Effects of Universal Screening for Depression Among Middle-Aged Adults in a Community With a High Suicide Rate

Oyama, Hirofumi; Sakashita, Tomoe

doi:10.1097/nmd.0000000000000119

Cited by 6 publications

(5 citation statements)

References 33 publications

(32 reference statements)

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“…Therefore, self-report questionnaires with reasonable cost-effectiveness have been preferred for screening depression [6]. Therefore, various countries have made efforts to screen depression in the general population using simple and accurate instruments [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Normative data and psychometric properties of the Patient Health Questionnaire-9 in a nationally representative Korean population

Shin

et al. 2020

BMC Psychiatry

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Background: The Patient Health Questionnaire-9 (PHQ-9) has been standardized in several populations and is widely used in clinical practice and health care. However, it has not been appropriately standardized in the Korean general population, and no normative data have been presented. The aim of this study was to provide the normative data and psychometric properties of the PHQ-9 in the nationally representative population of Korea. Methods: We used the nationwide cross-sectional survey data of Korea from 2014 to 2016. The data of 10,759 individuals aged over 19 years were analyzed in this study. As the distribution of the PHQ-9 scores was not normative, the percentile ranks for raw scores were provided. The survey questionnaires included the PHQ-9, The EuroQol-5 Dimension (EQ-5D), and demographic characteristics. We analyzed the construct validity and internal consistency of the PHQ-9. Results: The normative data of the PHQ-9 were generated according to the sex and different age categories. The correlation coefficient between the sum of the PHQ-9 scores and the EQ-5D index was 0.44, which was moderate. The most appropriate model was the two-factor model with five 'affective-somatic' labeled items and four 'cognitive' labeled items. Cronbach's α for the PHQ-9 was 0.79. Conclusions: Our result supports reliability and validity with two-factor structure of PHQ-9 for measuring depression in the Korean nationally representative population. The Korean normative data on the PHQ-9 according to percentile rank can assist in interpreting and comparing scores with other populations.

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Section: Introductionmentioning

confidence: 99%

Normative data and psychometric properties of the Patient Health Questionnaire-9 in a nationally representative Korean population

Shin

et al. 2020

BMC Psychiatry

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“…Although mental illness is prevalent among general hospital inpatients, most general hospitals in China do not yet have psychiatric departments [ 16 ]. It has been reported that nonpsychiatrists in general hospitals usually pay more attention to physical diseases when diagnosing and treating patients, and they often ignore mental health problems, resulting in a generally low recognition rate of psychological disorders among general hospital inpatients [ 17 ]. A screening of depression and anxiety disorders in 15 general hospitals in China showed that about 16.5% of inpatients were screened for depression or anxiety disorders, of which only 8.5% were recommended for psychiatric consultation, only 6.4% received psychiatric pharmacological interventions, and most patients (80.8%) received only routine management of their own somatic diseases [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

The reliability, validity and screening effect of the happiness index scale among inpatients in a general hospital

Shen

Yuan

et al. 2022

BMC Psychiatry

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Background The Happiness Index Scale (HIS) is a newly developed scale by our group to screen for common psychological illnesses among general hospital inpatients. This study aimed to analyze the reliability, validity and screening effect of the HIS and to explore its clinical application. Methods From April 1, 2021, to December 31, 2021, a total of 8405 continuous inpatients were enrolled from different departments of a large tertiary general hospital with 1385 inpatient beds in Guangzhou, Guangdong Province, China. Using a cross-sectional survey design, each participant was assessed with the Patient Health Questionnaire 9(PHQ-9), Generalized Anxiety Disorder 7 items(GAD-7), Athens Insomnia Scale (AIS), Columbia Suicide Severity Rating Scale (C-SSRS) and HIS within 24 h of admission. McDonald's ω coefficient, the Guttman split-half coefficient and the test–retest reliability coefficient were used to evaluate the reliability of the HIS and the construct validity and criterion validity of the validity tests. Scores on the PHQ-9, GAD-7, AIS, and C-SSRS were used as the gold standard tools to analyze the screening effect of the HIS. Results The HIS exhibited very good reliability, with a McDonald's ω coefficient of 0.825, a Guttman split-half coefficient of 0.920 and a test–retest reliability coefficient of 0.745 (P < 0.05). Confirmatory factor analysis showed a satisfactory model fitting index with a χ2/df = 2.602, a root mean squared error of approximation (RMSEA) of 0.014, a standardized root mean square residual (SRMR) of 0.010, a comparative fit index (CFI) of 0.992, and a Tucker–Lewis index (TLI) of 0.983. The correlation coefficient between the total score of each dimension of the scale and the corresponding criterion was 0.854 ~ 0.949 (P < 0.001). The HIS showed a very good distinguishing effect. The average HIS score of inpatients who screened positive for psychological problems was significantly higher than that of inpatients who screened negative for psychological problems (t = 3790.619, P < 0.001). The effect size was very large (Cohens d = 2.695, 95% CI = 2.630 ~ 2.761). Approximately 90.2% of the positive and negative screening results of the HIS were matched with the gold standard tools, with a kappa value of 0.747 (P < 0.001). The screening effect test showed a sensitivity (true positive rate) of 92.9% and a specificity (true negative rate) of 89.5%. Conclusion The HIS exhibited satisfactory reliability and validity and a clinically meaningful screening effect with a much shorter version compared to the commonly used screening scales. Thus, it could potentially be useful as the first screening step to rule out psychological conditions for inpatients in general hospitals or to remind medical teams of further psychological concerns.

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“…Middle-aged adults (40-65 years) [ 1 ] report higher stress levels than most other age groups [ 2 , 3 ], with 75% reporting moderate to high stress and 33% reporting extreme stress [ 4 ]. Major sources of stress include managing children, employment, and aging parents [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Mobile App for Stress Management in Middle-Aged Men and Women (Calm): Feasibility Randomized Controlled Trial

Laird¹,

Puzia²,

Larkey³

et al. 2022

JMIR Form Res

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Background Middle-aged adults (40-65 years) report higher stress levels than most other age groups. There is a need to determine the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in middle-aged adults with a focus on men, as previous meditation app–based studies have reported a low proportion of or even no male participants. Objective This study aims to (1) determine the feasibility (ie, acceptability and demand with a focus on men) of a consumer-based meditation app (Calm), to reduce stress among middle-aged adults reporting elevated stress levels, and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (anxiety, depressive symptoms, mindfulness, and general coping), health behaviors (physical activity and eating habits), and COVID-19 perceptions. Methods This feasibility randomized controlled trial evaluated an app-based meditation intervention in middle-aged adults (N=83) with elevated stress levels (ie, Perceived Stress Scale score ≥15) and limited or no previous experience with meditation. Participants were randomized to the intervention group (Calm app) or a control (educational podcasts; POD) group. Participants completed self-report assessments at baseline and postintervention (week 4). Feasibility was measured as acceptability and demand using Bowen framework. Feasibility and COVID-19 perceptions data were examined using descriptive statistics, and preliminary effects were evaluated using repeated measures analysis of variance. Results Participants were satisfied with Calm (27/28, 96%) and found it appropriate or useful (26/28, 93%). Most reported they would likely continue using the Calm app (18/28, 64%). More Calm users reported satisfaction, appropriateness or usefulness, and intent to continue app use than POD users. Calm users (n=33) completed a mean of 20 (SD 31.1) minutes of meditation on the days they meditated and 103 (SD 109.1) minutes of meditation per week. The average adherence rate to the prescribed meditation was 71% among Calm app users, compared to 62% among POD users. Recruitment rate of men was 35% (29/83). Of those randomized to Calm, 55% (15/29) were men, and retention among them was higher (14/15, 93%) than that among women (12/20, 60%). No significant within or between group differences were observed. Conclusions A 4-week, app-based mindfulness meditation intervention (Calm) may be feasible for middle-aged adults and a useful stress-management tool. Calm users expressed satisfaction with the app and felt it was appropriate and useful. Significant improvements in perceived stress and psychological outcomes or stress-related health behaviors were not observed. Even though men spent less time in meditation than women did and completed fewer weekly sessions, they were more likely to adhere to the prescription. Further research is needed for improving stress and stress-related outcomes among middle-aged adults with emphasis on the effects of mindfulness meditation apps for men. Trial Registration ClinicalTrials.gov NCT04272138; https://clinicaltrials.gov/ct2/show/NCT04272138

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Effects of Universal Screening for Depression Among Middle-Aged Adults in a Community With a High Suicide Rate

Cited by 6 publications

References 33 publications

Normative data and psychometric properties of the Patient Health Questionnaire-9 in a nationally representative Korean population

Normative data and psychometric properties of the Patient Health Questionnaire-9 in a nationally representative Korean population

The reliability, validity and screening effect of the happiness index scale among inpatients in a general hospital

A Mobile App for Stress Management in Middle-Aged Men and Women (Calm): Feasibility Randomized Controlled Trial

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