A feasibility trial of an internet-delivered psychological intervention to manage mental health and functional outcomes in neurological disorders

Gandy, Milena; Karin, Eyal; McDonald, Sarah; Meares, Susanne; Scott, Allan; Titov, Nickolai; Dear, Blake F.

doi:10.1016/j.jpsychores.2020.110173

Cited by 23 publications

(37 citation statements)

References 49 publications

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“…There is now substantial evidence for the effectiveness and acceptability of these interventions for common mental health 50,51 and some physical health conditions 52,53 . Several trials of remotely delivered interventions to improve mental health outcomes in PWE have yielded very encouraging results, 54–56 and these treatments can be optimized for people with cognitive difficulties 54,57 …”

Section: Discussionmentioning

confidence: 99%

“…52,53 Several trials of remotely delivered interventions to improve mental health outcomes in PWE have yielded very encouraging results, [54][55][56] and these treatments can be optimized for people with cognitive difficulties. 54,57 This study has several limitations, including online survey administration, which likely yielded lower participation rates (<10%) for countries who have lower resources and poor Internet access. While online survey administration was practical, relatively accessible and time and cost-efficient, study findings are likely biased toward more middle-to high-income countries and health systems.…”

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confidence: 99%

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Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force

et al. 2021

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Summary Objectives The Psychology Task Force of the Medical Therapies Commission of the International League Against Epilepsy (ILAE) has been charged with taking steps to improve global mental health care for people with epilepsy. This study aimed to inform the direction and priorities of the Task Force by examining epilepsy healthcare providers’ current practical experiences, barriers, and unmet needs around addressing depression and anxiety in their patients. Methods A voluntary 27‐item online survey was distributed via ILAE chapters and networks. It assessed practices in the areas of screening, referral, management, and psychological care for depression and anxiety. A total of 445 participants, from 67 countries (68% high income), commenced the survey, with 87% completing all components. Most respondents (80%) were either neurologists or epileptologists. Results Less than half of respondents felt adequately resourced to manage depression and anxiety. There was a lack of consensus about which health professionals were responsible for screening and management of these comorbidities. About a third only assessed for depression and anxiety following spontaneous report and lack of time was a common barrier (>50%). Routine referrals to psychiatrists (>55%) and psychologists (>41%) were common, but approximately one third relied on watchful waiting. A lack of both trained mental health specialists (>55%) and standardized procedures (>38%) was common barriers to referral practices. The majority (>75%) of respondents’ patients identified with depression or anxiety had previously accessed psychotropic medications or psychological treatments. However, multiple barriers to psychological treatments were endorsed, including accessibility difficulties (52%). Significance The findings suggest that while the importance of managing depression and anxiety in patients with epilepsy is being recognized, there are ongoing barriers to effective mental health care. Key future directions include the need for updated protocols in this area and the integration of mental health professionals within epilepsy settings.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force

et al. 2021

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“…One study provided patients with various neurological disorders with a 6-week course that integrated elements from cognitive therapies. Completing the course at home and unsupervised was feasible [ 66 ]. An RCT added telephone-based cognitive behavioural therapy to treatment as usual, which led to a stronger reduction in depressive symptoms for persons with PD [ 67 ▪ ].…”

Section: Teletreatmentmentioning

confidence: 99%

The state of telemedicine for persons with Parkinson's disease

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Meinders³

et al. 2021

Current Opinion in Neurology

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Purpose of review The COVID-pandemic has facilitated the implementation of telemedicine in both clinical practice and research. We highlight recent developments in three promising areas of telemedicine: teleconsultation, telemonitoring, and teletreatment. We illustrate this using Parkinson's disease as a model for other chronic neurological disorders. Recent findings Teleconsultations can reliably administer parts of the neurological examination remotely, but are typically not useful for establishing a reliable diagnosis. For follow-ups, teleconsultations can provide enhanced comfort and convenience to patients, and provide opportunities for blended and proactive care models. Barriers include technological challenges, limited clinician confidence, and a suboptimal clinician-patient relationship. Telemonitoring using wearable sensors and smartphone-based apps can support clinical decision-making, but we lack large-scale randomized controlled trials to prove effectiveness on clinical outcomes. Increasingly many trials are now incorporating telemonitoring as an exploratory outcome, but more work remains needed to demonstrate its clinical meaningfulness. Finding a balance between benefits and burdens for individual patients remains vital. Recent work emphasised the promise of various teletreatment solutions, such as remotely adjustable deep brain stimulation parameters, virtual reality enhanced exercise programs, and telephone-based cognitive behavioural therapy. Personal contact remains essential to ascertain adherence to teletreatment. Summary The availability of different telemedicine tools for remote consultation, monitoring, and treatment is increasing. Future research should establish whether telemedicine improves outcomes in routine clinical care, and further underpin its merits both as intervention and outcome in research settings.

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“…[ 30 , 31 ]. The WHODAS assessment tool proved to have good psychometric properties and also suitable reliability and validity [ 32 ]. The WHODAS questionnaire was applied in the Romanian language, using the form provided by a professional psychology association [ 33 ].…”

Section: Methodsmentioning

confidence: 99%

WHODAS Assessment Feasibility and Mental Health Impact on Functional Disability in Systemic Lupus Erythematosus

et al. 2022

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Systemic lupus erythematosus (SLE), besides rheumatological dysfunction, manifests in neuropsychiatric disorders like depression and anxiety. Mental health illnesses in SLE patients have a high prevalence and a profound impact on quality of life, generating an increased disability and premature mortality. This study aimed to establish the degree of disability in patients with SLE and the impact of depression and anxiety on patients’ functioning. Additionally, the study aimed to verify whether World Health Organization-Disability Assessment Schedule (WHODAS) 2.0 is suitable for the evaluation of patients with SLE associating depression and/or anxiety symptoms. Cross-sectional research was performed, including adult patients, diagnosed with SLE. To evaluate depression, anxiety, and functioning, approved questionnaires Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and, World Health Organization-Disability Assessment Schedule (WHODAS) were applied. Confirmatory factor analysis was performed on WHODAS subscales. Sixty-two patients were included in the research, with a mean of SLE diagnosis of 12.48 years; 53 patients (85%) had depression (p < 0.001). Anxiety was found in 38 patients (61.29%, p < 0.05). WHODAS assessment results depicted that 39 patients (62.90%, p < 0.05) manifested disability, from which 26 (66.66%, p < 0.05) presented moderate and severe disability. A strong correlation between the severity of anxiety and the degree of disability (r > 0.6, p < 0.001) was found. The WHODAS scale assessment proved to be a valuable tool for SLE patient’s functioning assessment. This study suggests that depression and anxiety negatively impact WHODAS disability scores, decreasing the quality of life in SLE patients.

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A feasibility trial of an internet-delivered psychological intervention to manage mental health and functional outcomes in neurological disorders

Cited by 23 publications

References 49 publications

Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force

Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force

The state of telemedicine for persons with Parkinson's disease

WHODAS Assessment Feasibility and Mental Health Impact on Functional Disability in Systemic Lupus Erythematosus

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