180 results on '"A T F, Beekman"'
Search Results
102. Collaborative Care for Patients With Severe Personality Disorders: Preliminary Results and Active Ingredients From a Pilot Study (Part I)
- Author
-
Barbara, Stringer, Berno, van Meijel, Pieter, Karman, Bauke, Koekkoek, Adriaan W, Hoogendoorn, Ad J F M, Kerkhof, and Aartjan T F, Beekman
- Subjects
Adult ,Male ,Mental Health Services ,Psychiatric Status Rating Scales ,Pilot Projects ,Middle Aged ,Nurse's Role ,Caregivers ,Borderline Personality Disorder ,Humans ,Female ,Self Report ,Cooperative Behavior ,Problem Solving ,Netherlands - Abstract
To test if a collaborative care program (CCP) with nurses in a coordinating position is beneficial for patients with severe personality disorders.A pilot study with a comparative multiple case study design using mixed methods investigating active ingredients and preliminary results.Most patients, their informal caregivers, and nurses value (parts of) the CCP positively; preliminary results show a significant decrease in severity of borderline symptoms.With the CCP, we may expand the supply of available treatments for patients with (severe) personality disorders, but a larger randomized controlled trial is warranted to confirm our preliminary results.
- Published
- 2014
103. [Are psychiatric patients likely to benefit from DSM-5?]
- Author
-
A T F, Beekman and R A, Schoevers
- Subjects
Diagnostic and Statistical Manual of Mental Disorders ,Psychiatry ,Patient Satisfaction ,Mental Disorders ,Humans ,Netherlands - Abstract
The diagnosis plays a central role in medicine. If the validity of a diagnosis is in doubt, there will be doubt with regard to the existence of illness, the legitimacy of illness-behavior in the patient and the necessity of medical treatment. In this paper we discuss the changes made in DSM-5, testing whether they will contribute to a better position of our patients and of psychiatry.Critical appraisal of the changes made in DSM-5 and their potential impact on the position of our patients and of psychiatry.Critical discussion.DSM-5 has seen improvements in a series of essential areas, which will indeed benefit our patients. However, the most fundamental problems inherent in a system that aims to classify symptoms, disregarding their etiology, have not been solved.Given our infrastructure, we are well positioned to further develop and standardise appropriate medical specialty psychiatric diagnosis. This is more fruitful than ongoing criticism of DSM.
- Published
- 2014
104. Health, drugs and service use among deprived single men: comparing (subgroups) of single male welfare recipients against employed single men in Amsterdam
- Author
-
A. T. F. Beekman, Stephan W Cremer, T.C. Kamann, M.A.S. de Wit, EMGO+ - Mental Health, Psychiatry, and EMGO - Mental health
- Subjects
Adult ,Male ,Gerontology ,medicine.medical_specialty ,Substance-Related Disorders ,Epidemiology ,Somatic Health ,Vulnerable Populations ,Interviews as Topic ,Risk Factors ,Surveys and Questionnaires ,Health care ,Urban Health Services ,medicine ,Health Status Indicators ,Humans ,Single person ,Health policy ,Netherlands ,Service Use ,business.industry ,Health Policy ,Mental Disorders ,Research ,Public health ,Single Person ,General Medicine ,SDG 10 - Reduced Inequalities ,Middle Aged ,Mental health ,Health equity ,Cross-Sectional Studies ,Mental Health ,Social Isolation ,Socioeconomic Factors ,Unemployment ,Health education ,Public Health ,business ,Social Welfare - Abstract
Objectives: To aid public health policy in preventing severe social exclusion (like homelessness) and promoting social inclusion (like labour market participation), we aimed to quantify (unmet) health needs of an expectedly vulnerable population on which little was known about: single male welfare recipients (SIM-welfare). One of the main policy questions was: is there need to promote access to healthcare for this specific group? Design: A cross-sectional study incorporating peer-to-peer methodology to approach and survey SIM-welfare. Sociodemographics, prevalence of ill health, harmful drug use and healthcare utilisation for subgroups of SIM-welfare assessed with a different distance to the labour market and exposed to different reintegration policy were described and compared against single employed men (SIM-work). Setting: Men between the age of 23 and 64, living in single person households in Amsterdam. Participants: A random and representative sample of 472 SIM-welfare was surveyed during 2009-2010. A reference sample of 212 SIM-work was taken from the 2008 Amsterdam Health Survey. Outcome measures: Standardised instruments were used to assess self-reported ill somatic and mental health, harmful drug use and service use. Results: SIM-welfare are mostly long-term jobless, low educated, older men; 70% are excluded from reemployment policy due to multiple personal barriers. Health: 50% anxiety and depression; 47% harmful drug use; 41% multiple somatic illnesses. Health differences compared with SIM-work: (1) controlled for background characteristics, SIM-welfare report more mental (OR 4.0; 95% CI 2.1 to 4.7) and somatic illnesses (OR 3.1; 95% CI 2.7 to 6.0); (2) SIM-welfare assessed with the largest distance to the labour market report most combined health problems. Controlled for ill health, SIM-welfare are more likely to have service contacts than SIM-work. Conclusions: SIM-welfare form a selection of men with disadvantaged human capital and health. Findings do not support a need to improve access to healthcare. The stratification of welfare clients distinguishes between health needs.
- Published
- 2014
105. Emergence and persistence of late life depression: a 3-year follow-up of the Longitudinal Aging Study Amsterdam
- Author
-
Robert A. Schoevers, W. van Tilburg, Dorly J. H. Deeg, Jan Smit, S. W. Geerlings, A. T. F. Beekman, Psychiatry, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, APH - Mental Health, Epidemiology and Data Science, APH - Aging & Later Life, Sociology and Social Gerontology, Sociology [until 2010], and The Social Context of Aging (SoCA)
- Subjects
Male ,Persistence (psychology) ,Gerontology ,Aging ,medicine.medical_specialty ,Population ,Life Change Events ,SDG 3 - Good Health and Well-being ,Risk Factors ,Epidemiology ,Prevalence ,medicine ,Humans ,Longitudinal Studies ,Age of Onset ,Risk factor ,education ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,Depressive Disorder ,education.field_of_study ,Middle Aged ,Late life depression ,Center for Epidemiologic Studies Depression Scale ,Prognosis ,Psychiatry and Mental health ,Clinical Psychology ,Geriatrics ,Female ,Age of onset ,Psychology ,Demography - Abstract
Background: The present study was designed to assess onset and persistence of late-life depression, systematically comparing the factors associated with prevalence, onset and prognosis. Methods: The data were derived from a large (n = 2200), random, age and sex stratified sample of the elderly (55-85 years) in The Netherlands. Using a 3-year, prospective longitudinal design, both the onset and the persistence of depression were assessed. Depression was measured using the Center for Epidemiologic Studies Depression Scale. Risk factors associated with prevalence, onset and persistence were compared using both bivariate and multivariate analyses. Results: In those not depressed at index assessment, the onset of depression was 9.7%. Among those depressed at baseline, persistence occurred in 50.4%. Risk factors predicting onset were almost identical to those associated with prevalence. Persistence was predicted by very few factors (external locus of control and chronic physical illness). Conclusions: The data suggest that cross-sectional studies are biased due to their overrepresenting chronic depressive episodes. However, the risk factors derived from cross-sectional studies do seem to adequately reflect factors associated with onset. The prognosis is not adequately predicted by variables usually included in epidemiological studies of late life depression. It is speculated that including more biological correlates of depression and data concerning positive life-changes may improve our understanding of the prognosis of late life depression. © 2001 Elsevier Science B.V.
- Published
- 2001
106. A 13-year prospective cohort study on the effects of aging and frailty on the depression-pain relationship in older adults
- Author
-
Joost B, Sanders, Hannie C, Comijs, Marijke A, Bremmer, Dorly J H, Deeg, and Aartjan T F, Beekman
- Subjects
Aged, 80 and over ,Male ,Aging ,Depressive Disorder ,Time Factors ,Frail Elderly ,Pain ,Middle Aged ,Risk Factors ,Linear Models ,Humans ,Female ,Longitudinal Studies ,Prospective Studies ,Aged - Abstract
The primary aim of the study is to investigate the effect of age and aging on the association between pain and depression over 13 years. We hypothesized that (1) this association would become stronger with age and frailty and that (2) this association is mainly driven by somatic and psychological factors.Data were derived from the Longitudinal Aging Study Amsterdam, a prospective population-based cohort study with four follow-up measurements over 13 years, consisting of 1528 respondents (mean age 67.9 ± 8.1). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale; pain was measured with an adapted version of the Nottingham Health Profile. Follow-up time and age were used as proxy variables for aging and gait speed as frailty marker. Cognition, mastery and neuroticism were measured using the mini mental state examination, the Pearlin Mastery Scale and the Dutch Personality Questionnaire respectively.Linear mixed models showed that pain and depressive symptoms were associated over the 13-year follow-up: b = 0.095, p0.001. Neither aging nor frailty changed this association. Measured somatic and psychological characteristics explained 40% of the covariance between pain and depressive symptoms over time.When dealing with people suffering from pain and depression, interventions should be similar for all aged people, encompassing both somatic and psychological factors, irrespective of age or frailty status.
- Published
- 2013
107. Comorbidity of the anxiety disorders in a community-based older population inThe Netherlands
- Author
-
E. (Edwin) de Beurs, R. van Dyck, W. van Tilburg, A.J.L.M. van Balkom, A. T. F. Beekman, and Dorly J. H. Deeg
- Subjects
medicine.medical_specialty ,Cross-sectional study ,Cognitive disorder ,Poison control ,medicine.disease ,Comorbidity ,Psychiatry and Mental health ,Severity of illness ,medicine ,Anxiety ,medicine.symptom ,Psychiatry ,Psychology ,Depression (differential diagnoses) ,Anxiety disorder ,Clinical psychology - Abstract
Objective: The aim of the study was to investigate patterns of comorbidity among the anxiety disorders in a community-based older population, and the relationship of these disorders with major depression, use of alcohol and benzodiazepines, cognitive impairment and chronic somatic illnesses. Method: The data were derived from the Longitudinal Aging Study Amsterdam (LASA) study. A two-stage screening design was adopted to identify respondents with anxiety disorders. Results: In total, 10% of the elderly with an anxiety diagnosis suffered from two or more anxiety disorders. Major depression (13% vs. 3%), benzodiazepine use (24% vs. 11%) and chronic somatic diseases (12% vs. 7%) were significantly more prevalent in respondents with an anxiety disorder than in respondents without anxiety disorders. Heavy or excessive alcohol intake (5% vs. 4%) and cognitive impairment (11% vs. 13%) were not significantly associated with any anxiety disorder. Conclusion: When anxiety disorders are diagnosed, in older people there is a relatively high probability of comorbid conditions being present.
- Published
- 2000
108. Cue reactivity is associated with duration and severity of alcohol dependence: an FMRI study
- Author
-
Zsuzsika, Sjoerds, Wim, van den Brink, Aartjan T F, Beekman, Brenda W J H, Penninx, and Dick J, Veltman
- Subjects
Adult ,Male ,Drugs and Devices ,Neuroimaging ,Neuropsychiatric Disorders ,Humans ,Psychology ,Learning ,Biology ,Drug Dependence ,Psychiatry ,Brain Mapping ,Mood Disorders ,fMRI ,Substance Abuse ,Cognitive Psychology ,Brain ,Middle Aged ,Magnetic Resonance Imaging ,Anxiety Disorders ,Alcoholism ,Mental Health ,Neurology ,Behavioral Pharmacology ,Medicine ,Female ,Public Health ,Cues ,Alcohol ,Research Article ,Neuroscience - Abstract
Introduction With the progression of substance dependence, drug cue-related brain activation is thought to shift from motivational towards habit pathways. However, a direct association between cue-induced brain activation and dependence duration has not yet been shown. We therefore examined the relationship between alcohol cue-reactivity in the brain, cue-induced subjective craving and alcohol dependence duration and severity. Since alcohol dependence is highly comorbid with depression/anxiety, which may modulate brain responses to alcohol cues, we also examined the relation between comorbid depression/anxiety and cue-reactivity. Methods We compared 30 alcohol dependent patients with 15 healthy controls and 15 depression/anxiety patients during a visual alcohol cue-reactivity task using functional magnetic resonance imaging blood oxygenated level-dependent responses and subjective craving as outcomes. Within the alcohol dependent group we correlated cue-reactivity with alcohol dependence severity and duration, with cue-induced craving and with depression/anxiety levels. Results Alcohol dependent patients showed greater cue-reactivity in motivational brain pathways and stronger subjective craving than depression/anxiety patients and healthy controls. Depression/anxiety was not associated with cue-reactivity, but depression severity in alcohol dependent patients was positively associated with craving. Within alcohol dependence, longer duration of alcohol dependence was associated with stronger cue-related activation of the posterior putamen, a structure involved in habits, whereas higher alcohol dependence severity was associated with lower cue-reactivity in the anterior putamen, an area implicated in goal-directed behavior preceding habit formation. Conclusion Cue-reactivity in alcohol dependence is not modulated by comorbid depression or anxiety. More importantly, the current data confirm the hypothesis of a ventral to dorsal striatal shift of learning processes with longer dependence duration, which could underlie increasingly habitual substance use with progressing substance dependence.
- Published
- 2013
109. Attention-deficit/hyperactivity disorder, physical health, and lifestyle in older adults
- Author
-
Evert J, Semeijn, J J, Sandra Kooij, Hannie C, Comijs, Marieke, Michielsen, Dorly J H, Deeg, and Aartjan T F, Beekman
- Subjects
Male ,Motor Activity ,Prognosis ,Attention Deficit Disorder with Hyperactivity ,Surveys and Questionnaires ,Disease Progression ,Methylphenidate ,Humans ,Attention ,Central Nervous System Stimulants ,Female ,Geriatric Assessment ,Life Style ,Aged ,Follow-Up Studies ,Netherlands ,Retrospective Studies - Abstract
To increase insight into the effect of attention-deficit/hyperactivity disorder (ADHD) on health in general in older adults.Two-phase sampling side-study.Longitudinal Aging Study Amsterdam (LASA).Two hundred twenty-three randomly selected LASA respondents.Information was collected during home visits on physical health, medication use, and lifestyle characteristics in Phase 1 and on ADHD diagnosis in Phase 2. The associations between independent variables and ADHD were examined with linear and logistic regression analyses.The adjusted regression estimates of the linear regression analysis showed that the number of ADHD symptoms was positively associated with the presence of chronic nonspecific lung diseases (CNSLD) (B = 2.58, P = .02), cardiovascular diseases (B = 2.18, P = .02), and number of chronic diseases (B = 0.69, P = .04) and negatively associated with self-perceived health (B = -2.83, P = .002). Lifestyle is not a mediator of the association between ADHD and physical health.Attention-deficit/hyperactivity disorder in older adults was associated with chronic physical illness and poorer self-perceived health. Contrary to expectations, there were no associations between symptoms of ADHD and lifestyle variables.
- Published
- 2013
110. Detained adolescent females' multiple mental health and adjustment problem outcomes in young adulthood
- Author
-
E, van der Molen, R R J M, Vermeiren, A A, Krabbendam, A T F, Beekman, T A H, Doreleijers, and L M C, Jansen
- Subjects
Psychiatric Status Rating Scales ,Young Adult ,Adolescent ,Mental Disorders ,Adaptation, Psychological ,Psychology, Adolescent ,Juvenile Delinquency ,Humans ,Female ,Prospective Studies ,Social Adjustment ,Follow-Up Studies - Abstract
Although prior studies have shown that detained females are marked by significant adverse circumstances, little is known about their adult outcomes.Prospective follow-up study of 184 (80.4% of original sample of 229) detained adolescent females who were reassessed 4.5 (SD=0.6) years later in young adulthood (mean age=20.0, SD=1.4) on mental health and adjustment outcomes. Associations between these outcomes and detained females' behavior problems and offense history were examined.In the total sample, 59.0% had one or more mental health problems at follow-up, whereas 96.2% were facing at least one adjustment problem. Subjects with a personality disorder (PD) reported more adjustment problems compared to subjects without PD. Mental health and adjustment problems in young adulthood were predicted by detained adolescent females' behavior problems and offense history.Detained adolescent females suffered from multiple mental health and adjustment problems in young adulthood. Females who developed PD were most impaired. Results of this study underline the compelling need for continued and gender-specific interventions. The identification of predictors during detention for poor adult outcomes can serve as targets for intervention.
- Published
- 2013
111. Criterion validity of an Attention Deficit Hyperactivity Disorder (ADHD) screening list for screening ADHD in older adults aged 60-94 years
- Author
-
J. J. S. Kooij, Marieke Michielsen, Hannie C. Comijs, E.J. Semeijn, Dorly J. H. Deeg, A. T. F. Beekman, EMGO - Mental health, Psychiatry, Epidemiology and Data Science, and EMGO+ - Mental Health
- Subjects
Male ,medicine.medical_specialty ,Psychometrics ,Population ,education ,Sensitivity and Specificity ,Older population ,Cronbach's alpha ,Structured diagnostic interview ,Internal consistency ,Surveys and Questionnaires ,Interview, Psychological ,medicine ,Criterion validity ,Attention deficit hyperactivity disorder ,Humans ,Psychiatry ,Aged ,Aged, 80 and over ,education.field_of_study ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Psychiatry and Mental health ,Younger adults ,Attention Deficit Disorder with Hyperactivity ,Female ,Geriatrics and Gerontology ,Psychology - Abstract
Objective: To identify Attention Deficit Hyperactivity disorder (ADHD) in older adults, a validated screener is needed. This study evaluates the reliability and criterion validity of an ADHD screener for younger adults on its usefulness in a population-based sample of older adults. Methods: Data were collected as a side study in the Longitudinal Aging Study Amsterdam. In a two-phase design the validity of the screener was tested against a structured diagnostic interview (DIVA 2.0). In Phase 1, 1,494 respondents (60-94 years) were assessed with the ADHD screener. In Phase 2, 231 respondents participated in the diagnostic interview. Results: Internal consistency (Cronbach's a) and reliability (ICC) of the screener were 0.71 and 0.56, respectively. The area under the curve was 0.82. The optimal cut-point was found at 2 (sensitivity: 0.80; specificity: 0.77; PPV: 0.13; NPV: 0.99). Conclusion: Despite its low ICC, the ADHD screener may serve as a useful contribution to measure ADHD in the older population. © 2013 American Association for Geriatric Psychiatry.
- Published
- 2013
112. Theory of Mind differences in older patients with early-onset and late-onset paranoid schizophrenia
- Author
-
Jan Smit, P. D. Meesters, M. L. Stek, Hannie C. Comijs, A. T. F. Beekman, L. de Haan, P. Eikelenboom, and Maureen M. J. Smeets-Janssen
- Subjects
Psychosis ,Paranoid schizophrenia ,medicine.medical_specialty ,Protective factor ,Late onset ,medicine.disease ,Psychiatry and Mental health ,Social cognition ,Schizophrenia ,Theory of mind ,mental disorders ,medicine ,Clinical significance ,Geriatrics and Gerontology ,Psychology ,Psychiatry - Abstract
Objective Theory of Mind (ToM) is considered an essential element of social cognition. In younger schizophrenia patients, ToM impairments have extensively been demonstrated. It is not clear whether similar impairments can be found in older schizophrenia patients and if these impairments differ between older patients with early-onset and late-onset schizophrenia. Methods Theory of Mind abilities were assessed using the Hinting Task in 15 older patients (age 60 years and older) with early-onset paranoid schizophrenia, 15 older patients with late-onset paranoid schizophrenia and 30 healthy controls. ANCOVA was performed to test differences between groups. Analyses were adjusted for level of education. Effect sizes, partial eta squared (e2), were computed as an indication of the clinical relevance of the findings. Results Patients with early-onset schizophrenia scored significantly lower on the Hinting Task (mean 16.1; SD 4.3) compared with patients with late-onset schizophrenia (mean 18.6; SD 1.5) and with healthy controls (mean 19.0; SD 1.4). The effect size of this difference was large (e2 = 0.2). Conclusions These results suggest that ToM functioning may be a protective factor modulating the age at onset of psychosis. Further studies into the relationship between social cognition and onset age of psychosis are warranted. Copyright © 2013 John Wiley & Sons, Ltd.
- Published
- 2013
113. [Staging and profiling of psychiatric disorders]
- Author
-
A T F, Beekman, J, van Os, H J C, van Marle, and P N, van Harten
- Subjects
Diagnosis, Differential ,Diagnostic and Statistical Manual of Mental Disorders ,Psychiatric Status Rating Scales ,Narration ,Psychometrics ,Mental Disorders ,Humans - Abstract
Diagnostic issues are at the heart of medicine. Although the existing systems to classify mental disorders have been of tremendous value to Psychiatry, there is growing pressure to reform psychiatric diagnosis. In other areas in medicine staging and profiling has been a fruitful strategy to model the diagnosis of complex disorders.To examine whether staging and profiling may be a fruitful model for the diagnosis of psychiatric disorders.Clinical staging and profiling may help to reform our current static, descriptive and largely categorical classification of mental disorders and arrive at a diagnostic system that is developmental, that can accommodate better the continuous nature of most mental health problems and that is sensitive to etiologic and prognostic risk factors.Looking beyond the forthcoming revisions of DSM and ICD, clinical staging and profiling provide the necessary framework for a more fundamental reform of psychiatric diagnosis.
- Published
- 2012
114. [Special issue on staging and profiling: reform of diagnostics]
- Author
-
A T F, Beekman, J, van Os, H J C, van Marle, and P N, van Harten
- Subjects
Psychiatric Status Rating Scales ,Psychiatry ,Mental Disorders ,Humans - Published
- 2012
115. Cost-effectiveness of a stepped care programme to prevent depression and anxiety in residents in homes for the older people: a randomised controlled trial
- Author
-
J E, Bosmans, E, Dozeman, Harm W J, van Marwijk, Digna J F, van Schaik, Max L, Stek, Aartjan T F, Beekman, and Henriette E, van der Horst
- Subjects
Aged, 80 and over ,Male ,Depressive Disorder, Major ,Cost-Benefit Analysis ,Incidence ,Outcome Assessment, Health Care ,Quality of Life ,Homes for the Aged ,Humans ,Female ,Anxiety ,Aged ,Netherlands - Abstract
Depression and anxiety are common in residents of elderly homes. Both disorders have negative effects on functioning, well-being and health-care utilisation. Besides treatment, prevention can be an option to reduce the burden of mental disorders. The objective of this study was to evaluate the cost-effectiveness of a stepped care programme to prevent the onset of depression and anxiety disorders in residents of elderly homes compared with usual care from a societal perspective.Outcomes were incidence of depression and/or anxiety, severity of depressive and anxiety symptoms and quality-adjusted life years. Health-care utilisation was measured during interviews. Multiple imputation was used to impute missing cost and effect data. Uncertainty around cost differences and incremental cost-effectiveness ratios was estimated using bootstrapping. Cost-effectiveness planes and acceptability curves were created.The incidence of depression and anxiety combined in the intervention group was not reduced in comparison with the usual care group. There was also no effect on the other outcomes. Mean total costs in the intervention group were €838 higher than in the usual care group, but this difference was not statistically significant (95% confidence interval, -593 to 2420). Cost-effectiveness planes showed that there was considerable uncertainty. Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective in comparison with usual care was 0.46 for reducing the incidence of depression and anxiety combined.A stepped care programme to prevent depression and anxiety in older people living in elderly homes was not considered cost-effective in comparison with usual care.
- Published
- 2012
116. [Recognition of psychiatric disorders with a religious content by members of the clergy of different denominations in the Netherlands]
- Author
-
A, Noort, A W, Braam, A R, van Gool, P J, Verhagen, and A T F, Beekman
- Subjects
Male ,Religion and Psychology ,Health Knowledge, Attitudes, Practice ,Interprofessional Relations ,Mental Disorders ,Middle Aged ,Religion ,Professional Competence ,Humans ,Female ,Clergy ,Antipsychotic Agents ,Demography ,Netherlands - Abstract
Clergy members (CMS) frequently provide support and counselling for people with psychological and psychiatric disorders. There is evidence in the literature that CMS consider themselves to be inadequately trained to recognise psychiatric disorders.To investigate to what extent CMS are able to recognise psychiatric symptoms.CMS were recruited in the south-west of the Netherlands among various denominations (Roman Catholic, strict (orthodox) Protestant, moderate Protestant and Evangelical; n = 143) by means of a regional sampling method. The participating CMS (n = 143) and a control group consisting of mental health care professionals MPHS; n = 73) evaluated four vignettes of psychiatric problems with a religious content: two were about a psychiatric disorder (a psychotic state and a psychotic depression/melancholic state), and two concerned non-psychiatric states (a spiritual/religious experience and a mourning reaction with a religious dilemma). For each vignette the respondents scored the suitability of psychiatric medication, the desirability of mental health care, the severity of the disorder and whether there was a religious or spiritual aetiology.Some CMS were able to recognise psychiatric problems almost as well as the MHPS, but among the CMS the degree of recognition varied according to the denomination. Recognition was relatively poor among Evangelical CMS, but was best among the strict Protestant CMS. Evangelical pastors and strict Protestant CMS tended to interpret the non-psychiatric states as pathological.The findings of this study emphasise the need for collaboration between MHPS and CMS and stress the importance of consultation.
- Published
- 2012
117. Preventing depression in homes for older adults: are effects sustained over 2 years?
- Author
-
Digna J F, van Schaik, Els, Dozeman, Harm W J, van Marwijk, Max L, Stek, Filip, Smit, Aartjan T F, Beekman, and Henriëtte E, van der Horst
- Subjects
Aged, 80 and over ,Male ,Depressive Disorder, Major ,Clinical Protocols ,Incidence ,Feasibility Studies ,Homes for the Aged ,Humans ,Female ,Aged ,Follow-Up Studies ,Netherlands - Abstract
The objective of this study was to evaluate the 2-year effects of a stepped-care programme to prevent the onset of a major depressive disorder (MDD) in older people living in residential homes.A 2-year follow-up study of a pragmatic randomised controlled trial was conducted in 14 residential homes in the Netherlands. A total of 185 residents (Center for Epidemiologic Studies Depression Scale score7), who did not meet the diagnostic criteria for MDD, were randomised to a stepped-care programme (n = 93) or to usual care (n = 92). Stepped-care participants sequentially underwent watchful waiting, a self-help intervention, life review and a consultation with the general practitioner. The primary outcome measure was the incidence of MDD during a period of 2 years, according to the Mini International Neuropsychiatric Interview.After 2 years, the incidence of MDD was not significantly reduced in the intervention group compared with the control group (incidence rate ratio: 0.98; 95% confidence interval (CI) [0.54, 1.81]). However, in the completer analysis, on the basis of 79 residents who completed the 2-year measurements, there was a significant difference in favour of the intervention group (incidence rate ratio: 0.53; 95% CI [0.32, 0.87]). Dropout percentages were high (44%), mostly accounted for by illness and death (68%).A minority of residents had benefit from the intervention that sustained after 2 years in the completer group. Yet, these findings cannot be generalised as the majority of the residents did not opt for participation in the project and many dropped out. Ways should be sought to motivate residents with depressive symptoms to engage in preventive interventions.
- Published
- 2012
118. Theory of Mind differences in older patients with early-onset and late-onset paranoid schizophrenia
- Author
-
M M J, Smeets-Janssen, P D, Meesters, H C, Comijs, P, Eikelenboom, J H, Smit, L, de Haan, A T F, Beekman, and M L, Stek
- Subjects
Male ,Analysis of Variance ,Schizophrenia, Paranoid ,Theory of Mind ,Middle Aged ,Neuropsychological Tests ,Executive Function ,Case-Control Studies ,Educational Status ,Humans ,Female ,Schizophrenic Psychology ,Age of Onset ,Aged - Abstract
Theory of Mind (ToM) is considered an essential element of social cognition. In younger schizophrenia patients, ToM impairments have extensively been demonstrated. It is not clear whether similar impairments can be found in older schizophrenia patients and if these impairments differ between older patients with early-onset and late-onset schizophrenia.Theory of Mind abilities were assessed using the Hinting Task in 15 older patients (age 60 years and older) with early-onset paranoid schizophrenia, 15 older patients with late-onset paranoid schizophrenia and 30 healthy controls. ANCOVA was performed to test differences between groups. Analyses were adjusted for level of education. Effect sizes, partial eta squared (ε(2) ), were computed as an indication of the clinical relevance of the findings.Patients with early-onset schizophrenia scored significantly lower on the Hinting Task (mean 16.1; SD 4.3) compared with patients with late-onset schizophrenia (mean 18.6; SD 1.5) and with healthy controls (mean 19.0; SD 1.4). The effect size of this difference was large (ε(2) = 0.2).These results suggest that ToM functioning may be a protective factor modulating the age at onset of psychosis. Further studies into the relationship between social cognition and onset age of psychosis are warranted.
- Published
- 2012
119. Collaborative care for major depressive disorder in an occupational healthcare setting
- Author
-
H.J. Adèr, A. T. F. Beekman, Moniek C Vlasveld, Rob Hoedeman, C.M. van der Feltz-Cornelis, W. van Mechelen, Johannes R. Anema, Tranzo, Scientific center for care and wellbeing, Public and occupational health, Psychiatry, EMGO - Mental health, and EMGO+ - Mental Health
- Subjects
Treatment response ,medicine.medical_specialty ,business.industry ,Outcome measures ,Collaborative Care ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,medicine.disease ,030227 psychiatry ,law.invention ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Randomized controlled trial ,SDG 3 - Good Health and Well-being ,law ,Health care ,Usual care ,Sick leave ,medicine ,Major depressive disorder ,030212 general & internal medicine ,business ,Psychiatry - Abstract
SummaryRandomised controlled trial to evaluate the effectiveness of collaborative care in a Dutch occupational healthcare setting: 126 workers on sick leave with major depressive disorder were randomised to usual care (n = 61) or collaborative care (n = 65). After 3 months, collaborative care was more effective on the primary outcome measure of treatment response (i.e. reduction in symptoms of ≥50%) on the Patient Health Questionnaire-9 (PHQ-9). However, the groups did not differ on the PHQ-9 as a continuous outcome measure. Implications of these results are discussed.
- Published
- 2012
120. [Emergency compulsory admission in crisis situations; the Amsterdam Study of Acute Psychiatry]
- Author
-
L F M, van der Post, C L, Mulder, C M H, Bernardt, R A, Schoevers, A T F, Beekman, and J J M, Dekker
- Subjects
Adult ,Male ,Mental Disorders ,Decision Making ,Cohort Studies ,Patient Admission ,Socioeconomic Factors ,Risk Factors ,Commitment of Mentally Ill ,Humans ,Female ,Prospective Studies ,Emergencies ,Referral and Consultation ,Demography ,Netherlands - Abstract
This article presents initial data from the Amsterdam Study of Acute Psychiatry (ASAP) which investigated the factors that play a role in the decision to admit a patient compulsorily to a psychiatric clinic in the Amsterdam area.To find out how socio-demographic factors, a patient’s psychiatric history and pathway to care influence a patient’s chance of being served with an emergency compulsory admission order during emergency consultation.We conducted a prospective cohort study of 1970 consecutive patients who consecutively came into contact with the Psychiatric Emergency Service Amsterdam (PESA) in the period September 2004 to September 2006.A patient who had been admitted compulsorily once in the previous five years ran an increased risk of compulsorily admission (or 3.9). Referral by the police or by the mental health services also implied a high risk of a compulsorily admission (or 2.2 and or 2.6 respectively).A previous compulsorily admission and referral by the police or mental health services were found to be predictors of emergency compulsory admission, irrespective of possible danger to the patient himself and others and irrespective of the patient’s lack of motivation for treatment.
- Published
- 2012
121. Predictors of the 2-year recurrence and persistence of alcohol dependence
- Author
-
Lynn, Boschloo, Nicole, Vogelzangs, Wim, van den Brink, Johannes H, Smit, Aartjan T F, Beekman, and Brenda W J H, Penninx
- Subjects
Adult ,Male ,Depressive Disorder ,Adolescent ,Middle Aged ,Anxiety Disorders ,Risk Assessment ,Alcoholism ,Young Adult ,Recurrence ,Risk Factors ,Chronic Disease ,Humans ,Female ,Prospective Studies ,Aged ,Netherlands - Abstract
To identify independent risk factors of the recurrence of alcohol dependence (AD) in people with a remitted disorder at baseline and persistence of AD in people with a current disorder at baseline.Prospective cohort study with assessments at baseline and 2-year follow-up.Recruitment from the general population, primary care and out-patient mental health-care services.People with remitted AD (n = 253) and current AD (n = 135).Recurrence and persistence of AD during 2-year follow-up were established using the Composite International Diagnostic Interview (CIDI) interview based on DSM-IV. Logistic regression analyses were performed to explore the role of potential risk factors (i.e. baseline severity of alcohol problems, measures for depression and anxiety, socio-demographics, vulnerability factors and addiction-related factors) as independent predictors of a negative course.Overall recurrence and persistence rates of AD were 14.6 and 40.7%, respectively, and were highly conditional on the severity of alcohol problems [adjusted odds ratio (OR) per standard deviation (SD) increase: OR = 3.64, 95% confidence interval (CI): 2.21-6.01 and OR = 2.12, 95% CI: 1.32-3.40, respectively). Severity of depressive/anxiety symptoms was an additional independent predictor of the recurrence of AD, whereas male gender and high education were significant independent risk factors of the persistence of AD.Alcohol dependence has a dynamic course, with only moderate levels of diagnostic stability. Both recurrence and persistence of alcohol dependence are highly dependent on severity of baseline alcohol problems, whereas severity of depressive/anxiety symptoms predicts only the recurrence of alcohol dependence. Both measures may be useful in identifying people at an increased risk of a negative course and who could be targeted by prevention strategies.
- Published
- 2012
122. [Staging and profiling of unipolar depression]
- Author
-
F P M L, Peeters, H G, Ruhé, A T F, Beekman, J, Spijker, R, Schoevers, F, Zitman, and A, Schene
- Subjects
Diagnosis, Differential ,Diagnostic and Statistical Manual of Mental Disorders ,Psychiatric Status Rating Scales ,Depressive Disorder ,Treatment Outcome ,Humans ,Observation ,Models, Theoretical ,Severity of Illness Index ,Antidepressive Agents - Abstract
BACKGROUND: Not only is the heterogeneous concept of depression too comprehensive, it is also insufficiently differentiated. This serves as a barrier to scientific research and obscures the symptoms that should indicate what treatment is required. AIM: To describe an accurate model for staging and profiling depression. METHOD: We placed depressive disorders in the context of the entire course of the disorder and we regarded the course as a continuum of psychopathology. RESULTS: First of all we distinguish five stages: (1) the prodromal phase, (2) the first depressive episode, (3) residual symptoms following an episode, (4) the relapse episode and (5) the chronic and/or treatment-resistant depression. The higher the stage, the greater the need for complex and specialised treatment. As characteristics for profiling we distinguish (a) aetiological and pathophysiological variables and (b) clinical factors. The latter are the ones that mainly influence treatment from stage 2 onwards. CONCLUSION: In our article we give a tentative overview of possible characteristics for profiling. At the moment the clinical factors are the ones used most for assessment. Current research into the value of aetiological characteristics for profiling will increase the applicability of a staging and profiling model.
- Published
- 2012
123. Late-life depression: systematic assessment of care needs as a basis for treatment
- Author
-
W, Houtjes, B, Van Meijel, D J H, Deeg, and A T F, Beekman
- Subjects
Aged, 80 and over ,Depressive Disorder ,Age Factors ,Humans ,Female ,Needs Assessment - Abstract
Research shows that most of the variance in depression severity levels in late life can be explained by the unmet psychological needs of patients, more in particular the care needs of patients related with psychological distress. This case report describes the treatment of an 84-year-old patient suffering from depression. Her complaints faded upon the use of nursing interventions that were defined on the basis of a systematic assessment of her care needs with the Camberwell Assessment of Needs for the Elderly. The methodical attention to her needs for care and the interventions carried out led to the patient feeling acknowledged and to a diminished need for care and a better quality of life. Although there is no scientific evidence to date, a systematic assessment of care needs may well be a meaningful addition to the nursing diagnostic process. Moreover, alleviating distress in patients by fulfilling unmet care needs through tailored interventions can be seen as an essential element of an effective multidisciplinary depression treatment process.
- Published
- 2011
124. The 7-year course of depression and anxiety in the general population
- Author
-
D, Rhebergen, N M, Batelaan, R, de Graaf, W A, Nolen, J, Spijker, A T F, Beekman, and B W J H, Penninx
- Subjects
Adult ,Psychiatric Status Rating Scales ,Depressive Disorder ,Neurotic Disorders ,Comorbidity ,Prognosis ,Anxiety Disorders ,Health Surveys ,Mental Health ,Physical Fitness ,Surveys and Questionnaires ,Chronic Disease ,Humans ,Child Abuse ,Child ,Netherlands - Abstract
Insight into the long-term course of depression and anxiety.Data were derived from Netherlands Mental Health Survey and Incidence Study/Netherlands Study of Depression and Anxiety, epidemiologic surveys in the adult population in the Netherlands. Three hundred and three respondents with depressive and/or anxiety Composite International Diagnostic Interview (CIDI) disorder were interviewed, examining the 7-year course of depression (n = 141), anxiety (n = 102) and the comorbid state (n = 60) and possible prognostic factors. Outcomes were CIDI diagnostic status after 7 years and percentage of time during 7 years with depressive and/or anxiety symptoms, retrospectively assessed by the Life Chart Interview (LCI).After 7 years, 60.7% of the subjects were free from a 12-month CIDI depression or anxiety diagnosis. The odds were higher for subjects with anxiety and comorbidity compared to subjects with depression. Low physical functioning and high neuroticism predicted the presence of a diagnosis after 7 years. During 7-year follow-up, 37.3% of the subjects were free from depressive and anxiety symptoms according to the LCI, 51.8% had symptoms50% of the time, and 10.9%≥50% of the time. (Comorbid) anxiety resulted in a poorer course. High neuroticism and childhood adversity predicted more follow-up time with symptoms.Course trajectories were more favorable than expected, although comorbidity resulted in poorer course. Neuroticism, physical functioning, and childhood adversity predicted an unfavorable course.
- Published
- 2011
125. More co-morbid depression in patients with Type 2 diabetes with multiple complications. An observational study at a specialized outpatient clinic
- Author
-
K M, van Steenbergen-Weijenburg, A L, van Puffelen, E K, Horn, J, Nuyen, P Sytze, van Dam, T B, van Benthem, A T F, Beekman, F F H, Rutten, L, Hakkaart-van Roijen, and C M, van der Feltz-Cornelis
- Subjects
Diagnostic and Statistical Manual of Mental Disorders ,Male ,Depressive Disorder ,Diabetes Mellitus, Type 2 ,Diabetic Neuropathies ,Humans ,Diabetic Nephropathies ,Female ,Comorbidity ,Middle Aged ,Risk Assessment ,United States - Abstract
The impact of depression on patients with chronic medical illnesses such as diabetes is well documented. Depression is relatively common in diabetes patients with diabetes-related complications and they are more likely to be referred to specialized outpatient facilities. Only a few studies have addressed the association between depression and multiple diabetes-related complications at these specialized outpatient facilities. The aim of this study was to determine the association between diabetes with multiple complications and depression in patients with Type 2 diabetes at a specialized outpatient clinic.After giving informed consent, 1194 patients were screened for depression using the Patient Health Questionnaire (PHQ-9). Additional data on the type of diabetes and complications were taken from the medical records. Logistic regression analysis was conducted, with complications as the predictor variable and the probability of depression as the dependent variable.A total of 596 (63%) patients with Type 2 diabetes participated in the study. The presence of two or more complications (OR 2.23, 95% CI 1.02–2.94) was significantly associated with depression. Neuropathy (OR 1.7, 95% CI 1.10–2.77) and nephropathy (OR 1.68, 95% CI 1.00–2.48) were especially related to depression.Patients with Type 2 diabetes with two or more complications, especially neuropathy or nephropathy, are at high risk of depression. Knowing this can help clinicians identify patients at risk for depression and facilitate timely and adequate treatment.
- Published
- 2011
126. Sombere stemming
- Author
-
J. J. B. de Groot, B. Terluin, H. de Vries, A. T. F. Beekman, de Jongh, T.O.H., de Vries, H., Grundmeijer, H.G.L.M., General practice, Psychiatry, EMGO - Quality of care, EMGO - Mental health, and Other Research
- Subjects
03 medical and health sciences ,0302 clinical medicine ,030212 general & internal medicine ,030217 neurology & neurosurgery - Published
- 2011
127. De gezinsbenadering bij rouw - Een literatuuronderzoek
- Author
-
W. F. Maillette de Buy Wenniger, A. T. F. Beekman, and Psychiatry
- Subjects
Health (social science) ,media_common.quotation_subject ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,Art ,Humanities ,media_common - Abstract
We review the literature on mourning in the family. The tasks and processes of mourning are described in terms of the family. Which features of the family determine the impact and meaning of a loss. The family lifecycle appears to be an illuminating framework in this. A host of phenomena have been said to be indicative of pathological mourning: the occurrence of patterns of destructive relationships after a loss, the issue of substitution, and undue emphasis on homeostasis in the family. This results in interferance with normal family development, the adoption and maintenance of disfunctional boundaries and a strong resistance to new relationships. Advantages and disadvantages of adopting a family approach when dealing with unresolved mourning are discussed. A family approach does not necessarily mean family therapy. We encourage taking on a family approach when dealing with unresolved mourning. The engagement of these families poses specific problems and may be crucial for any kind of treatment. A clinical vignette illustrates most issues.
- Published
- 1993
128. Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders: findings from the Netherlands Study of Depression and Anxiety (NESDA)
- Author
-
Lynn, Boschloo, Nicole, Vogelzangs, Johannes H, Smit, Wim, van den Brink, Dick J, Veltman, Aartjan T F, Beekman, and Brenda W J H, Penninx
- Subjects
Adult ,Male ,Depressive Disorder ,Chi-Square Distribution ,Adolescent ,Marital Status ,Age Factors ,Comorbidity ,Middle Aged ,Anxiety Disorders ,Cohort Studies ,Alcoholism ,Young Adult ,Logistic Models ,Sex Factors ,Risk Factors ,Interview, Psychological ,Humans ,Female ,Aged ,Netherlands - Abstract
This study examines comorbidity of alcohol abuse and alcohol dependence as well as its risk indicators among anxious and/or depressed persons, also considering temporal sequencing of disorders.Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 2329 persons with lifetime DSM-IV anxiety (social phobia, generalized anxiety disorder, panic disorder, and agoraphobia) and/or depressive (major depressive disorder and dysthymia) disorders and 652 controls. Lifetime diagnoses of DSM-IV alcohol abuse and dependence were established, as well as information about socio-demographic, vulnerability, addiction-related and anxiety/depression-related characteristics. Temporal sequencing of disorders was established retrospectively, using age of onset.Of persons with combined anxiety/depression 20.3% showed alcohol dependence versus 5.5% of controls. Prevalence of alcohol abuse was similar across groups (± 12%). Independent risk indicators for alcohol dependence among anxious and/or depressed persons were male gender, vulnerability factors (family history of alcohol dependence, family history of anxiety/depression, openness to experience, low conscientiousness, being single, and childhood trauma), addiction-related factors (smoking and illicit drug use) and early anxiety/depression onset. Persons with secondary alcohol dependence were more neurotic, more often single and lonelier, while persons with primary alcohol dependence were more often male and more extravert.Alcohol dependence, but not abuse, is more prevalent in anxious and/or depressed persons. Persons with comorbid alcohol dependence constitute a distinct subgroup of anxious and/or depressed persons, characterized by addiction-related habits and vulnerability. However, considerable variation in characteristics exists depending on temporal sequencing of disorders. This knowledge may improve identification and treatment of those anxious and/or depressed patients who are additionally suffering from alcohol dependence.
- Published
- 2010
129. [Alexithymia: important for understanding mood disorders with older adults?]
- Author
-
B, Mooi, H C, Comijs, M A, Cladder, and A T F, Beekman
- Subjects
Aged, 80 and over ,Male ,Depressive Disorder ,Personality Inventory ,Mood Disorders ,Humans ,Female ,Affective Symptoms ,Middle Aged ,Aged - Abstract
Alexithymia (cognitive and affective emotion regulation) may be important for understanding mood disorders in older adults. In the present study it is examined whether alexithymia (i) acts as a stable personality trait, (ii) is independent from the Big Five personality traits, and (iii) is associated with the course and outcome of depressive disorder. Alexithymia was assessed at intake and after three months in older adults with a (sub)clinical depressive disorder using the The Bermond Vorst Alexithymia Questionnaire (BVAQ). The results show that alexithymia acts as a stable and independent personality trait. Alexithymia was no predictor for the outcome of depression after three months. It was concluded that alexithymia should be considered when assessing and treating depression in older adults. However, further research is necessary.
- Published
- 2010
130. Involuntary admission of emergency psychiatric patients: report from the Amsterdam Study of Acute Psychiatry
- Author
-
Louk, van der Post, Cornelis L, Mulder, Clemens M L, Bernardt, Robert A, Schoevers, Aartjan T F, Beekman, and J, Dekker
- Subjects
Adult ,Male ,Mental Disorders ,Commitment of Mentally Ill ,Humans ,Female ,Prospective Studies ,Emergencies ,Netherlands - Abstract
This brief report presents initial data from the Amsterdam Study of Acute Psychiatry (ASAP-I) about factors associated with the decision to admit patients compulsorily (involuntarily) to emergency psychiatric services in the Amsterdam region of the Netherlands.The study was a prospective cohort study of 1,970 consecutive patients who came into contact with the Psychiatric Emergency Service Amsterdam.A history of more than 14 outpatient contacts the previous year was associated with a low risk of compulsory admission (OR=.3). An involuntary admission in the previous five years was associated with a higher risk (OR=3.7). Referral by a general practitioner was associated with a low risk compared with referral by police (OR=2.4) or by mental health services (OR=2.3).The hypothesis that outpatient treatment may help to prevent compulsory admission found some support in this study. More research is needed to understand the mechanisms of the associations so that an intervention study can be developed to test this hypothesis.
- Published
- 2009
131. Identifying target groups for the prevention of anxiety disorders in the general population
- Author
-
N M, Batelaan, F, Smit, R, de Graaf, A J L M, van Balkom, W A M, Vollebergh, and A T F, Beekman
- Subjects
Adult ,Male ,Mood Disorders ,Incidence ,Health Promotion ,Middle Aged ,Anxiety Disorders ,Severity of Illness Index ,Young Adult ,Socioeconomic Factors ,Risk Factors ,Preventive Health Services ,Odds Ratio ,Humans ,Panic Disorder ,Female ,Age of Onset ,Somatoform Disorders ,Netherlands - Abstract
To avert the public health consequences of anxiety disorders, prevention of their onset and recurrence is necessary. Recent studies have shown that prevention is effective. To maximize the health gain and minimize the effort, preventive strategies should focus on high-risk groups.Using data from a large prospective national survey, high-risk groups were selected for i) the prevention of first ever (n = 4437) and ii) either first-ever or recurrent incident anxiety disorders (n = 4886). Indices used were: exposure rate, odds ratio, population attributable fraction and number needed to be treated. Risk indicators included sociodemographic, psychological and illness-related factors.Recognition of a few patient characteristics enables efficient identification of high-risk groups: (subthreshold) panic attacks; an affective disorder; a history of depressed mood; a prior anxiety disorder; chronic somatic illnesses and low mastery.Preventive efforts should be undertaken in the selected high-risk groups.
- Published
- 2009
132. [Treatment for chronic depression: cognitive behavioral analysis system of psychotherapy (CBASP)]
- Author
-
J E, Wiersma, D J F, van Schaik, M B J, Blom, L, Bakker, P, van Oppen, and A T F, Beekman
- Subjects
Depressive Disorder ,Depressive Disorder, Major ,Evidence-Based Medicine ,Treatment Outcome ,Cognitive Behavioral Therapy ,Chronic Disease ,Practice Guidelines as Topic ,Humans ,Randomized Controlled Trials as Topic - Abstract
Chronic depression is a common disorder in secondary care. Treatment results for this group of depressed patients are often disappointing and the existing treatment protocols are insufficiently tailored to chronic MDD. For this reason, an effective psychotherapeutic treatment will constitute a welcome addition to the range of treatments currently available for chronically depressed patients.To describe 'cognitive behavioral analysis system of psychotherapy' (CBASP), the first form of psychotherapy specifically designed for the treatment of chronic depression.This article describes the evidence, rational and the most important techniques of CBASP.In the United States CBASP has proven to be effective in one trial. As a result of these findings, CBASP is recommended in the Dutch treatment guidelines as an evidence-based treatment option for chronic depression. However, the findings have not yet been replicated and little is known about possible ways of implementing CBASP in the Netherlands. For this reason a randomised controlled trial on the effectiveness of CBASP has started in three psychiatric hospitals in the Netherlands.CBASP is recommended as a treatment option for chronic depression in the Dutch treatment guidelines, but evidence should be further supported by additional research.
- Published
- 2009
133. The current status of urban-rural differences in psychiatric disorders
- Author
-
Jack Dekker, A. T. F. Beekman, Robert A. Schoevers, Jaap Peen, Psychiatry, EMGO - Mental health, Clinical Psychology, and EMGO+ - Mental Health
- Subjects
Rural Population ,medicine.medical_specialty ,Urban Population ,Substance-Related Disorders ,Population ,Poison control ,SDG 3 - Good Health and Well-being ,Surveys and Questionnaires ,medicine ,Prevalence ,Humans ,education ,Psychiatry ,education.field_of_study ,business.industry ,Developed Countries ,Mental Disorders ,medicine.disease ,Mental illness ,Anxiety Disorders ,Substance abuse ,Psychiatry and Mental health ,Mood ,Mood disorders ,National Comorbidity Survey ,Anxiety ,medicine.symptom ,business - Abstract
Peen J, Schoevers RA, Beekman AT, Dekker J. The current status of urban–rural differences in psychiatric disorders. Objective: Reviews of urban–rural differences in psychiatric disorders conclude that urban rates may be marginally higher and, specifically, somewhat higher for depression. However, pooled results are not available. Method: A meta‐analysis of urban–rural differences in prevalence was conducted on data taken from 20 population survey studies published since 1985. Pooled urban–rural odds ratios (OR) were calculated for the total prevalence of psychiatric disorders, and specifically for mood, anxiety and substance use disorders. Results: Significant pooled urban–rural OR were found for the total prevalence of psychiatric disorders, and for mood disorders and anxiety disorders. No significant association with urbanization was found for substance use disorders. Adjustment for various confounders had a limited impact on the urban–rural OR. Conclusion: Urbanization may be taken into account in the allocation of mental health services.
- Published
- 2009
134. Effect of fish oil supplementation on quality of life in a general population of older Dutch subjects: a randomized, double-blind, placebo-controlled trial
- Author
-
Ondine, van de Rest, Johanna M, Geleijnse, Frans J, Kok, Wija A, van Staveren, Marcel G M, Olderikkert, Aartjan T F, Beekman, and Lisette C P G M, de Groot
- Subjects
Male ,Analysis of Variance ,Docosahexaenoic Acids ,Capsules ,Placebos ,Fish Oils ,Treatment Outcome ,Double-Blind Method ,Eicosapentaenoic Acid ,Surveys and Questionnaires ,Dietary Supplements ,Quality of Life ,Humans ,Female ,Aged ,Netherlands - Abstract
To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL).Randomized, double-blind, placebo-controlled trial.Independently living individuals from the general older Dutch population.Three hundred two individuals aged 65 and older without depression or dementia.1,800 mg/d EPA-DHA (n=96), 400 mg/d EPA-DHA (n=100), or placebo capsules (n=106) for 26 weeks.QOL was assessed using the short version of the World Health Organization QOL questionnaire (WHOQOL-BREF). The WHOQOL-BREF covers four domains: physical health, psychological health, social relationships, and satisfaction with environment. The total score range is 26 to 130, with higher scores indicating a more favorable condition.Mean age of the participants was 70, and 55% were male. Plasma concentrations of EPA-DHA increased 238% in the high-dose and 51% in the low-dose EPA-DHA group, reflecting excellent adherence. Median baseline total WHOQOL scores ranged from 107 to 110 in the three groups and were not significantly different from each other. After 26 weeks, the mean difference from placebo was -1.42 (95% confidence interval (CI)=-3.40-0.57) for the high-dose and 0.02 (95% CI=-1.95-1.99) for the low-dose fish oil group. Treatment with 1,800 mg or 400 mg EPA-DHA did not affect total QOL or any of the separate domains after 13 or 26 weeks of intervention.Supplementation with high or low doses of fish oil for 26 weeks did not influence the QOL of healthy older individuals.
- Published
- 2009
135. [Changes in crisis intervention and emergency psychiatry, Amsterdam emergency consultations in 1983 and 2005]
- Author
-
L F M, van der Post, J J M, Dekker, J F J, Jonkers, A T F, Beekman, C L, Mulder, L, de Haan, W G, Mulder, and R A, Schoevers
- Subjects
Adult ,Counseling ,Male ,Emergency Services, Psychiatric ,Adolescent ,Mental Disorders ,Middle Aged ,Cohort Studies ,Young Adult ,Crisis Intervention ,Patient Admission ,Commitment of Mentally Ill ,Humans ,Female ,Emergency Service, Hospital ,Netherlands - Abstract
Since 1992 The Netherlands has seen a striking increase in the number of compulsory admissions. There is a danger that coercion will become the dominant form of treatment in the Amsterdam clinics.To build up a picture of the changes in emergency psychiatry which have contributed to the increase in the number of acute compulsory admissions.A cohort (n = 460) of consultations conducted by the city crisis service in 1983 was compared with a similar cohort (n = 436) of consultations conducted in 2004-2005 based on the following variables: crisis-service procedures, patient characteristics, diagnosis and consultation outcomes.In 2003-2004 more services were involved with psychiatric patients in acute situations in the public domain than were involved in 1983. The number of patients referred by the police almost doubled, rising from 29.3 to 62.7%. In 1983 all consultations took place where the patients were located; in 2004-2005 60% took place at the premises of the crisis service. The number of psychotic patients in the cohort rose from 52 to 63.3%. There was a rise in the number of compulsory admissions (from 16.7 to 20%) and a sharp decline in voluntary admissions (from 25.7 to 7.6%). The total number of admissions following a consultation decreased from 42 to 28%.The front-line outreach service of 1983 has been transformed into a specialist psychiatric emergency department with only a modest outreach component. Voluntary admissions via the consultation service have almost ceased. Further research is needed into the characteristics of the consultations and into the variables that play a role in the use of compulsion in emergency psychiatry.
- Published
- 2009
136. The Depression Initiative. Description of a collaborative care model for depression and of the factors influencing its implementation in the primary care setting in the Netherlands
- Author
-
Christina M. van der Feltz-Cornelis, Aartjan T. F. Beekman, Klaas M.L. Huijbregts, Kirsten M van Steenbergen-Weijenburg, Fransina J. de Jong, Harm W.J. van Marwijk, and Moniek C Vlasveld
- Subjects
Health (social science) ,Sociology and Political Science ,media_common.quotation_subject ,Collaborative Care ,primary care ,Nursing ,Health care ,integrated care ,collaborative care ,major depressive disorder ,policy ,implementation ,health care system ,Medicine ,Reimbursement ,media_common ,lcsh:R5-920 ,business.industry ,Health Policy ,medicine.disease ,Mental health ,Integrated care ,Negotiation ,Projects and Developments ,Major depressive disorder ,Professional association ,business ,lcsh:Medicine (General) - Abstract
Background: In the Depression Initiative, a promising collaborative care model for depression that was developed in the US was adapted for implementation in the Netherlands. Aim: Description of a collaborative care model for major depressive disorder (MDD) and of the factors influencing its implementation in the primary care setting in the Netherlands. Data sources: Data collected during the preparation phase of the CC:DIP trial of the Depression Initiative, literature, policy documents, information sheets from professional associations. Results: Factors facilitating the implementation of the collaborative care model are continuous supervision of the care managers by the consultant psychiatrist and the trainers, a supportive web-based tracking system and the new reimbursement system that allows for introduction of a mental health care-practice nurse (MHC-PN) in the general practices and coverage of the treatment costs. Impeding factors might be the relatively high percentage of solo-primary care practices, the small percentage of professionals that are located in the same building, unfamiliarity with the concept of collaboration as required for collaborative care, the reimbursement system that demands regular negotiations between each health care provider and the insurance companies and the reluctance general practitioners might feel to expand their responsibility for their depressed patients. Conclusion: Implementation of the collaborative care model in the Netherlands requires extensive training and supervision on micro level, facilitation of reimbursement on meso- and macro level and structural effort to change the treatment culture for chronic mental disorders in the primary care setting.
- Published
- 2009
137. A NEO-PI-R short form for older adults
- Author
-
Bianca, Mooi, Hannie C, Comijs, Filip, De Fruyt, Dineke, De Ritter, Hans A, Hoekstra, and Aartjan T F, Beekman
- Subjects
Adult ,Aged, 80 and over ,Cross-Cultural Comparison ,Male ,Aging ,Principal Component Analysis ,Adolescent ,Personality Inventory ,Psychometrics ,Age Factors ,Middle Aged ,Personality Disorders ,Young Adult ,Humans ,Female ,Research Articles ,Aged - Abstract
This article reports on the construction and examination of a 120 item version (NEO‐PI‐R‐SF) of the Dutch/Belgian NEO‐Personality Inventory‐Revised (NEO‐PI‐R). The item selection was based on criteria of appropriateness for older adults and psychometric contribution. The factor structure of the NEO‐PI‐R‐SF proved highly equivalent to the parent instrument, indicating concordant validity. Coefficients alpha were generally lower due to the reduction of items. When assessed in a new sample of older adults (N = 794), the factor structure of the NEO‐PI‐R‐SF proved replicable, except for the facet scales A1: Trust and A3: Altruism. Coefficients alpha for the domain scales were satisfactory, while the coefficients alpha for the facet scales were marginal to satisfactory and below those found in two adult samples (N = 1305 and N = 682). It was concluded that the NEO‐PI‐R‐SF may be a time‐saving alternative for research when a fine‐grained description of personality among older adults is required. Copyright © 2011 John Wiley & Sons, Ltd.
- Published
- 2009
138. [Old age psychiatry in the Netherlands]
- Author
-
M L, Stek, P, Eikelenboom, and A T F, Beekman
- Subjects
Aged, 80 and over ,Mental Health Services ,Patient Care Team ,Patient Admission ,Mental Disorders ,Geriatric Psychiatry ,Humans ,Curriculum ,Aged ,Netherlands - Abstract
In recent years there have been significant developments in psychiatry for the elderly in the Netherlands. Epidemiological research has widened its scope, collaborating with other disciplines and thereby creating a range of new perspectives. Patient care is shifting gradually to the general hospital and psychiatry for the elderly has a definite place in the curriculum for trainee psychiatrists. Increasingly, integrated care arrangements are becoming available for elderly psychiatric patients with handicaps. Psychiatry for the elderly has obtained a firm foothold in the Netherlands and should be able to participate in and benefit from the developments that are expected in the years to come.
- Published
- 2008
139. [Screening for depression and anxiety in residential homes for the elderly]
- Author
-
E, Dozeman, D J F, van Schaik, H W J, van Marwijk, A E, de Wit, and A T F, Beekman
- Subjects
Aged, 80 and over ,Male ,Psychiatric Status Rating Scales ,Depression ,Geriatric Psychiatry ,Anxiety ,Quality of Life ,Homes for the Aged ,Humans ,Mass Screening ,Female ,Aged ,Netherlands ,Program Evaluation - Abstract
Elderly persons in residential homes in the Netherlands are at high risk for developing major depressive and anxiety disorders. A stepped-care protocol being used in a study for vulnerable elderly in the community may also be feasible and effective for this group. A pilot study in a residential home in Amsterdam showed more problems than expected in screening and motivating the inhabitants for this intervention protocol. This article describes the problems in our screening procedure. A personal approach, performed by familiar persons, directed at the more independent inhabitants is most likely to succeed. The need for research on effectiveness and feasibility of evidence based methods in residential care remains evident. However, the more vulnerable inhabitants need something else. For this group of inhabitants we need to look more closely to the needs and possibilities by conducting research using a qualitative design.
- Published
- 2008
140. [The GDS-8; a short, client- and user-friendly shortened version of the Geriatric Depression Scale for nursing homes]
- Author
-
D L, Gerritsen, K, Jongenelis, A M, Pot, A T F, Beekman, A M H, Eissese, H, Kluiter, and M W, Ribbe
- Subjects
Aged, 80 and over ,Male ,Psychiatric Status Rating Scales ,Depressive Disorder ,Middle Aged ,Sensitivity and Specificity ,Nursing Homes ,ROC Curve ,Predictive Value of Tests ,Surveys and Questionnaires ,Homes for the Aged ,Humans ,Female ,Geriatric Assessment ,Aged ,Netherlands - Abstract
The objective of this study was to construct a patient- and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n=410), the Mini Mental State Examination (n=410) and a diagnostic interview (SCAN; n=333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, seven items that were identified as unsuitable were removed using the GDS-data of the Assess-project (n=77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specificity, area under ROC and positive and negative predictive values), the newly constructed 8-item version of the GDS was validated in the AGED data set (n=333), using DSM-IV diagnosis for depression as measured by the SCAN as 'gold standard'. In the AGED dataset, the GDS-8 was internally consistent (alpha=.80) and high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population.
- Published
- 2008
141. ECT in the treatment of depressed elderly: lessons from a terminated clinical trial
- Author
-
F. B. van der Wurff, A. T. F. Beekman, M. L. Stek, W. J. G. Hoogendijk, Bernard M. J. Uitdehaag, Psychiatry, APH - Aging & Later Life, APH - Mental Health, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, and Neurology
- Subjects
Geriatrics ,medicine.medical_specialty ,Psychotherapist ,business.industry ,Depression ,medicine.medical_treatment ,Pilot Projects ,Fear ,Nortriptyline ,Antidepressive Agents, Tricyclic ,Middle Aged ,Clinical trial ,Psychiatry and Mental health ,Electroconvulsive therapy ,Treatment Outcome ,medicine ,Feasibility Studies ,Humans ,Geriatrics and Gerontology ,business ,Psychiatry ,Electroconvulsive Therapy ,Depression (differential diagnoses) ,Aged - Published
- 2007
142. Sombere stemming
- Author
-
H. W. J. van Marwijk, H. de Vries, and A. T. F. Beekman
- Published
- 2007
143. [Stability of personality in later life]
- Author
-
B, Mooi, H C, Comijs, A T F, Beekman, and A J F M, Kerkhof
- Subjects
Aged, 80 and over ,Male ,Aging ,Personality Inventory ,Geriatric Psychiatry ,Humans ,Female ,Longitudinal Studies ,Middle Aged ,Models, Psychological ,Geriatric Assessment ,Aged ,Personality - Abstract
The relation of aging and the stability of personality in late life is evaluated by a literature review. The findings of six longitudinal studies reveal that rank-order consistency continues into old age. The mean-level stability reveals a concave curve for 'neuroticism' with an increase after age 80, a decrease for 'extraversion', and an increase for 'agreeableness'. The methodological and conceptual issues of personality assessment with old adults can be resolved by using a self report scale which corresponds to the capacities and the lifestyle of older adults and by involving age related variables into analyses.
- Published
- 2006
144. [Epidemiology of panic]
- Author
-
N M, Batelaan, R, De Graaf, A J L M, Van Balkom, W A M, Vollebergh, and A T F, Beekman
- Subjects
Depression ,Prevalence ,Humans ,Panic Disorder ,Comorbidity - Abstract
There is uncertainty about the clinical relevance of panic disorder and subsyndromal panic disorder.To assess the clinical relevance ofpanic disorder and subsyndromal panic disorder.We searched Medline and PsycINFO for population studies performed as from 1980. We used as search terms: 'general population', 'psychiatr', 'prevalence' and 'panic'. On the basis of the studies found we compiled a review of the epidemiology of panic which enabled us to assess the clinical relevance.The life time prevalence of panic disorder is 2.1%; subsyndromal panic disorder is more prevalent (limited symptom attacks 7.5%, infrequent panic attacks 5.1%). Lifetime psychiatric comorbidity is high. The risk and symptom profile for panic disorder and subsyndromal panic disorder is the same. The course of both disorders is unfavourable. There is an increased risk that someone with panic disorder will develop a depression; subsyndromal panic disorder is a non-specific precursor of psychopathology. Both panic disorder and subsyndromal panic disorder are associated with attempted suicide, deficiencies and the use of the health care services, even after comorbidity has been corrected for.It is incorrect only to label panic symptoms 'pathological' if they satisfy the DSM criteriafor panic disorder; both panic disorder and subsyndromal panic disorder are clinically relevant.
- Published
- 2006
145. Depression among older people in Europe: the EURODEP studies
- Author
-
John R M, Copeland, Aartjan T F, Beekman, Arjan W, Braam, Michael E, Dewey, Philippe, Delespaul, Rebecca, Fuhrer, Christopher, Hooijer, Brian A, Lawlor, Sirkka-Liisa, Kivela, Anthony, Lobo, Halgrimur, Magnusson, Anthony H, Mann, Ingeborg, Meller, Martin J, Prince, Friedel, Reischies, Marc, Roelands, Ingmar, Skoog, Cesare, Turrina, Marten W, deVries, and Kenneth C M, Wilson
- Subjects
Research Report - Abstract
The data from nine centres in Europe which had used the Geriatric Mental Scale (GMS) AGECAT were analysed to compare prevalence of diagnoses in subjects aged 65 years and over living in the community. Levels of depressive illness were: Iceland 8.8%, Liverpool 10.0%; Zaragoza 10.7%; Dublin 11.9%; Amsterdam 12.0%; Berlin 16.5%; London 17.3%; Verona 18.3% and Munich 23.6%. Taking all levels of depression, five high (Amsterdam, Berlin, Munich, London and Verona) and four low (Dublin, Iceland, Liverpool, Zaragoza) scoring centres were identified. Meta-analysis of all 13,808 subjects yielded a mean level of depression of 12.3% (95% CI 11.8-12.9), 14.1% for women (95% CI 13.5-14.8) and 8.6% for men (95% CI 7.9-9.3). Symptom levels varied between centres: 40% of the total study population in Amsterdam reported depressive mood against only 26% in Zaragoza. To incorporate studies from other centres using other methods for depression identification, the EURO-D scale was developed from 12 items of the GMS and validated against other scales and expert diagnosis. A two factor solution emerged, an 'affective suffering factor' and a 'motivation factor'. The EURO-D scale was applied to 14 population based surveys. Depression score tended to increase with age unlike levels of prevalence of depression. Large between centre differences were evident in levels of depression unexplained by age, gender or marital status. These data show that depressive illness defined as suitable for intervention is common among older people in Europe. Opportunities for effective treatment are almost certainly being lost. Levels of depressive symptoms vary significantly between high and low scoring centres, prompting the next phase of this study, an examination of risk factors in Europe.
- Published
- 2006
146. [The prevention of psychiatric disorders]
- Author
-
A T F, Beekman, P, Cuijpers, H W J, van Marwijk, F, Smit, R A, Schoevers, and C, Hosman
- Subjects
Depressive Disorder ,Cognitive Behavioral Therapy ,Incidence ,Mental Disorders ,Humans ,Antipsychotic Agents ,Netherlands - Abstract
About 450 million people all over the world suffer from psychiatric disorders. Limitations and handicaps are caused especially by unipolar depression, excessive alcohol consumption, schizophrenia and manic-depressive disorder. It is expected that the importance of psychiatric disorders for public health will increase in the coming decades. Psychiatric disorders are often the cause of death, destroy the lives of both patients and their families, have far-reaching economic consequences and are often complicated by somatic diseases. The advances in the field of treatment are impressive but can have only a limited effect on the consequences of psychiatric disorders for public health. The incidence of psychiatric disorders can be reduced by more than 25%. The greatest effects have been seen with depressive disorders, indicated prevention and the use of cognitive therapy. Indicated prevention has also been found to be effective in psychotic disorders. Debriefing is ineffective in posttraumatic stress disorder. The efficacy of universal prevention has not been investigated. There are still insufficient data to develop evidence-based guidelines for the prevention of psychiatric disorders.
- Published
- 2006
147. Depression and generalized anxiety disorder: co-occurrence and longitudinal patterns in elderly patients
- Author
-
Robert A, Schoevers, D J H, Deeg, W, van Tilburg, and A T F, Beekman
- Subjects
Aged, 80 and over ,Male ,Depressive Disorder ,Neurocognitive Disorders ,Comorbidity ,Neuropsychological Tests ,Anxiety Disorders ,Severity of Illness Index ,Sampling Studies ,Risk Factors ,Activities of Daily Living ,Interview, Psychological ,Humans ,Female ,Aged ,Follow-Up Studies - Abstract
The authors sought to establish the natural course and risk-profile of depression, generalized anxiety disorder (GAD), and depression with co-existing GAD in later life.A total of 2,173 community-living elderly persons were interviewed at baseline, and at a 3-year follow-up. The course of "pure" depression, "pure" GAD, and depression with coexisting GAD was studied in 258 subjects with baseline psychopathology. Authors assessed bivariate and multivariate relationships between risk factors and course types. The risk-profile for onset of pure depression, pure GAD, and the mixed condition at follow-up was studied in 1,915 subjects without baseline psychopathology.Remission rate at follow-up was 41% for subjects with depression-only, 48% for pure GAD, and significantly lower (27%) for depression with coexisting GAD. A pattern of temporal sequencing was established, with anxiety often progressing to depression or depression with GAD. Onset of pure depression and depression with co-existing GAD was predicted by loss events, ill health, and functional disability. Onset of pure GAD, and, more strongly, that of depression with coexisting GAD, was associated with longstanding, possibly genetic vulnerability.In comparison with either depression-only or anxiety-only, the co-occurrence of these represents more severe and more chronic psychopathology, associated with longstanding vulnerability. In elderly persons, GAD often progresses to depression or to the mixed condition. These findings mostly favor a dimensional, rather than a categorical, classification of anxiety and depression.
- Published
- 2005
148. Depression in first generation labour migrants in Western Europe: The utility of the Center for Epidemiologic Studies Depression Scale (CES-D)
- Author
-
Arnoud P. Verhoeff, J. Spijker, E. C. Poort, F. B. van der Wurff, C. H. M. Smits, A. T. F. Beekman, Psychiatry, and EMGO - Mental health
- Subjects
Gerontology ,Male ,medicine.medical_specialty ,Psychometrics ,Turkey ,Turkish ,Interpersonal communication ,behavioral disciplines and activities ,Epidemiology ,Medicine ,Humans ,Mass Screening ,Geriatric Assessment ,Aged ,Netherlands ,Geriatrics ,Psychiatric Status Rating Scales ,Transients and Migrants ,Depressive Disorder ,business.industry ,Public health ,Construct validity ,Reproducibility of Results ,social sciences ,Center for Epidemiologic Studies Depression Scale ,Middle Aged ,Patient Acceptance of Health Care ,language.human_language ,humanities ,Psychiatry and Mental health ,Morocco ,Convergent validity ,Socioeconomic Factors ,language ,population characteristics ,Female ,Geriatrics and Gerontology ,business ,geographic locations - Abstract
Objective The number of elderly migrants from Turkish and Moroccan descent in Western Europe will increase sharply in the coming decades. Identifying depressed elderly migrants necessitates a screening instrument that is both acceptable and has good psychometric properties. This study examines the utility of Turkish and Arabic translations of the Center for Epidemiologic Studies Depression Scale (CES-D) among elderly labour migrants from Turkish and Moroccan descent in the Netherlands. Method The data were derived from a community based health survey among 304 native Dutch, 330 Turkish and 299 Moroccan migrants, aged 55–74 years, living in Amsterdam, the Netherlands. Acceptability, reliability, convergent and construct validity were studied. Results Acceptability of the CES-D was satisfactory, although Moroccan migrants and Turkish females had difficulty answering one or more of the (interpersonal) items from the CES-D. Translated versions of the CES-D proved to be highly internal consistent and have good convergent validity in both Turkish and Moroccan elderly. Depressed and somatic items were much more intermingled in Turkish and Moroccan elderly compared to earlier studies and native Dutch elderly. This fits to the hypothesis that Turkish and Moroccan elderly migrants tend to somatize their depressive symptoms much more than native Western elderly. Conclusion The utility of the CES-D for elderly migrants of Turkish and Moroccan descent was found to be satisfactory. Copyright © 2004 John Wiley & Sons, Ltd.
- Published
- 2004
149. Upward trends in the use of community mental health and social work services in the Netherlands between 1979 and 1995: are particular sociodemographic groups responsible?
- Author
-
M, ten Have, M, te Grotenhuis, V, Meertens, P, Scheepers, A T F, Beekman, and W, Vollebergh
- Subjects
Time Factors ,Socioeconomic Factors ,Mental Disorders ,Social Work, Psychiatric ,Humans ,Community Mental Health Services ,Demography ,Netherlands - Abstract
We investigate 1) trends in use of community mental health care (CMHC) and community social work (CSW) by Dutch households in 1979-1995; 2) whether such trends can be explained by long-term relative changes in service use or in sizes of particular household categories.Data was derived from the Facilities Use Surveys, cross-sectional population studies recording Dutch household characteristics and service use since 1979. A simulation technique was used to explain trends in service use.Use of CMHC and CSW virtually doubled in recent decades. Such trends are not explained by increasing relative service utilization in particular household categories, and only marginally by shifts in the relative sizes of such categories. They are attributable to growing rates of utilization throughout society.Trends in service use are explained by broad changes in help-seeking behaviour. Policymakers should act on these findings to narrow the persisting inequalities in service uptake.
- Published
- 2003
150. The efficacy and safety of ECT in depressed older adults: a literature review
- Author
-
A. T. F. Beekman, F. B. van der Wurff, M. L. Stek, W. J. G. Hoogendijk, Psychiatry, and EMGO - Mental health
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Disease ,behavioral disciplines and activities ,Electroconvulsive therapy ,mental disorders ,medicine ,Dementia ,Humans ,Intensive care medicine ,Psychiatry ,Vascular dementia ,Electroconvulsive Therapy ,Depression (differential diagnoses) ,Aged ,Randomized Controlled Trials as Topic ,Retrospective Studies ,Clinical Trials as Topic ,Depressive Disorder ,business.industry ,Late life depression ,medicine.disease ,Psychiatry and Mental health ,Treatment Outcome ,Concomitant ,Major depressive disorder ,Geriatrics and Gerontology ,business - Abstract
Background: Although little doubt exists among practising clinicians in old age psychiatry about the efficacy and safety of ECT in depression, opinions about acceptability differ widely. The objectives of this review were to determine the efficacy and safety of ECT based on both randomised and non-randomised evidence in elderly with a major depressive disorder. Methods: Randomised and non-randomised studies on efficacy and safety of ECT in elderly with and without concomitant disorders such as cerebrovascular disorders, Alzheimer's dementia, vascular dementia and Parkinson's disease were selected. Literature was systematically searched in a number of electronic databases. Results: Although 121 studies were included in the review process, only four provided randomised evidence. No negative studies with respect to efficacy were found. ECT is effective in the acute treatment of late life depression. ECT is generally safe, although a number of serious complications possibly related to ECT have been described. Most of the objectives of this review could not be answered or refuted with certainty, because firm randomised evidence on the efficacy and safety of ECT in the depressed elderly is missing. Conclusions: ECT is effective in the acute treatment of late life depression and is generally safe. Important questions such as the relative efficacy of ECT over antidepressants, the long-term efficacy of ECT, morbidity and mortality related to ECT, cost-effectiveness and the efficacy of ECT in subgroups of patients cannot be answered and need to be studied further.
- Published
- 2003
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.