimal intervention is much needed. In this study, we evaluated the effectiveness of a supported self-help preventive cognitive therapy (S-PCT) added to treatment as usual (TAU) in primary care, compared to TAU alone. Methods: We conducted a randomized controlled trial among 248 patients with a history of depression, currently in full or partial remission or recovery. Participants were randomized to TAU augmented with S-PCT (n = 124) or TAU alone (n = 124). S-PCT consisted of an 8-week self-help intervention, supported by weekly telephone guidance by a counselor. The intervention included a self-help book that could be read at home. The primary outcome was the incidence of relapse or recurrence and was assessed over the telephone by the Structured Clinical Interview for DSM-IV axis 1 disorders. Participants were observed for 12 months. Secondary outcomes were depressive symptoms, quality of life (EQ-5D and SF-12), comorbid psychopathology, and self-efficacy. These secondary outcomes were assessed by digital questionnaires. Results: In the S-PCT group, 44 participants (35.5%) experienced a relapse or recurrence, compared to 62 participants (50.0%) in the TAU group (incidence rate ratio = 0.71, 95% CI 0.52-0.97; risk difference = 14, 95% CI 2-24, number needed to treat = 7). Compared to the TAU group, the S-PCT group showed a significant reduction in depressive symptoms over 12 months (mean difference -2.18; 95% CI -3.09 to -1.27) and a significant increase in quality of life (EQ-5D) (mean difference 0.04; 95% CI 0.004-0.08). S-PCT had no effect on comorbid psychopathology, self-efficacy, and quality of life based on the SF-12. Conclusions: A supported self-help preventive cognitive therapy, guided by a counselor in primary care, proved to be effective in reducing the burden of recurrent depression.
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- 2017
10. Effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: A pragmatic cluster randomized controlled trial
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Barengo, Noel Christopher, Pols, Alide D, van Dijk, Susan E, Bosmans, Judith E, Hoekstra, Trynke, van Marwijk, Harm W J, van Tulder, Maurits W, Adriaanse, Marcel C, Health Economics and Health Technology Assessment, Methodology and Applied Biostatistics, Health Sciences, APH - Health Behaviors & Chronic Diseases, APH - Methodology, APH - Mental Health, AMS - Sports and Work, APH - Societal Participation & Health, AMS - Ageing and Morbidity, General practice, and Epidemiology and Data Science
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Male ,Time Factors ,Medical Doctors ,Health Care Providers ,lcsh:Medicine ,Nurses ,Coronary Disease ,Comorbidity ,Severity of Illness Index ,Vascular Medicine ,0302 clinical medicine ,Endocrinology ,Surveys and Questionnaires ,Medicine and Health Sciences ,Cluster Analysis ,Coronary Heart Disease ,030212 general & internal medicine ,lcsh:Science ,Problem Solving ,Netherlands ,Medicine(all) ,Multidisciplinary ,Agricultural and Biological Sciences(all) ,Depression ,Incidence ,Middle Aged ,Type 2 Diabetes ,Self-Help Groups ,Professions ,Female ,Research Article ,Drug Research and Development ,Patients ,Endocrine Disorders ,Cardiology ,Research and Analysis Methods ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,General Practitioners ,Physicians ,Mental Health and Psychiatry ,Diabetes Mellitus ,Humans ,Clinical Trials ,Watchful Waiting ,Primary Care ,Aged ,Pharmacology ,Depressive Disorder, Major ,Primary Health Care ,Mood Disorders ,Biochemistry, Genetics and Molecular Biology(all) ,lcsh:R ,Randomized Controlled Trials ,030227 psychiatry ,Health Care ,Diabetes Mellitus, Type 2 ,Metabolic Disorders ,People and Places ,lcsh:Q ,Population Groupings ,Clinical Medicine ,Follow-Up Studies - Abstract
Purpose\ud \ud Given the public health significance of poorly treatable co-morbid major depressive disorders (MDD) among patients with type 2 diabetes mellitus (DM2) and coronary heart disease (CHD), we need to investigate whether strategies to prevent the development of major depression could reduce its burden of disease. We therefore evaluated the effectiveness of a stepped-care program for subthreshold depression in comparison with usual care in patients with DM2 and/or CHD.\ud \ud Methods\ud \ud A cluster randomized controlled trial, with 27 primary care centers serving as clusters. A total of 236 DM2 and/or CHD patients with subthreshold depression (nine item Patient Health Questionnaire (PHQ-9) score ≥ 6, no current MDD according to DSM-IV criteria) were allocated to the intervention group (N = 96) or usual care group (n = 140). The stepped-care program was delivered by trained practice nurses during one year and consisted of four sequential treatment steps: watchful waiting, guided self-help, problem solving treatment and referral to the general practitioner. The primary outcome was the 12-month cumulative incidence of MDD as measured with the Mini International Neuropsychiatric Interview (MINI). Secondary outcomes included severity of depression (measured by PHQ-9) at 3, 6, 9 and 12 months.\ud \ud Results\ud \ud Of 236 patients (mean age, 67,5 (SD 10) years; 54.7% men), 210 (89%) completed the MINI at 12 months. The cumulative incidence of MDD was 9 of 89 (10.1%) participants in the intervention group and 12 of 121 (9.9%) participants in the usual care group. We found no statistically significant overall effect of the intervention (OR = 1.21; 95% confidence interval (0.12 to 12.41)) and there were no statistically significant differences in the course or severity of depressive symptoms between the two groups.\ud \ud Conclusions\ud \ud This study suggest that Step-Dep was not more effective in preventing MDD than usual care in a primary care population with DM2 and/or CHD and subthreshold depression.
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- 2017
11. Two-year effectiveness of a stepped-care depression prevention intervention and predictors of incident depression in primary care patients with diabetes type 2 and/or coronary heart disease and subthreshold depression: data from the Step-Dep cluster randomised controlled trial
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Pols, Alide Danielle, primary, Adriaanse, Marcel C, additional, van Tulder, Maurits W, additional, Heymans, Martijn W, additional, Bosmans, Judith E, additional, van Dijk, Susan E, additional, and van Marwijk, Harm W J, additional
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- 2018
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12. Comparative Effect of Collaborative Care, Pain Medication, and Duloxetine in the Treatment of Major Depressive Disorder and Comorbid (Sub)Chronic Pain: Results of an Exploratory Randomized, Placebo-Controlled, Multicenter Trial (CC:PAINDIP)
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de Heer, Eric W., primary, Dekker, Jack, additional, Beekman, Aartjan T. F., additional, van Marwijk, Harm W. J., additional, Holwerda, Tjalling J., additional, Bet, Pierre M., additional, Roth, Joost, additional, Timmerman, Lotte, additional, and van der Feltz-Cornelis, Christina M., additional
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- 2018
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13. Behavioural activation by mental health nurses for late-life depression in primary care: A randomized controlled trial
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Janssen, Noortje, Huibers, Marcus J.H., Lucassen, Peter L B J, Voshaar, Richard Oude, van Marwijk, Harm W J, Bosmans, Judith, Pijnappels, Mirjam, Spijker, Jan, Hendriks, Gert Jan, Janssen, Noortje, Huibers, Marcus J.H., Lucassen, Peter L B J, Voshaar, Richard Oude, van Marwijk, Harm W J, Bosmans, Judith, Pijnappels, Mirjam, Spijker, Jan, and Hendriks, Gert Jan
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Background: Depressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) protocols are less complicated and more easy to train than other psychological therapies, making them very suitable for delivery by less specialised therapists. The recent introduction of the mental health nurse in primary care centres in the Netherlands has created major opportunities for improving the accessibility of psychological treatments for late-life depression in primary care. BA may thus address the needs of older patients while improving treatment outcome and lowering costs.The primary objective of this study is to compare the effectiveness and cost-effectiveness of BA in comparison with treatment as usual (TAU) for late-life depression in Dutch primary care. A secondary goal is to explore several potential mechanisms of change, as well as predictors and moderators of treatment outcome of BA for late-life depression. Methods/design: Cluster-randomised controlled multicentre trial with two parallel groups: a) behavioural activation, and b) treatment as usual, conducted in primary care centres with a follow-up of 52 weeks. The main inclusion criterion is a PHQ-9 score > 9. Patients are excluded from the trial in case of severe mental illness that requires specialized treatment, high suicide risk, drug and/or alcohol abuse, prior psychotherapy, change in dosage or type of prescribed antidepressants in the previous 12 weeks, or moderate to severe cognitive impairment. The intervention consists of 8 weekly 30-min BA sessions delivered by a trained mental health nurse. Discussion: We expect BA to be an effective and cost-effective treatment for late-life depression compared to TAU. BA delivered by mental health nurs
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- 2017
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14. Effectiveness of Supported Self-Help in Recurrent Depression: A Randomized Controlled Trial in Primary Care
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Leerstoel Bockting, Clinical Psychology (onderzoeksprogramma), Biesheuvel-Leliefeld, Karolien E M, Dijkstra-Kersten, Sandra M A, van Schaik, Digna J F, van Marwijk, Harm W J, Smit, Filip, van der Horst, Henriette E, Bockting, Claudi L H, Leerstoel Bockting, Clinical Psychology (onderzoeksprogramma), Biesheuvel-Leliefeld, Karolien E M, Dijkstra-Kersten, Sandra M A, van Schaik, Digna J F, van Marwijk, Harm W J, Smit, Filip, van der Horst, Henriette E, and Bockting, Claudi L H
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- 2017
15. Effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: A pragmatic cluster randomized controlled trial
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Pols, Alide D., primary, van Dijk, Susan E., additional, Bosmans, Judith E., additional, Hoekstra, Trynke, additional, van Marwijk, Harm W. J., additional, van Tulder, Maurits W., additional, and Adriaanse, Marcel C., additional
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- 2017
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16. The CIPRUS study, a nurse-led psychological treatment for patients with undifferentiated somatoform disorder in primary care: study protocol for a randomised controlled trial
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Sitnikova, Kate, primary, Leone, Stephanie S., additional, Zonneveld, Lyonne N. L., additional, van Marwijk, Harm W. J., additional, Bosmans, Judith E., additional, van der Wouden, Johannes C., additional, and van der Horst, Henriëtte E., additional
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- 2017
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17. Process evaluation of a stepped-care program to prevent depression in primary care: patients’ and practice nurses’ experiences
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Pols, Alide D., primary, Schipper, Karen, additional, Overkamp, Debbie, additional, van Dijk, Susan E., additional, Bosmans, Judith E., additional, van Marwijk, Harm W. J., additional, Adriaanse, Marcel C., additional, and van Tulder, Maurits W., additional
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- 2017
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18. Pulling out all the stops: what motivates 65+ year olds with depressive symptoms to participate in an outreaching preference-led intervention programme?
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van Beljouw, Ilse M J, Heerings, Marjolijn, Abma, Tineke A, Laurant, Miranda G H, Veer-Tazelaar, Petronella J Van't, Baur, Vivianne E, Stek, Max L, van Marwijk, Harm W J, Van Exel, Eric, Heerings, M., Technology Assessment (TA), Psychiatry, Ethics, Law & Medical humanities, General practice, and EMGO - Mental health
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Male ,medicine.medical_specialty ,Psychological intervention ,Logistic regression ,Severity of Illness Index ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,Intervention (counseling) ,Surveys and Questionnaires ,Medicine ,Humans ,Psychiatry ,Mass screening ,Depression (differential diagnoses) ,Aged ,Netherlands ,Aged, 80 and over ,business.industry ,Depression ,Loneliness ,Social Support ,Patient Acceptance of Health Care ,Preference ,Psychiatry and Mental health ,Cross-Sectional Studies ,Female ,Geriatrics and Gerontology ,Pshychiatric Mental Health ,medicine.symptom ,business ,Gerontology ,Qualitative research ,Clinical psychology - Abstract
Item does not contain fulltext OBJECTIVES: Many older adults have significant depressive symptoms but few people access care for these. This study explores which personal, clinical and need factors facilitate or hinder acceptance of a new outreaching preference-led intervention programme. METHODS: From a sample of 9661 community-dwelling 65+ year olds, 244 persons with depressive symptoms according to the Patient Health Questionnaire-9 were included. Data on programme effectiveness in terms of care utilisation were collected. Associations between programme acceptance and personal, clinical and need factors were studied using quantitative (logistic regression analyses) and qualitative methods (semi-structured interviews with 26 subjects, who accepted (n = 20) or declined (n = 6) the programme). RESULTS: Fifty-six per cent (n = 137) took part in the interventions. Quantitative logistic regression analyses showed that participants were more often female, suffered from more severe depressive symptoms and perceived more loneliness. Qualitative analyses revealed that people accepting the intervention programme felt that medical terms as having a depressed mood were applicable to their situation, more often perceived their symptoms as hindering, felt lonely and more often perceived a need for care. They were more often advised by their general practitioner to participate than individuals who refused the interventions. Many participating individuals did not see a match between the intervention programme and their needs, especially with respect to meeting new people. CONCLUSION: Many older persons with depressive symptoms did not feel the need to take part in the programme. Providing support in alleviating loneliness and further adaptation to older adults' illness representations and perceptions when discussing depressive symptoms might enhance care utilisation.
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- 2015
19. Case Finding of Mild Cognitive Impairment and Dementia and Subsequent Care; Results of a Cluster RCT in Primary Care
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van den Dungen, Pim, primary, Moll van Charante, Eric P., additional, van de Ven, Peter M., additional, van Marwijk, Harm W. J., additional, van der Horst, Henriëtte E., additional, and van Hout, Hein P. J., additional
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- 2016
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20. Cross-cultural validation of the Turkish Four-Dimensional Symptom Questionnaire (4DSQ) using differential item and test functioning (DIF and DTF) analysis
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Terluin, Berend, primary, Unalan, Pemra C., additional, Turfaner Sipahioğlu, Nurver, additional, Arslan Özkul, Seda, additional, and van Marwijk, Harm W. J., additional
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- 2016
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21. The association between medically unexplained physical symptoms and health care use over two years and the influence of depressive and anxiety disorders and personality traits: a longitudinal study
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den Boeft, Madelon, primary, Twisk, Jos W. R., additional, Terluin, Berend, additional, Penninx, Brenda W. J. H., additional, van Marwijk, Harm W. J., additional, Numans, Mattijs E., additional, van der Wouden, Johannes C., additional, and van der Horst, Henriette E., additional
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- 2016
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22. Pain as a risk factor for common mental disorders. Results from the Netherlands Mental Health Survey and Incidence Study-2: a longitudinal, population-based study.
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de Heer, Eric W., ten Have, Margreet, van Marwijk, Harm W. J., Dekker, Jack, de Graaf, Ron, Beekman, Aartjan T. F., van der Feltz-Cornelis, Christina M., Have, Margreet Ten, and Graaf, Ron de
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- 2018
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23. Dutch family physicians’ awareness of cognitive impairment among the elderly
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van den Dungen, Pim, primary, Moll van Charante, Eric P., additional, van de Ven, Peter M., additional, Foppes, Gerbrand, additional, van Campen, Jos P. C. M., additional, van Marwijk, Harm W. J., additional, van der Horst, Henriëtte E., additional, and van Hout, Hein P. J., additional
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- 2015
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24. Depression increases the onset of cardiovascular disease over and above other determinants in older primary care patients, a cohort study
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van Marwijk, Harm W. J., primary, van der Kooy, Koen G., additional, Stehouwer, Coen D. A., additional, Beekman, Aartjan T. F., additional, and van Hout, Hein P. J., additional
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- 2015
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25. Effects of Two-Year Vitamin B12 and Folic Acid Supplementation on Depressive Symptoms and Quality of Life in Older Adults with Elevated Homocysteine Concentrations: Additional Results from the B-PROOF Study, an RCT.
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de Koning, Elisa J., van der Zwaluw, Nikita L., van Wijngaarden, Janneke P., Sohl, Evelien, Brouwer-Brolsma, Elske M., van Marwijk, Harm W. J., Enneman, Anke W., Swart, Karin M. A., van Dijk, Suzanne C., Ham, Annelies C., van der Velde, Nathalie, Uitterlinden, André G., Penninx, Brenda W. J. H., Elders, Petra J. M., Lips, Paul, Dhonukshe-Rutten, Rosalie A. M., van Schoor, Natasja M., and de Groot, Lisette C. P. G. M.
- Abstract
Lowering elevated plasma homocysteine (Hcy) concentrations by supplementing vitamin B
12 and folic acid may reduce depressive symptoms and improve health-related quality of life (HR-QoL) in older adults. This study aimed to test this hypothesis in a randomized controlled trial. Participants (N = 2919, ≥65 years, Hcy concentrations ≥12 µmol/L) received either 500 µg vitamin B12 and 400 µg folic acid daily or placebo for two years. Both tablets contained 15 µg vitamin D3 . Depressive symptoms were measured with the Geriatric Depression Scale-15 (GDS-15). HR-QoL was assessed with the SF-12 Mental and Physical component summary scores and the EQ-5D Index score and Visual Analogue Scale. Differences in two-year change scores were analyzed with Analysis of Covariance (ANCOVA). Hcy concentrations decreased more in the intervention group, but two-year change scores of the GDS-15 and three of four HR-QoL measures did not differ between groups. The EQ-5D Index score declined less in the intervention group than in the placebo group (mean change 0.00 vs. -0.02, p = 0.004). In conclusion, two-year supplementation with vitamin B12 and folic acid in older adults with hyperhomocysteinemia showed that lowering Hcy concentrations does not reduce depressive symptoms, but it may have a small positive effect on HR-QoL. [ABSTRACT FROM AUTHOR]- Published
- 2016
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26. The Association of Depression and Anxiety with Pain: A Study from NESDA
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de Heer, Eric W., primary, Gerrits, Marloes M. J. G., additional, Beekman, Aartjan T. F., additional, Dekker, Jack, additional, van Marwijk, Harm W. J., additional, de Waal, Margot W. M., additional, Spinhoven, Philip, additional, Penninx, Brenda W. J. H., additional, and van der Feltz-Cornelis, Christina M., additional
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- 2014
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27. Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care.
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Bosman, Renske C., Huijbregts, Klaas M., Verhaak, Peter F. M., Ruhé, Henricus G., van Marwijk, Harm W. J., van Balkom, Anton J. L. M., Batelaan, Neeltje M., Verhaak, Peter Fm, van Marwijk, Harm Wj, and van Balkom, Anton Jlm
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ANTIDEPRESSANTS ,MENTAL depression ,THERAPEUTICS ,ANXIETY ,PATIENT acceptance of health care ,HEALTH outcome assessment ,ATTITUDE (Psychology) ,DRUG administration ,FAMILY medicine ,INTERVIEWING ,LONG-term health care ,RESEARCH methodology ,MEDICAL personnel ,PRIMARY health care ,QUALITATIVE research ,TREATMENT effectiveness ,ANXIETY disorders ,PSYCHOLOGY - Abstract
Background: Antidepressant use is often prolonged in patients with anxiety and/or depressive disorder(s) compared with recommendations in treatment guidelines to discontinue after sustained remission.Aim: To unravel the motivations of patients and GPs causing long-term antidepressant use and to gain insight into possibilities to prevent unnecessary long-term use.Design and Setting: Qualitative study using semi-structured, in-depth interviews with patients and GPs in the Netherlands.Method: Patients with anxiety and/or depressive disorder(s) (n = 38) and GPs (n = 26) were interviewed. Innovatively, the interplay between patients and their GPs was also investigated by means of patient-GP dyads (n = 20).Results: The motives and barriers of patients and GPs to continue or discontinue antidepressants were related to the availability of supportive guidance during discontinuation, the personal circumstances of the patient, and considerations of the patient or GP. Importantly, dyads indicated a large variation in policies of general practices around long-term use and continuation or discontinuation of antidepressants. Dyads further indicated that patients and GPs seemed unaware of each other's (mismatching) expectations regarding responsibility to initiate discussing continuation or discontinuation.Conclusion: Although motives and barriers to antidepressant continuation or discontinuation were related to the same themes for patients and GPs, dyads indicated discrepancies between them. Discussion between patients and GPs about antidepressant use and continuation or discontinuation may help clarify mutual expectations and opinions. Agreements between a patient and their GP can be included in a patient-tailored treatment plan. [ABSTRACT FROM AUTHOR]- Published
- 2016
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28. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study.
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van Eck van der Sluijs, Jonna F., ten Have, Margreet, Rijnders, Cees A., van Marwijk, Harm W. J., de Graaf, Ron, and van der Feltz-Cornelis, Christina M.
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MENTAL health ,MENTAL illness ,PATHOLOGICAL psychology ,MENTAL health services ,MEDICAL care - Abstract
Objective: The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods: Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face cohort study among the general population aged 18-64 years. We selected subjects with medically unexplained symptoms (MUS) only (MUSonly; n=177), explained physical symptoms only (PHYonly, n=1,952), combined MUS and explained physical symptoms (MUS + PHY, n=209), and controls without physical symptoms (NONE, n=4,168). We studied entry into mental health care and the number of treatment contacts for mental problems, in both primary care and specialized mental health care. Analyses were adjusted for sociodemographic characteristics and presence of any 12-month mental disorder assessed with the Composite International Diagnostic Interview 3.0. Results: At the primary care level, all three groups of subjects with physical symptoms showed entry into care for mental health problems significantly more often than controls. The adjusted odds ratios were 2.29 (1.33, 3.95) for MUSonly, 1.55 (1.13, 2.12) for PHYonly, and 2.25 (1.41, 3.57) for MUS + PHY. At the specialized mental health care level, this was the case only for MUSonly subjects (adjusted odds ratio 1.65 [1.04, 2.61]). In both the primary and specialized mental health care, there were no significant differences between the four groups in the number of treatment contacts once they entered into treatment. Conclusion: All sorts of physical symptoms, unexplained as well as explained, were associated with significant higher entry into primary care for mental problems. In specialized mental health care, this was true only for MUSonly. No differences were found in the number of treatment contacts. This warrants further research aimed at the content of the treatment contacts. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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29. Collaborative care for anxiety disorders in primary care: a systematic review and meta-analysis.
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Muntingh, Anna D. T., van der Feltz-Cornelis, Christina M., van Marwijk, Harm W. J., Spinhoven, Philip, and van Balkom, Anton J. L. M.
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ANXIETY treatment ,ANXIETY ,CINAHL database ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,MEDICAL practice ,MEDLINE ,META-analysis ,ONLINE information services ,PRIMARY health care ,SYSTEMATIC reviews ,TREATMENT effectiveness - Abstract
Background: Studies evaluating collaborative care for anxiety disorders are recently emerging. A systematic review and meta-analysis to estimate the effect of collaborative care for adult patients with anxiety disorders in primary care is therefore warranted. Methods: A literature search was performed. Data sources: PubMed, Psycinfo, Embase, Cinahl, and the Cochrane library. Study eligibility criteria: Randomized controlled trials examining the effects of collaborative care for adult primary care patients with an anxiety disorder, compared to care as usual or another intervention. Synthesis methods: Standardized mean differences (SMD) on an anxiety scale closest to twelve months follow-up were calculated and pooled in a random effects meta-analysis. Results: Of the 3073 studies found, seven studies were included with a total of 2105 participants. Included studies were of moderate to high quality. Collaborative care was superior to care as usual, with a small effect size (SMD = 0.35 95 % CI 0.14-0.56) for all anxiety disorders combined and a moderate effect size (SMD = 0.59, 95 % CI 0.41-0.78) in a subgroup analysis (five studies) on patients with panic disorder. Conclusions: Collaborative care seems to be a promising strategy for improving primary care for anxiety disorders, in particular panic disorder. However, the number of studies is still small and further research is needed to evaluate the effectiveness in other anxiety disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
30. Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study.
- Author
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Biesheuvel-Leliefeld, Karolien E. M., Kok, Gemma D., Bockting, Claudi L. H., de Graaf, Ron, ten Have, Margreet, van der Horst, Henriette E., van Schaik, Anneke, van Marwijk, Harm W. J., and Smit, Filip
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DEPRESSED persons ,EPIDEMIOLOGICAL research ,PSYCHIATRIC research ,MENTAL health ,DIAGNOSIS of mental depression - Abstract
Background: Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity. Methods: We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Results: Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity. Conclusions: The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
31. Vitamin D supplementation to prevent depression and poor physical function in older adults: Study protocol of the D-Vitaal study, a randomized placebo-controlled clinical trial.
- Author
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de Koning, Elisa J., van Schoor, Natasja M., Penninx, Brenda W. J. H., Elders, Petra J. M., Heijboer, Annemieke C., Smit, Jan. H., Bet, Pierre M., van Tulder, Maurits W., den Heijer, Martin, van Marwijk, Harm W. J., and Lips, Paul
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VITAMIN D in human nutrition ,PREVENTION of mental depression ,QUALITY of life ,ANXIETY ,RANDOMIZED controlled trials ,DIAGNOSIS of mental depression ,THERAPEUTICS ,ACTIVITIES of daily living ,COGNITION ,COMPARATIVE studies ,MENTAL depression ,DIETARY supplements ,RESEARCH methodology ,MEDICAL cooperation ,MOTOR ability ,HEALTH outcome assessment ,RESEARCH ,STATISTICAL sampling ,VITAMIN D ,VITAMINS ,EVALUATION research ,BLIND experiment ,PSYCHOLOGY - Abstract
Background: Depressive symptoms and decreased physical functioning are interrelated conditions and common in older persons, causing significant individual and societal burden. Evidence suggests that vitamin D supplementation may be beneficial for both mental and physical functioning. However, previous randomized controlled trials have yielded inconsistent results and often had suboptimal designs. This study examines the effect of vitamin D supplementation on both depressive symptoms and physical functioning in a high-risk population of older persons with low vitamin D status.Methods/design: The D-Vitaal study is a randomized, double-blind, placebo-controlled trial investigating the effects of a daily dose of 1200 IU vitamin D3 versus placebo for one year on depressive symptoms and physical functioning (primary outcomes) in older adults. Participants (N = 155, age 60-80 years) were recruited from the general population. Eligibility criteria included the presence of depressive symptoms, ≥1 functional limitation and serum 25-hydroxyvitamin D levels between 15 and 50/70 nmol/L (depending on season). Secondary outcomes include incidence of major depressive disorder, anxiety symptoms, health-related quality of life, cognitive function and cost-effectiveness of the intervention.Discussion: With this study, we aim to elucidate the effects of vitamin D supplementation on depressive symptoms and physical functioning in older persons who are at high risk of developing more substantial mental and physical problems. If effective, vitamin D supplementation can be a preventive intervention strategy that is easy to implement in the primary care setting.Trial Registration: Netherlands Trial Register NTR3845. Registered 6 February 2013. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
32. Predictors of Societal Costs in Dementia Patients and Their Informal Caregivers: A Two-Year Prospective Cohort Study.
- Author
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Joling, Karlijn J., Schöpe, Jakob, van Hout, Hein P. J., van Marwijk, Harm W. J., van der Horst, Henriëtte E., and Bosmans, Judith E.
- Abstract
Objectives: Dementia poses a substantial economic burden on society. Knowing which factors predict high costs in dementia may help to better target interventions and optimize resource allocation. This study aimed to identify predictors of the total societal costs in dementia patients and their informal caregivers.Design: Prospective cohort study with 2-year follow up.Setting and Participants: 192 community-dwelling patients with dementia and their primary informal caregivers in the Netherlands.Measurements: Data on health care resource utilization, informal carer time and caregivers' work absenteeism were collected by cost diaries and interviews. Predictors of total costs were identified for patient-caregiver dyads, and for patients and informal caregivers separately by performing univariate and multivariate generalized linear models.Results: Societal costs of patient-caregiver dyads averaged €75,084 (SEM: €4,263) in the first year and €99,369 (SEM: €6,441) in the second year. Sixty percent was attributed to costs of informal care. Patient impairments in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), disruptions during daily activities of the caregiver, and receiving case management were significantly associated with higher costs in dyads. The same predictors remained significant for patients' costs separately, and for informal caregivers, a poorer caregiver's quality of life and having more chronic diseases determined higher costs.Conclusions: The societal costs of dementia are substantial and mainly due to high costs of informal care. The burden for caregivers caused by a disrupted schedule and patients' ADL and IADL dependencies contributed most to the total costs. Interventions targeting these factors effectively might result in relevant economic benefits for society. [ABSTRACT FROM AUTHOR]- Published
- 2015
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33. Does an Outreaching Stepped Care Program Reduce Depressive Symptoms in Community-Dwelling Older Adults? A Randomized Implementation Trial.
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van Beljouw, Ilse M. J., van Exel, Eric, van de Ven, Peter M., Joling, Karlijn J., Dhondt, Ton D. F., Stek, Max L., and van Marwijk, Harm W. J.
- Abstract
The article presents a study which evaluated the effects of an outreaching stepped care intervention program called Lust for Life on the depressive symptoms of older adults living in a community. Study participants included 263 community-dwelling 65+-year-old patients with depressive symptoms in 18 general practices and a home care organization in the Netherlands. In the short term, it was found that the Lust for Life program relieves the depressive symptoms of older adults in primary care.
- Published
- 2015
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34. The Two-Year Incidence of Depression and Anxiety Disorders in Spousal Caregivers of Persons with Dementia: Who is at the Greatest Risk?
- Author
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Joling, Karlijn J., van Marwijk, Harm W. J., Veldhuijzen, Aaltje E., van der Horst, Henriëtte E., Scheltens, Philip, Smit, Filip, and van Hout, Hein P. J.
- Abstract
The article reports on research which was conducted to investigate the incidence of depression and anxiety in spousal caregivers who cared for patients with dementia. Researchers evaluated 181 caregivers. They found that caregivers of dementia patients have a high risk of developing a mental disorder, including anxiety and depression.
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- 2015
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35. Vitamin D supplementation to prevent depression and poor physical function in older adults: Study protocol of the DVitaal study, a randomized placebocontrolled clinical trial.
- Author
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de Koning, Elisa J., van Schoor, Natasja M., Penninx, Brenda W. J. H., Elders, Petra J. M., Heijboer, Annemieke C., Smit, Jan. H., Bet, Pierre M., van Tulder, Maurits W., den Heijer, Martin, van Marwijk, Harm W. J., and Lips, Paul
- Subjects
VITAMIN D in human nutrition ,DIETARY supplements ,PREVENTION of mental depression ,MENTAL health of older people ,RESEARCH protocols ,CLINICAL trials - Abstract
Background: Depressive symptoms and decreased physical functioning are interrelated conditions and common in older persons, causing significant individual and societal burden. Evidence suggests that vitamin D supplementation may be. beneficial for both mental and physical functioning. However, previous randomized controlled trials have yielded inconsistent results and often had suboptimal designs. This study examines the effect of vitamin D supplementation on both depressive symptoms and physical functioning in a high-risk population of older persons with low vitamin D status. Methods/design: The D-Vitaal study is a randomized, double-blind, placebo-controlled trial investigating the effects of a daily dose of 1200 IU vitamin D3 versus placebo for one year on depressive symptoms and physical functioning (primary outcomes) in older adults. Participants (N = 155, age 60-80 years) were recruited from the general population. Eligibility criteria included the presence of depressive symptoms, =1 functional limitation and serum 25-hydroxyvitamin D levels between 15 and 50/70 nmol/L (depending on season). Secondary outcomes include incidence of major depressive disorder, anxiety symptoms, health-related quality of life, cognitive function and cost-effectiveness of the intervention. Discussion: With this study, we aim to elucidate the effects of vitamin D supplementation on depressive symptoms and physical functioning in older persons who are at high risk of developing more substantial mental and physical problems. If effective, vitamin D supplementation can be a preventive intervention strategy that is easy to implement in the primary care setting. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
36. A Scoping Review of Correctional-Based Interventions for Women Prisoners with Mental Health Problems.
- Author
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Hidayati, Nur Oktavia, Suryani, Suryani, Rahayuwati, Laili, Fitrasanti, Berlian Isnia, and Ahmad, Che an
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MENTAL illness ,WOMEN'S mental health ,MENTAL health services ,ACCEPTANCE & commitment therapy ,MEDICAL personnel - Abstract
Women prisoners are a population at a high risk of experiencing stress, anxiety, and other mental health problems. This is because stressors in prisons, such as strict prison rules, intimidation, and conflicts with other inmates and staff, cause a high prevalence of mental health problems in women prisoners. Mental health services, such as correctional-based interventions, are an important part of overcoming these problems. Therefore, this study aimed to identify correctional-based interventions for women prisoners with mental health problems, specifically to determine the types of correctional-based interventions, the types of mental health problems experienced by women prisoners, and the effectiveness of the interventions. The method used was a scoping review based on Arksey and O'Malley's framework. Articles were searched using Scopus, CINAHL, PubMed, Science Direct, and Google Scholar with the keywords "Mental Health Care" OR "Mental Health Services" AND "Correctional Program" AND "Interventions" AND "Mental Disorder" OR "Mental Health Problems" AND Women" OR "Female" AND "Inmates" OR "Offenders" OR "Prisoners" OR "Convicts". The inclusion criteria used were the year of publication (2000–2023), full-text articles in English, and the study sample was women prisoners with mental health problems. After selection, a total of 10 articles were found to meet the review inclusion criteria. The results showed that the correctional-based interventions given to women prisoners with mental health problems included Yoga, which combines mind and body; Seeking Safety, which was a manual CBT model; Transactional Analysis (TA) training program to enhance communication, relationships, and personal well-being; Transcendental Meditation (TM), a simple technique to reduce mental stress; Acceptance and Commitment Therapy (ACT) teaches the ability to accept painful or unwanted emotions; and Trauma Effect Regulation to reduce post-traumatic stress disorder (PTSD). All correctional-based interventions had significant results and can be used by health practitioners in prisons to address mental health problems experienced by women prisoners. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
37. Systematic review of measurement properties of questionnaires measuring somatization in primary care patients.
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Sitnikova, Kate, Dijkstra-Kersten, Sandra M A, Mokkink, Lidwine B, Terluin, Berend, van Marwijk, Harm W J, Leone, Stephanie S, van der Horst, Henriëtte E, and van der Wouden, Johannes C
- Subjects
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SOMATOFORM disorders , *PRIMARY health care , *QUESTIONNAIRES , *SELF-evaluation , *SYSTEMATIC reviews , *DIAGNOSIS ,RESEARCH evaluation - Abstract
Objective: The aim of this review is to critically appraise the evidence on measurement properties of self-report questionnaires measuring somatization in adult primary care patients and to provide recommendations about which questionnaires are most useful for this purpose.Methods: We assessed the methodological quality of included studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. To draw overall conclusions about the quality of the questionnaires, we conducted an evidence synthesis using predefined criteria for judging the measurement properties.Results: We found 24 articles on 9 questionnaires. Studies on the Patient Health Questionnaire-15 (PHQ-15) and the Four-Dimensional Symptom Questionnaire (4DSQ) somatization subscale prevailed and covered the broadest range of measurement properties. These questionnaires had the best internal consistency, test-retest reliability, structural validity, and construct validity. The PHQ-15 also had good criterion validity, whereas the 4DSQ somatization subscale was validated in several languages. The Bodily Distress Syndrome (BDS) checklist had good internal consistency and structural validity. Some evidence was found for good construct validity and criterion validity of the Physical Symptom Checklist (PSC-51) and good construct validity of the Symptom Check-List (SCL-90-R) somatization subscale. However, these three questionnaires were only studied in a small number of primary care studies.Conclusion: Based on our findings, we recommend the use of either the PHQ-15 or 4DSQ somatization subscale for somatization in primary care. Other questionnaires, such as the BDS checklist, PSC-51 and the SCL-90-R somatization subscale show promising results but have not been studied extensively in primary care. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
38. Is the association between precarious employment and mental health mediated by economic difficulties in males? Results from two Italian studies.
- Author
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Ferrante, Gianluigi, Fasanelli, Francesca, Gigantesco, Antonella, Ferracin, Elisa, Contoli, Benedetta, Costa, Giuseppe, Gargiulo, Lidia, Marra, Michele, Masocco, Maria, Minardi, Valentina, Violani, Cristiano, Zengarini, Nicolás, d'Errico, Angelo, and Ricceri, Fulvio
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MENTAL health ,CONTINGENT employment ,HEALTH behavior ,QUALITY of life ,DYSTHYMIC disorder - Abstract
Background: Flexible employment is increasing across Europe and recent studies show an association with poor mental health. The goal of the current study is to examine this association in the Italian population to assess the possible mediating role of financial strain.Methods: Data were obtained by two Italian cross-sectional studies (PASSI and HIS) aimed at monitoring the general population health status, health behaviours and determinants. Mental health status was assessed using alternatively two validated questionnaires (the PHQ-2 and the MCS-12 score) and Poisson regression models were performed to assess if precarious work was associated with poor mental health. A formal mediation analysis was conducted to evaluate if the association between precarious work and mental health was mediated by financial strain.Results: The analyses were performed on 31,948 subjects in PASSI and on 21,894 subjects in HIS. A nearly two-fold risk of depression and poor mental health was found among precarious workers, compared to workers with a permanent contract, which was strongly mediated by financial strain.Conclusions: Even with the limitations of a cross-sectional design, this research supports that precarious employment contributes through financial strain to reduce the mental health related quality of life and to increase mental disorders such as symptoms of depression or dysthymia. This suggests that when stability in work cannot be guaranteed, it would be appropriate to intervene on the wages of precarious jobs and to provide social safety nets for ensuring adequate income. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
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39. Psychological Interventions for Dementia Caregivers: What We Have Achieved, What We Have Learned.
- Author
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Cheng, Sheung-Tak, Au, Alma, Losada, Andrés, Thompson, Larry W., and Gallagher-Thompson, Dolores
- Abstract
With the rising dementia population, more and more programs have been developed to help caregivers deal with the care-recipient as well as their own frustrations. Many interventions aim to enhance caregiver's ability to manage behavior problems and other deteriorations in functioning, with less direct emphasis placed on caring for the caregivers. We argue that techniques based on psychotherapy are strategically important in assistance provided to caregivers because of their utility for promoting emotional health. This article provides a focused review of such methods used in evidence-based intervention programs, along with the mechanisms of change associated with these methods. While cognitive-behavioral therapy (CBT) has a strong evidence base, there is also a growing trend to package CBT techniques into various psychoeducational programs. These programs, which we call psychoeducation with psychotherapeutic programs, have been consistently found to be effective in reducing caregiver distress and are suited for delivery in group format, even by paraprofessionals, to lower the cost of intervention. A recent trend is the effective use of technological aids (e.g., the internet) to deliver CBT and psychoeducation, reaching more caregivers. As for therapeutic mechanisms, the use of coping skills, reduced dysfunctional thoughts, and increased self-efficacy in controlling upsetting thoughts has received support in studies. We conclude that psychotherapeutic techniques are increasingly being used effectively and efficiently to assist caregivers, aided by successful adaptation for educational or technologically advanced means of delivery. More research on therapeutic mechanisms is needed to understand how the techniques work and how they can be further refined. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
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