The state of care for persons with a diagnosis of depression

Stahmeyer, Jona T.; Märtens, Caroline; Eidt-Koch, Daniela; Kahl, Kai G.; Zeidler, Jan; Eberhard, Sveja

doi:10.3238/arztebl.m2022.0204

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…While almost 20% of the old-old adults report demoralization syndrome (DS-II score > 12), only 0.9% of individuals 70-79 years and 0.0% of those aged 90+ years compared to 13.2% of young adults (18-29 years) receive psychotherapeutic treatment (59). Yet, evidence for the effectiveness of meaning-centered interventions in reducing demoralization is limited to patients with cancer (60,62) but its effects on the broader target group of older adults remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Older adults coping with critical life events - results of the revised demoralization scale in a representative sample of older adulthood

Ramm,

Jedamzik,

Lenz

et al. 2024

Front. Psychiatry

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BackgroundHigh suicide rates in older adults are a relevant public health concern. Social isolation or widowhood as well as physical decline play a crucial role for suicidality in older adulthood. Previous evidence suggested that demoralization is an important risk factor for suicide. Whether demoralization is a relevant phenomenon in older adulthood which possibly could account for high suicide rates remains unclear.MethodsDemoralization Scale II (DS-II) scores assessed in a survey of the German general population were investigated with respect to older adults (aged ≥ 65 years). DS-II scores were compared between older (≥ 65 years) and younger (< 65 years) adulthood and between young-old (65–74y), middle-old (75–84y), and old-old (85+y) individuals. We tested the impact of sociodemographic factors on DS-II scores within older adults.ResultsThe sample comprised N = 545 adults ≥ 65 years and N = 1922 adults < 65 years. DS-II scores increased in older compared to younger adults (F(1,2465) = 6.1; p = 0.013; d = 0.09) and further from young-old to old-old (Mdiff = 2.7; 95% CI 0.45, 5.46; p = 0.034). One-fourth of individuals ≥ 65 years and almost half of old-old individuals reported DS-II scores above the cut-off > 5. Living with a partner protected from demoralization in old-old individuals.DiscussionThis study provides first evidence for an increased rate of demoralization in very old adults, in particular women, which is partly related to partnership status. We suggest that demoralization is considered as a crucial entity in older adulthood which can be missed by standard psychological screenings.

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Section: Discussionmentioning

confidence: 99%

Older adults coping with critical life events - results of the revised demoralization scale in a representative sample of older adulthood

Ramm,

Jedamzik,

Lenz

et al. 2024

Front. Psychiatry

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“…Accordingly, in the German health system, general practitioners (GPs) are the first contact for health concerns for many patients with depressive disorders and essential providers of basic psychosomatic care (9,10). Given the lack in mental health care supply, patients do not always receive treatment according to guideline recommendations (11)(12)(13). Hence, prevention and healthcare provision for depressive disorders are important subjects and tasks for public health (4,14).…”

Section: Introduction 1depressive Disorders and The Burden Of Diseasementioning

confidence: 99%

A qualitative interview study of patients' attitudes towards and intention to use digital interventions for depressive disorders on prescription

Posselt,

Baumann,

Dierks

2024

Front. Digit. Health

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BackgroundDepressive disorders are an emerging public health topic. Due to their increasing prevalence, patients with depressive disorders suffer from the lack of therapeutic treatment. Digital health interventions may offer an opportunity to bridge waiting times, supplement, or even substitute in-person treatment. Among others, the Unified Theory of Acceptance and Use of Technology (UTAUT) explains that actual technology use is affected by users' behavioural intention. However, patients' perspectives on digital interventions are rarely discussed within the specific context of primary care provided by general practitioners (GP) and need further exploration.MethodA qualitative study design with semi-structured interviews was used to explore DTx-acceptance of patients with mild or moderate depression (n = 17). The audio-recorded interviews were transcribed verbatim, coded, and thematically analysed by qualitative content analysis.ResultsPatients' performance expectancies reveal that DTx are not perceived as a substitute for face-to-face treatment. Effort expectancies include potential advantages and efforts concerning technical, motivational, and skill-based aspects. Moreover, we identified health status and experience with depressive disorders as other determinants and potential barriers to patients' DTx acceptance: Difficult stages of depression or long-time experience are perceived hurdles for DTx use. GPs' recommendations were just partly relevant for patients and varied according to patients' consultancy preferences. But still, GPs have a crucial role for access due to prescription. GPs' influence on patients' DTx acceptance varies between three situations: (1) pre-use for consultation, (2) pre-use for access and (3) during DTx-use. Further, GPs' guidance could be especially relevant for patients during DTx-use in routine care.DiscussionThe UTAUT-based exploration suggests that acceptance determinants should be considered independently and embedded in personal and situational aspects. DTx require a healthcare professional to prescribe or diagnose the disease, unlike other digital offerings. We identified prescription- and depression-related determinants, exceeding existing theoretical constructs. GPs' guidance can compensate for some barriers to DTx use e.g., by increasing commitment and motivational support to strengthen patients' acceptance.ConclusionWe argue for a multidimensional integration of acceptance determinants for further development of health technology acceptance research. Future research should specify how DTx can be integrated into routine care to strengthen user acceptance.

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“…Guidelines recommend regular screenings for MD [ 6 , 12 ] and suggest specific treatment for comorbid MD in CHD, such as psychotherapeutic or psychopharmacological treatment [ 6 ]. However, screening and treatment appear to be inadequately implemented in routine care [ 13 ]. There seems to be a lack of knowledge among physicians regarding the cardiovascular disease guidelines [ 14 ] and the role of MDs like depression in CHD [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of health care for patients with coronary heart disease and comorbid mental disorders: a prospective cohort study

Nordmeyer,

Leikert,

Sannemann

et al. 2024

BMC Psychol

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Background Coronary heart disease (CHD) is often associated with mental disorders (MDs). Comorbid MDs reduce the quality of life and increase cardiac morbidity and mortality. Nevertheless, there is little and inconsistent research on the management of MDs in CHD patients. To bridge this gap, this study aims to gain insight into the long-term course of MD-related health care for patients with CHD, in order to identify opportunities for care improvement. Methods In this prospective cohort study, we investigated whether CHD patients with or without expert-rated MD at baseline (N = 364) received different MD-related health care from either their general practitioner (GP) or cardiologist at follow-up, M = 2.7 [2.0–4.0] years later. In the follow-up assessment, N = 131 CHD patients participated and received questionnaires capturing sociodemographic, mental health, and MD-related health care characteristics. Descriptive statistics, t-tests and chi-squared tests were used for analyses. Results We found significant differences in MD-related health care. CHD patients with MD were more likely to be examined psychologically/psychiatrically (MD 55.9%, non-MD 16.7%, p = < .001) and diagnosed with MD (MD 55.9%, non-MD 13.5%, p = .020) by their GP or cardiologist. Recommendations for and responses to requests for psychotherapy were more likely in MD patients compared to non-MD patients (MD 38.7%, non-MD 11.8%, p = .012 and MD 38.5%, non-MD 11.8%, p = .031, respectively). No significant differences were found concerning physicians’ active demand for patients’ mental health, referral to a specialist for additional diagnostics, provision of information about the diagnosed MD and further treatment options, response to the patients’ request for psychopharmacotherapy, help received in finding psychotherapy or psychopharmacotherapy, and actual receipt of these treatments. Conclusions The results indicate differences in MD-related health care of CHD patients with and without comorbid MD. However, they still highlight the need to further encourage primary care physicians treating CHD to adequately address MDs, provide further diagnostics, support, and information to affected patients. To address this, physicians may benefit from awareness training on the association between CHD and MDs and on appropriate communication with MD patients. Trial registration German clinical trials register (Deutsches Register Klinischer Studien, DRKS) Registration Number: ID DRKS00022154, date of registration: 02.11.2021.

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The state of care for persons with a diagnosis of depression

Cited by 13 publications

References 18 publications

Older adults coping with critical life events - results of the revised demoralization scale in a representative sample of older adulthood

Older adults coping with critical life events - results of the revised demoralization scale in a representative sample of older adulthood

A qualitative interview study of patients' attitudes towards and intention to use digital interventions for depressive disorders on prescription

Quality of health care for patients with coronary heart disease and comorbid mental disorders: a prospective cohort study

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