Depression Treatment: Implementation Research: Reducing the Research-to-Practice Gap in Depression Treatment.

Implementation Research: Reducing the Research-to-Practice Gap in Depression Treatment.

Filed under: Depression Treatment

Depress Res Treat. 2012; 2012: 476027
Kilbourne AM, Williams M, Bauer MS, Arean P

HubMed – depression


Stimulant and atypical antipsychotic medications for children placed in foster homes.

Filed under: Depression Treatment

PLoS One. 2013; 8(1): e54152
Linares LO, Martinez-Martin N, Castellanos FX

The purpose of this study is to examine the use of prescribed psychoactive medications in a prospective cohort of children shortly after they entered foster homes; and to identify demographics, maltreatment history, psychiatric diagnoses including ADHD comorbidity, and level of aggression that contribute to prescribed use of stimulant and atypical antipsychotic medication over time.The sample included N?=?252 children (nested in 95 sibling groups) followed for three years up to 4 yearly waves.Nearly all (89%) met criteria for at least one of eight psychiatric diagnoses and 31% (75/252) used one or more prescribed psychoactive medications. Over half (55%) were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD); of these 38% used stimulants and 36% used atypical antipsychotics. Of the 75 medicated children, 19% received ?3 different classes of drugs over the course of the study. Stimulants (69%) and atypical antipsychotics (65%) were the most frequently used drugs among medicated children. Adjusted odds ratios (AOR) showed that male gender (AOR?=?3.2; 95% CI?=?1.5-9.3), African American vs Latino ethnicity (AOR?=?5.4; 95% CI?=?2.1-14.2), ADHD regardless of Oppositional Defiant (ODD) or Conduct (CD) comorbidity (AOR?=?6.0, 95% CI?=?1.3-27.5), ODD or CD (AOR?=?11.1, 95% CI?=?2.1-58.6), and Separation Anxiety (AOR?=?2.0, 95% CI?=?1.0-4.0) psychiatric disorders were associated with the use of prescribed stimulants; while male gender (AOR?=?3.8, 95% CI?=?1.5-9.3), African American vs Latino (AOR?=?5.1, 95% CI?=?1.2-9.2) or Mixed/Other ethnicity (AOR?=?3.3, 95% CI?=?1.9-13.7), ADHD regardless of ODD or CD comorbidity (AOR?=?5.8, 95% CI?=?1.2-28.7), ODD or CD (AOR?=?13.9, 95% CI?=?3.3-58.5), Major Depression/Dysthymia (AOR?=?2.8, 95% CI?=?1.1-6.7) psychiatric disorders, and history of sexual abuse (AOR?=?4.6, 95% CI?=?1.3-18.4) were associated with the use of prescribed atypical antipsychotics.The aggressive use of atypical antipsychotics, which has unknown metabolic risks, suggests that the efficacy and safety of such treatment strategies for psychiatrically ill children in foster care should be monitored.
HubMed – depression


Cross-Language Measurement Equivalence of the Center for Epidemiologic Studies Depression (CES-D) Scale in Systemic Sclerosis: A Comparison of Canadian and Dutch Patients.

Filed under: Depression Treatment

PLoS One. 2013; 8(1): e53923
Kwakkenbos L, Arthurs E, van den Hoogen FH, Hudson M, van Lankveld WG, Baron M, van den Ende CH, Thombs BD,

OBJECTIVES: Increasingly, medical research involves patients who complete outcomes in different languages. This occurs in countries with more than one common language, such as Canada (French/English) or the United States (Spanish/English), as well as in international multi-centre collaborations, which are utilized frequently in rare diseases such as systemic sclerosis (SSc). In order to pool or compare outcomes, instruments should be measurement equivalent (invariant) across cultural or linguistic groups. This study provides an example of how to assess cross-language measurement equivalence by comparing the Center for Epidemiologic Studies Depression (CES-D) scale between English-speaking Canadian and Dutch SSc patients. METHODS: The CES-D was completed by 922 English-speaking Canadian and 213 Dutch SSc patients. Confirmatory factor analysis (CFA) was used to assess the factor structure in both samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess the amount of differential item functioning (DIF). RESULTS: A two-factor model (positive and negative affect) showed excellent fit in both samples. Statistically significant, but small-magnitude, DIF was found for 3 of 20 items on the CES-D. The English-speaking Canadian sample endorsed more feeling-related symptoms, whereas the Dutch sample endorsed more somatic/retarded activity symptoms. The overall estimate in depression scores between English and Dutch was not influenced substantively by DIF. CONCLUSIONS: CES-D scores from English-speaking Canadian and Dutch SSc patients can be compared and pooled without concern that measurement differences may substantively influence results. The importance of assessing cross-language measurement equivalence in rheumatology studies prior to pooling outcomes obtained in different languages should be emphasized.
HubMed – depression


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