scholarly journals Formulating a return-to-work decision for employees with major depressive disorders: occupational therapists’ experiences

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Enos Ramano ◽  
Tania Buys ◽  
Marianne De Beer
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Vocational Rehabilitation ◽  
Depressive Disorders ◽  
Work Productivity ◽  
Occupational Therapists ◽  
Point Of View ◽  
Major Depressive ◽  
Permanent Disability ◽  
Postgraduate Qualification

Background: Major depressive disorder (MDD) is worldwide one of the most concerning health problems as it is associated with reduced work productivity and permanent disability. Occupational therapists are often called upon to make a return-to-work decision on employees with MDD in order to facilitate continued employment. Sustaining employment is in alignment with achieving the Millennium Development Goal 1: Eradicating extreme poverty, as it is known that people suffering from mental health disorders are frequently denied employment opportunities leading to reduced financial resources and therefore possible poverty.Aim: This study described occupational therapists’ experiences of formulating a return-to workdecision on employees with MDD. It formed part of a larger study.Setting: Occupational therapists working in vocational rehabilitation or mental health in South Africa with a postgraduate qualification in vocational rehabilitation or mental health participated in the study.Method: A qualitative research design was used. Two separate focus groups explored 11 occupational therapists’ experiences of formulating a return-to-work decision on employees with MDD. Ethics clearance number: S34/2007.Results: Seven themes emerged, which were, (1) the biographical profile of the employee, (2) point of view of employer, (3) point of view of employee, (4) point of view of occupational therapist, (5) declaring the employee as temporary incapacitated, (6) declaring the employee as permanently incapacitated and (7) employee’s level of motivation.Conclusion: Occupational therapists ought to have sound knowledge, skill, experience and the ability to collaborate with employees and employers in formulating a return-to-work decision.

scholarly journals Efficacy and cost-effectiveness of a Transdiagnostic group-based exercise intervention: study protocol for a pragmatic multi-site randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sebastian Wolf ◽  
Britta Seiffer ◽  
Johanna-Marie Zeibig ◽  
Jana Welkerling ◽  
Leonie Louisa Bauer ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Cost Effectiveness ◽  
Depressive Disorders ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Cost Utility ◽  
Major Depressive ◽  
Outpatient Mental Health ◽  
Major Depressive Disorders

Abstract Background Mental disorders are prevalent and cause considerable burden of disease. Exercise has been shown to be efficacious to treat major depressive disorders, insomnia, panic disorder with and without agoraphobia and post traumatic stress disorder (PTSD). Methods This pragmatic, two arm, multi-site randomised controlled trial will evaluate the efficacy and cost-effectiveness of the manualized, group-based six-months exercise intervention “ImPuls”, among physically inactive patients with major depressive disorders, insomnia, panic disorder, agoraphobia and PTSD within a naturalistic outpatient context in Germany. A minimum of 375 eligible outpatients from 10 different study sites will be block-randomized to either ImPuls in addition to treatment as usual (TAU) or TAU only. ImPuls will be conducted by trained exercise therapists and delivered in groups of six patients. The program will combine (a) moderate to vigorous aerobic exercise carried out two-three times a week for at least 30 min with (b) behavior change techniques for sustained exercise behavior change. All outcomes will be assessed pre-treatment, post-treatment (six months after randomization) and at follow-up (12 months after randomization). Primary outcome will be self-reported global symptom severity assessed with the Brief Symptom Inventory (BSI-18). Secondary outcomes will be accelerometry-based moderate to vigorous physical activity, self-reported exercise, disorder-specific symptoms, quality-adjusted life years (QALY) and healthcare costs. Intention-to-treat analyses will be conducted using mixed models. Cost-effectiveness and cost-utility analysis will be conducted using incremental cost-effectiveness and cost-utility ratios. Discussion Despite its promising therapeutic effects, exercise programs are currently not provided within the outpatient mental health care system in Germany. This trial will inform service providers and policy makers about the efficacy and cost-effectiveness of the group-based exercise intervention ImPuls within a naturalistic outpatient health care setting. Group-based exercise interventions might provide an option to close the treatment gap within outpatient mental health care settings. Trial registration The study was registered in the German Clinical Trials Register (ID: DRKS00024152, 05/02/2021).

scholarly journals An Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth Diagnosed With Major Depressive Disorders: Protocol for a Randomized Controlled Trial

10.2196/11591 ◽  
2019 ◽  
Vol 8 (7) ◽  
pp. e11591
Author(s):  
Paul Ritvo ◽  
Zafiris J Daskalakis ◽  
George Tomlinson ◽  
Arun Ravindran ◽  
Renee Linklater ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Mental Health Disorders ◽  
Major Depressive ◽  
Randomized Controlled ◽  
The Past ◽  
Health Disorders

Background About 70% of all mental health disorders appear before the age of 25 years. When untreated, these disorders can become long-standing and impair multiple life domains. When compared with all Canadian youth (of different ages), individuals aged between 15 and 25 years are significantly more likely to experience mental health disorders, substance dependencies, and risks for suicidal ideation and death by suicide. Progress in the treatment of youth, capitalizing on their online responsivity, can strategically address depressive disorders. Objective We will conduct a randomized controlled trial to compare online mindfulness-oriented cognitive behavioral therapy (CBT-M) combined with standard psychiatric care versus psychiatric care alone in youth diagnosed with major depressive disorder. We will enroll 168 subjects in the age range of 18 to 30 years; 50% of subjects will be from First Nations (FN) backgrounds, whereas the other 50% will be from all other ethnic backgrounds. There will be equal stratification into 2 intervention groups (INT1 and INT2) and 2 wait-list control groups (CTL1 and CTL2) with 42 subjects per group, resulting in an equal number of INT1 and CTL1 of FN background and INT2 and CTL2 of non-FN background. Methods The inclusion criteria are: (1) age 18 to 30 years, FN background or other ethnicity; (2) Beck Depression Inventory (BDI)-II of at least mild severity (BDI-II score ≥14) and no upper limit; (3) Mini-International Neuropsychiatric Interview (MINI)–confirmed psychiatric diagnosis of major depressive disorder; and (4) fluent in English. All patients are diagnosed by a Centre for Addiction and Mental Health psychiatrist, with diagnoses confirmed using the MINI interview. The exclusion criteria are: (1) individuals receiving weekly structured psychotherapy; (2) individuals who meet the Diagnostic and Statistical Manual of Mental Disorders criteria for severe alcohol/substance use disorder in the past 3 months, or who demonstrate clinically significant suicidal ideation defined as imminent intent, or who have attempted suicide in the past 6 months; and (3) individuals with comorbid diagnoses of borderline personality, schizophrenia, bipolar disorder, and/or obsessive compulsive disorder. All subjects are provided standard psychiatric care defined as 1 monthly session that focuses on appropriate medication, with session durations of 15 to 30 min. Experimental subjects receive an additional intervention consisting of the CBT-M online software program (in collaboration with Nex J Health, Inc). Exposure to and interaction with the online workbooks are combined with navigation-coaching delivered by phone and secure text message interactions. Results The outcomes selected, combined with measurement blinding, are key features in assessing whether significant benefits regarding depression and anxiety symptoms occur. Conclusions If results confirm the hypothesis that youth can be effectively treated with online CBT-M, effective services may be widely delivered with less geographic restriction. International Registered Report Identifier (IRRID) PRR1-10.2196/11591

scholarly journals Use of Mental Health Services for Patients Diagnosed with Major Depressive Disorders in Primary Care

2021 ◽  
Vol 18 (3) ◽  
pp. 885
Author(s):  
Laura González-Suñer ◽  
Cristina Carbonell-Duacastella ◽  
Ignacio Aznar-Lou ◽  
Maria Rubio-Valera ◽  
Maria Iglesias-González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Depressive Disorders ◽  
Mental Healthcare ◽  
Major Depressive ◽  
Use Of Services

Major depressive disorder (MDD) is one of the most disabling diseases worldwide, generating high use of health services. Previous studies have shown that Mental Health Services (MHS) use is associated with patient and Family Physician (FP) factors. The aim of this study was to investigate MHS use in a naturalistic sample of MDD outpatients and the factors influencing use of services in specialized psychiatric care, to know the natural mental healthcare pathway. Non-randomized clinical trial including newly depressed Primary Care (PC) patients (n = 263) with a 12-month follow-up (from 2013 to 2015). Patient sociodemographic variables were assessed along with clinical variables (mental disorder diagnosis, severity of depression or anxiety, quality of life, disability, beliefs about illness and medication). FP (n = 53) variables were also evaluated. A multilevel logistic regression analysis was performed to assess factors associated with public or private MHS use. Subjects were clustered by FP. Having previously used MHS was associated with the use of MHS. The use of public MHS was associated with worse perception of quality of life. No other sociodemographic, clinical, nor FP variables were associated with the use of MHS. Patient self-perception is a factor that influences the use of services, in addition to having used them before. This is in line with Value-Based Healthcare, which propose to put the focus on the patient, who is the one who must define which health outcomes are relevant to him.

scholarly journals Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth With Major Depressive Disorders: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Paul Ritvo ◽  
Yuliya Knyahnytska ◽  
Meysam Pirbaglou ◽  
Wei Wang ◽  
George Tomlinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Mental Health Disorders ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Score Difference ◽  
Health Disorders

BACKGROUND Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth to communicate online, can strategically address depressive disorders. OBJECTIVE We performed a randomized controlled trial (RCT) that compared online mindfulness-based cognitive behavioral therapy (CBT-M) combined with standard psychiatric care to standard psychiatric care alone in youth (18-30 years old) diagnosed with major depressive disorder. METHODS Forty-five participants were randomly assigned to CBT-M and standard care (n=22) or to standard psychiatric care alone (n=23). All participants were provided standard psychiatric care (ie, 1 session per month), while participants in the experimental group received an additional intervention consisting of the CBT-M online software program. Interaction with online workbooks was combined with navigation coaching delivered by phone and secure text messaging. RESULTS In a two-level linear mixed-effects model intention-to-treat analysis, significant between-group differences were found for the Beck Depression Inventory-II score (difference –8.54, <i>P</i>=.01), Quick Inventory of Depressive Symptoms score (difference –4.94, <i>P</i>=.001), Beck Anxiety Inventory score (difference –11.29, <i>P</i>&lt;.001), and Brief Pain Inventory score (difference –1.99, <i>P</i>=.03), while marginal differences were found for the Five Facet Mindfulness Questionnaire–Nonjudging subscale (difference –2.68, <i>P</i>=.05). CONCLUSIONS These results confirm that youth depression can be effectively treated with online CBT-M that can be delivered with less geographic restriction. CLINICALTRIAL Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052

scholarly journals Mental Health of Canadian Firefighters: The Impact of Sleep

2021 ◽  
Vol 18 (24) ◽  
pp. 13256
Author(s):  
Heidi Cramm ◽  
Rachel Richmond ◽  
Laleh Jamshidi ◽  
Megan Edgelow ◽  
Dianne Groll ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Work Organization ◽  
Mental Health Disorders ◽  
Fire Service ◽  
Major Depressive ◽  
Design Fire ◽  
Significant Difference ◽  
Health Disorders ◽  
The Impact

Volunteer and career firefighters are at risk of major depressive disorders, posttraumatic stress disorder (PTSD), alcohol use disorder, and other mental health disorders due to the demanding and unpredictable nature of their employment. The mental health risks are exacerbated by the need to work extended hours, night shifts, and/or rotating schedules, or the competing demands of other employment, especially in volunteer firefighters. The mental health disorders and risk factors interact with altered sleeping patterns. In the current study, we examined volunteer and career firefighters regarding the association between mental health and sleep, drawing from a national Canadian mental health survey of 1217 firefighters. Most (69%) of the firefighters reported less than ideal sleep quality and 21% screened positive for clinical insomnia, with no significant difference between volunteer and career subgroups. Firefighters with insomnia had higher odds ratios (OR) and frequencies for PTSD (OR = 4.98), generalized anxiety disorder (OR = 7.15), panic disorder (OR = 6.88), social phobia (OR = 4.98), and major depressive disorder (OR = 7.91), than firefighters without insomnia. The burden of sleep disorders and their association with mental health disorders suggests that sleep should be considered in health monitoring and self-management, environmental design, fire service work-organization policies, and health programming.

scholarly journals A smartphone-online intervention for youth diagnosed with major depressive disorders: Protocol for a randomized controlled trial. (Preprint)

2018 ◽  
Author(s):  
Paul Ritvo ◽  
Zafiris Daskalakis ◽  
George Tomlinson ◽  
Arun Ravindran ◽  
Renee Linklater ◽  
...  
Keyword(s):  
Mental Health ◽  
First Nations ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Cognitive Behavioural

BACKGROUND Seventy percent of mental health problems appear before the age of 25 years and when untreated can become long-standing, and significant, impairing multiple life domains (1). Although the problem is especially acute for youth from First Nations backgrounds, all Canadian youth aged 15- to 25 years are highly likely to experience mental health disorders, substance dependencies and suicide. Progress in the treatment of youth that capitalizes on tendencies to respond to online contacts strategically addresses mental health problems, particularly depressive disorders. OBJECTIVE We will conduct a randomized controlled trial (RCT), to compare online mindfulness-based cognitive behavioural therapy combined with standard psychiatric care vs. psychiatric care alone (wait-list controls) in youth diagnosed with major depressive disorder. We will enrol N = 168 subjects in the age range of 18-30 years, 50% of whom will be from First Nations backgrounds and the other 50% from all other ethnic backgrounds, equally stratified in two intervention groups and two (wait-list) control groups (42 subjects per group, where INT1 and CTL1 are FN background, and INT2 and CTL2 are non-FN background). METHODS In this RCT, the primary outcome will be self-reported depression on the Beck Depression Inventory II. Secondary outcomes include anxiety (Beck Anxiety Inventory), depression (Quick Inventory of Depressive Symptomatology, 24-item Hamilton Rating Scale for Depression (HRSD-24)), pain (Brief Pain Inventory) and mindfulness (Five-Facet Mindfulness Questionnaire). RESULTS Recruitment/retention rates will be assessed with estimates for the proportion of participants with complete data per outcome and time points divided by the total number of study participants. Variability of the main and interaction effects will be examined in the primary clinical outcome and each secondary outcome using separate repeated measures ANCOVA models, with Bonferroni corrections applied to the models applied. Hedges' g and associated confidence intervals will be calculated as an estimate of the effect size both over time (within groups) and between groups. Missing data will be evaluated on a case-by-case basis such that drop-outs will be excluded. CONCLUSIONS If results confirm hypotheses that youth can be effectively treated with online mindfulness-based cognitive behavioural therapy at reduced costs, effective services can be delivered more widely with less geographic restrictions. CLINICALTRIAL Clinical Trials.gov

scholarly journals Mental health in Finland

2006 ◽  
Vol 3 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Eero Lahtinen
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Mental Illnesses ◽  
Depression And Anxiety ◽  
Major Depressive ◽  
Global Trends ◽  
Major Depressive Disorders ◽  
Clear Increase

The prevalence of mental illnesses in Finland generally reflects global trends, with a clear increase in the occurrence of depression and anxiety. At any time, between 4% and 9% of the population of 5.2 million suffer from major depressive disorders. Some 10–20% of the population experience depression during their lifetime. Bipolar depressive disorders affect 1–2% and schizophrenia 0.5–1.5% of the population. The prevalence of alcoholism is 4–8%.

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