ABSTRACT
Within teletherapy, email interventions have been studied scarcely. For this reason, this exploratory study aims to characterize the assistance provided by email in a university telepsychology service and to compare the data with the assistance provided by telephone in the same service and period. For this purpose, the records of 81 users assisted via email during the COVID-19 pandemic lockdown in Spain were analyzed. The data were compared with those of the 338 users assisted by telephone in the same period. Despite its many limitations, results indicate high satisfaction with the email modality. Users express that they prefer a preference for using email when they do not feel safe in other ways. We found a lot of variation between the number of emails exchanged and the days that each case was active. Additionally, differences were found with telephone users in aspects such as age (email users being younger) and in a depression screening (email users scoring more positively). This study concludes on the high potential of this channel for the application of certain techniques (e.g., psychoeducation) or for people with certain characteristics.
Subject(s)
COVID-19 , Electronic Mail , Mental Health Teletherapy , Program Evaluation , Quarantine , Adolescent , Adult , Female , Humans , Male , COVID-19/epidemiology , COVID-19/prevention & control , Depression/psychology , Follow-Up Studies , Mental Health Teletherapy/methods , Mental Health Teletherapy/standards , Mental Health Teletherapy/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Psychology/methods , Psychology/standards , Spain/epidemiology , Telephone , UniversitiesABSTRACT
BACKGROUND: There is heterogeneity in the long-term trajectories of depressive symptoms among patients. To date, there has been little effort to inform the long-term trajectory of symptom change and the factors associated with different trajectories. Such knowledge is key to treatment decision-making in primary care, where depression is a common reason for consultation. We aimed to identify distinct long-term trajectories of depressive symptoms and explore pre-treatment characteristics associated with them. METHODS: A total of 483 patients from the PsicAP clinical trial were included. Growth mixture modeling was used to identify long-term distinct trajectories of depressive symptoms, and multinomial logistic regression models to explore associations between pre-treatment characteristics and trajectories. RESULTS: Four trajectories were identified that best explained the observed response patterns: "recovery" (64.18%), "late recovery" (10.15%), "relapse" (13.67%), and "chronicity" (12%). There was a higher likelihood of following the recovery trajectory for patients who had received psychological treatment in addition to the treatment as usual. Chronicity was associated with higher depressive severity, comorbidity (generalized anxiety, panic, and somatic symptoms), taking antidepressants, higher emotional suppression, lower levels on life quality, and being older. Relapse was associated with higher depressive severity, somatic symptoms, and having basic education, and late recovery was associated with higher depressive severity, generalized anxiety symptoms, greater disability, and rumination. CONCLUSIONS: There were different trajectories of depressive course and related prognostic factors among the patients. However, further research is needed before these findings can significantly influence care decisions.
Subject(s)
Depression , Medically Unexplained Symptoms , Humans , Anxiety , Anxiety Disorders/psychology , Depression/psychology , Longitudinal Studies , Primary Health CareABSTRACT
Since the inclusion of the Internet Gaming Disorder (IGD) in the Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), a short nine items test, has become one of the most used standardized instruments for its psychometric evaluation. This study presents a validation and psychometric evaluation of the Spanish version of the IGDS9-SF. A sample of 2173 videogame players between 12 and 22 years old, comprising both genders, was employed, achieved with a randomized selection process from educational institutions in the city of Madrid. Participants completed the adapted version of the IGDS9-SF, the General Health Questionnaire (GHQ-12) and a negative cognitions scale associated with videogame use, as well as sociodemographic data and frequency of videogame play. A unifactorial structure with sufficient reliability and internal consistency was found through exploratory and confirmatory analyses. In addition, the instrument was found to have good construct validity; the scoring of the IGDS9-SF were found to show a positive association with gaming frequency, with general health problems, and to a greater extent, with problematic cognitions with regard to videogames. Factorial invariance was found concerning the age of participants. However, even though the factorial structure was consistent across genders, neither metric nor scalar invariance were found; for this reason, we present a scale for the whole sample and a different one for gender. These results suggest that this Spanish version of the IGDS9-SF is a reliable and valid instrument, useful to evaluate the severity of IGD in Spanish students, and we provide a scoring scale for measurement purposes.
Subject(s)
Internet Addiction Disorder/diagnosis , Psychiatric Status Rating Scales/standards , Psychometrics/standards , Video Games , Adolescent , Adult , Child , Female , Humans , Male , Reproducibility of Results , Spain , Young AdultABSTRACT
Since the inclusion of the Internet Gaming Disorder (IGD) in the Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), a short nine items test, has become one of the most used standardized instruments for its psychometric evaluation. This study presents a validation and psychometric evaluation of the Spanish version of the IGDS9-SF. A sample of 2173 videogame players between 12 and 22 years old, comprising both genders, was employed, achieved with a randomized selection process from educational institutions in the city of Madrid. Participants completed the adapted version of the IGDS9-SF, the General Health Questionnaire (GHQ-12) and a negative cognitions scale associated with videogame use, as well as sociodemographic data and frequency of videogame play. A unifactorial structure with sufficient reliability and internal consistency was found through exploratory and confirmatory analyses. In addition, the instrument was found to have good construct validity; the scoring of the IGDS9-SF were found to show a positive association with gaming frequency, with general health problems, and to a greater extent, with problematic cognitions with regard to videogames. Factorial invariance was found concerning the age of participants. However, even though the factorial structure was consistent across genders, neither metric nor scalar invariance were found; for this reason, we present a scale for the whole sample and a different one for gender. These results suggest that this Spanish version of the IGDS9-SF is a reliable and valid instrument, useful to evaluate the severity of IGD in Spanish students, and we provide a scoring scale for measurement purposes
No disponible
Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Video Games/adverse effects , Behavior, Addictive/psychology , Psychometrics/instrumentation , Brief Psychiatric Rating Scale , Webcasts as Topic , Reproducibility of Results , Translations , Social ProblemsABSTRACT
BACKGROUND: Empirically supported psychological treatments (ESTs) have demonstrated their effectiveness and clinical utility for the treatment of anxiety disorders (AD) but few studies have assessed the factors associated with premature termination in ESTs for AD. METHOD: The goals of this study, which involved 291 patients with a diagnosis of anxiety who had received outpatient psychological care, consisted of examining premature termination of treatment (PTT), comparing the individual characteristics of the patients who successfully completed treatment with those who terminate it prematurely, and analyzing the predictors of PTT. RESULTS: Of the sample, 8.2% refused to start treatment, 28.5% dropped out before completing it, and 63.2% successfully completed treatment. In 50% of the cases, PTT occurred during the first 7 sessions, and in 80%, before the 15th session. Alternatively, 76.4% of the patients who complete treatment successfully do so before session 20. We found that patients with PTT attended a significantly lower number of treatment sessions and attended the sessions more irregularly and unpunctually. Presenting a generalized anxiety disorder (GAD), problems with punctuality and with task performance were predictors of failure to complete treatment. CONCLUSIONS: These findings suggest the need to reinforce early adherence to treatments to help patients remain in treatment
ANTECEDENTES: los tratamientos psicológicos empíricamente apoyados (TEAs) han demostrado utilidad clínica para el abordaje de los trastornos de ansiedad (TA), pero pocos estudios han evaluado los factores asociados a la terminación prematura (TPT). MÉTODO: se examinaron las tasas de TPT, sus predictores y las características de aquellos pacientes que terminaron prematuramente frente a los que completan, en una muestra de 291 pacientes, en atención ambulatoria y diagnosticados de algún trastorno de ansiedad. RESULTADOS: el 8,2% de los participantes rechazaron comenzar el tratamiento, el 28,5% abandonaron antes de completarlo y el 63,2% completaron con éxito. El 50% de los casos de TPT se produce durante las 7 primeras sesiones y en el 80% antes de la sesión 15. El 76,4% de los pacientes que finalizan con éxito su tratamiento lo hacen antes de la sesión 20. El grupo TPT acudió a un número significativamente menor de sesiones y asistieron de manera más irregular e impuntual. Resultaron predictores de no completar el tratamiento presentar un Trastorno de Ansiedad Generalizada, problemas de puntualidad y en la ejecución de tareas. CONCLUSIONES: los resultados apuntan la necesidad de reforzar la adhesión temprana a los tratamientos para ayudar a los pacientes a mantenerse en los mismos
Subject(s)
Humans , Anxiety Disorders/therapy , Treatment Refusal/psychology , Psychotherapy/statistics & numerical data , Patient Dropouts/psychology , Patient Compliance/psychology , Medication Adherence/psychologyABSTRACT
BACKGROUND: Empirically supported psychological treatments (ESTs) have demonstrated their effectiveness and clinical utility for the treatment of anxiety disorders (AD) but few studies have assessed the factors associated with premature termination in ESTs for AD. METHOD: The goals of this study, which involved 291 patients with a diagnosis of anxiety who had received outpatient psychological care, consisted of examining premature termination of treatment (PTT), comparing the individual characteristics of the patients who successfully completed treatment with those who terminate it prematurely, and analyzing the predictors of PTT. RESULTS: Of the sample, 8.2% refused to start treatment, 28.5% dropped out before completing it, and 63.2% successfully completed treatment. In 50% of the cases, PTT occurred during the first 7 sessions, and in 80%, before the 15th session. Alternatively, 76.4% of the patients who complete treatment successfully do so before session 20. We found that patients with PTT attended a significantly lower number of treatment sessions and attended the sessions more irregularly and unpunctually. Presenting a generalized anxiety disorder (GAD), problems with punctuality and with task performance were predictors of failure to complete treatment. CONCLUSIONS: These findings suggest the need to reinforce early adherence to treatments to help patients remain in treatment.
Subject(s)
Anxiety Disorders/therapy , Psychotherapy , Treatment Refusal , Adult , Female , Humans , Male , Retrospective StudiesABSTRACT
El objetivo de este trabajo fue analizar las diferencias entre los casos de corta (5-10 sesiones), media (10-18 sesiones) y larga duración (más de 18 sesiones) en variables sociodemográficas, clínicas y de tratamiento. Se analizaron los datos de 349 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense de Madrid (CUP-UCM), que habían terminado el tratamiento con éxito. El número de técnicas aplicadas durante la intervención fue la variable más discriminativa, seguida por la comorbilidad -haber recibido un tratamiento anterior- número de tratamientos anteriores y número de objetivos establecidos antes de la intervención. Los resultados señalan la importancia de identificar las técnicas más eficaces para cada problema u objetivo para reducir, en la medida de lo posible, la duración de las intervenciones sin disminuir su eficacia.
The aim of this study was to analyze differences among cases of short (5-10 sessions), medium (11-18 sessions) and long term (more than 18 sessions) in sociodemografic, clinical and treatment variables. Data from 349 patients of the Clínica Universitaria de Psicología de la Universidad Complutense de Madrid (CUP-UCM), who had successfully completed treatment, were analyzed. Number of intervention techniques was the most significant variable, followed by comorbidity, previous treatment, number of previous treatments and number of therapeutic objectives. The results indicate the importance of identifying which techniques are more effective for each problem or objective in order to reduce, as far as possible, the extension of the treatment without decreasing its effectivity.
Subject(s)
Psychology, Clinical , PsychotherapyABSTRACT
Major Depressive Disorder (MDD) is the most prevalent mental disorder in our environment, and one of the main causes of disability. While several empirically supported treatments (ESTs) for MDD exist, some doubts have been cast on the applicability--in time, components, and effectiveness--of these ESTs in routine clinical practice. A few attempts have been made to contrast the effectiveness of ESTs, but usually the precise components of the treatment developed are not considered in detail. The purpose of this study is to analyze the components of an EST-based treatment on a sample of 69 MDD cases from a University Psychology Clinic, and to benchmark them against the results of published efficacy studies on ESTs (behavioral activation, cognitive therapy, interpersonal therapy). Results show that treatments delivered at this clinical facility are similar in components, length, and effectiveness (in effect size, completers and improved ratio) to the benchmarked studies. Cognitive restructuring is the most frequent component of the delivered treatments. Therapy results show a 3.12 effect size, and a 55.1% improved ratio over initial sample, an 80% of completers. Results and limitations of the current study, especially those related to sample and center characteristics, are discussed.
Subject(s)
Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/therapy , Adolescent , Adult , Aged , Cognitive Behavioral Therapy/classification , Cognitive Behavioral Therapy/standards , Female , Hospitals, University/standards , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Treatment Outcome , Young AdultABSTRACT
Major Depressive Disorder (MDD) is the most prevalent mental disorder in our environment, and one of the main causes of disability. While several empirically supported treatments (ESTs) for MDD exist, some doubts have been cast on the applicability-in time, components, and effectiveness-of these ESTs in routine clinical practice. A few attempts have been made to contrast the effectiveness of ESTs, but usually the precise components of the treatment developed are not considered in detail. The purpose of this study is to analyze the components of an EST-based treatment on a sample of 69 MDD cases from a University Psychology Clinic, and to benchmark them against the results of published efficacy studies on ESTs (behavioral activation, cognitive therapy, interpersonal therapy). Results show that treatments delivered at this clinical facility are similar in components, length, and effectiveness (in effect size, completers and improved ratio) to the benchmarked studies. Cognitive restructuring is the most frequent component of the delivered treatments. Therapy results show a 3.12 effect size, and a 55.1% improved ratio over initial sample, an 80% of completers. Results and limitations of the current study, especially those related to sample and center characteristics, are discussed (AU)
El Trastorno Depresivo Mayor (TDM) es el trastorno mental más prevalente en nuestro entorno y uno de las principales causas de incapacidad. Aunque se dispone de Tratamientos Empíricamente Apoyados (TEAs) para el mismo, existen dudas sobre la aplicabilidad, en tiempos y componentes, y la efectividad de estas intervenciones en la práctica profesional cotidiana. Son escasos los estudios que intentan contrastar la efectividad de los TEAs para el TDM, y no suele considerar en detalle los contenidos del tratamiento desarrollado. El objetivo de este trabajo es analizar las características del tratamiento basado en TEAs, en una muestra de 69 casos de TDM, en una Clínica Universitaria de Psicología (CUP), y compararlo con las referencias bibliográficas y resultados de los estudios de eficacia de TEAs (Activación Conductual, Terapia Cognitiva, Terapia Interpersonal). Los resultados señalan que las intervenciones de la CUP son similares en componentes, duración y efectividad (en tasa de abandonos, porcentaje de mejorados y tamaño del efecto) a los datos de referencia. La reestructruración cognitiva es el elemento más presente en los tratamientos. Los resultados terapéuticos señalan un Tamaño del Efecto de 3,12 y un porcentaje de mejorados del 55,1% sobre la muestra inicial, un 80% sobre los que completan el tratamiento. Se discuten los resultados y las limitaciones del estudio, en especial referidas a las características de la muestra y del centro (AU)
Subject(s)
Humans , Male , Female , Cognitive Behavioral Therapy/methods , Cognitive Dissonance , Cognitive Science/trends , Psychology, Clinical/methods , Psychology, Clinical/trends , Depressive Disorder, Major/psychology , Mental Disorders/psychology , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/prevention & control , Interpersonal Relations , Codependency, Psychological/physiology , Evaluation of the Efficacy-Effectiveness of Interventions , 50303ABSTRACT
BACKGROUND: The proportion of adults with positive varicella serology is lower in populations from tropical countries. Therefore immigrants to countries with a temperate climate are at risk of acquiring varicella infection during adulthood. METHODS: We tested two different strategies to prevent varicella outbreaks in housing facilities for asylum seekers arriving in the Canton of Vaud, Switzerland. The first strategy consisted of a rapid response with isolation of the affected individuals and vaccination of the susceptible contacts. The second strategy consisted of a general vaccination upon arrival of all asylum seekers aged 15-39 years with no history of chickenpox. RESULTS: From May 2008 to January 2009 we applied the rapid response strategy. Eight hundred and fifty-eight asylum seekers arrived in the Canton and an attack rate of 2.8% (seven cases among 248 exposed asylum seekers) was observed. The mean cost was US$ 31.35 per asylum seeker. The general vaccination strategy was applied from February 2009 to May 2010, a period during which 966 asylum seekers were registered. This second strategy completely prevented any outbreak at a mean cost of US$ 83.85 per asylum seeker. CONCLUSIONS: Of the two analyzed interventions to prevent varicella outbreaks in housing facilities for asylum seekers, the general vaccination strategy was more effective, more sustainable, and ethically preferable, although more costly.
Subject(s)
Chickenpox/epidemiology , Chickenpox/prevention & control , Disease Outbreaks/prevention & control , Herpesvirus 3, Human , Refugees , Adolescent , Adult , Child , Child, Preschool , Female , Herpesvirus 3, Human/immunology , Humans , Male , Patient Isolation/economics , Switzerland/epidemiology , Switzerland/ethnology , Vaccination/economics , Young AdultABSTRACT
Limited access to care due to the new laws and to the patient's state of deprivation can prevent the physician from fulfilling his main duty: to respect principals of medical ethics, and to make the patient feels better without causing harm. In which case, the doctor could become an accomplice of the patient's state of deprivation. A local interdisciplinary working group defined medical criteria for asylum seekers in the Canton of Vaud which justifies health insurance coverage and/or accommodation adapted to the patient's state of health. The hardening of laws contributes to increase the anxiety of uncertainty and social stigmatization. Such sufferings open onto devastating health problems, particularly concerning mental health.
