The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report.

BACKGROUND: Previous studies have suggested a bidirectional association between sleep problems and anxiety symptoms in adolescents. These studies used methods that do not separate between-person effects from within-person effects, and therefore their conclusions may not pertain to within-person mutual influences of sleep and anxiety. We examined bidirectional associations between sleep problems and anxiety during adolescence and young adulthood while differentiating between person effects from within-person effects. METHODS: Data came from the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study including six waves of data spanning 15 years. Young adolescents (N = 2230, mean age at baseline 11.1 years) were followed every 2-3 years until young adulthood (mean age 25.6 years). Sleep problems and anxiety symptoms were measured by the Youth Self-Report, Adult Self-Report and Nottingham Health Profile. Temporal associations between sleep and anxiety were investigated using the random intercept cross-lagged panel model. RESULTS: Across individuals, sleep problems were significantly associated with (ß = 0.60, p < 0.001). At the within-person level, there were significant cross-sectional associations between sleep problems and anxiety symptoms at all waves (ß = 0.12-0.34, p < 0.001). In addition, poor sleep predicted greater anxiety symptoms between the first and second, and between the third and fourth assessment wave. The reverse association was not statistically significant. CONCLUSIONS: Within-person associations between sleep problems and anxiety are considerably weaker than between-person associations. Yet, our findings tentatively suggest that poor sleep, especially during early and mid-adolescence, may precede anxiety symptoms, and that anxiety might be prevented by alleviating sleep problems in young adolescents.

HowNutsAreTheDutch (HoeGekIsNL): A crowdsourcing study of mental symptoms and strengths.

HowNutsAreTheDutch (Dutch: HoeGekIsNL) is a national crowdsourcing study designed to investigate multiple continuous mental health dimensions in a sample from the general population (n = 12,503). Its main objective is to create an empirically based representation of mental strengths and vulnerabilities, accounting for (i) dimensionality and heterogeneity, (ii) interactivity between symptoms and strengths, and (iii) intra-individual variability. To do so, HowNutsAreTheDutch (HND) makes use of an internet platform that allows participants to (a) compare themselves to other participants via cross-sectional questionnaires and (b) to monitor themselves three times a day for 30 days with an intensive longitudinal diary study via their smartphone. These data enable for personalized feedback to participants, a study of profiles of mental strengths and weaknesses, and zooming into the fine-grained level of dynamic relationships between variables over time. Measuring both psychiatric symptomatology and mental strengths and resources enables for an investigation of their interactions, which may underlie the wide variety of observed mental states in the population. The present paper describes the applied methods and technology, and presents the sample characteristics. Copyright © 2015 John Wiley & Sons, Ltd.

Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys.

OBJECTIVE: To assess prevalence and correlates of family caregiver burdens associated with mental and physical conditions worldwide. METHODS: Cross-sectional community surveys asked 43,732 adults residing in 19 countries of the WHO World Mental Health (WMH) Surveys about chronic physical and mental health conditions of first-degree relatives and associated objective (time, financial) and subjective (distress, embarrassment) burdens. Magnitudes and associations of burden are examined by kinship status and family health problem; population-level estimates are provided. RESULTS: Among the 18.9-40.3% of respondents in high, upper-middle, and low/lower-middle income countries with first-degree relatives having serious health problems, 39.0-39.6% reported burden. Among those, 22.9-31.1% devoted time, 10.6-18.8% had financial burden, 23.3-27.1% reported psychological distress, and 6.0-17.2% embarrassment. Mean caregiving hours/week was 12.9-16.5 (83.7-147.9 hours/week/100 people aged 18+). Mean financial burden was 15.1% of median family income in high, 32.2% in upper-middle, and 44.1% in low/lower-middle income countries. A higher burden was reported by women than men, and for care of parents, spouses, and children than siblings. CONCLUSIONS: The uncompensated labor of family caregivers is associated with substantial objective and subjective burden worldwide. Given the growing public health importance of the family caregiving system, it is vital to develop effective interventions that support family caregivers.

Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys

Objective: To assess prevalence and correlates of family caregiver burdens associated with mental and physical conditions worldwide. Methods: Cross-sectional community surveys asked 43,732 adults residing in 19 countries of the WHO World Mental Health (WMH) Surveys about chronic physical and mental health conditions of first-degree relatives and associated objective (time, financial) and subjective (distress, embarrassment) burdens. Magnitudes and associations of burden are examined by kinship status and family health problem; population-level estimates are provided. Results: Among the 18.9-40.3% of respondents in high, upper-middle, and low/lower-middle income countries with first-degree relatives having serious health problems, 39.0-39.6% reported burden. Among those, 22.9-31.1% devoted time, 10.6-18.8% had financial burden, 23.3-27.1% reported psychological distress, and 6.0-17.2% embarrassment. Mean caregiving hours/week was 12.9-16.5 (83.7-147.9 hours/week/100 people aged 18+). Mean financial burden was 15.1% of median family income in high, 32.2% in upper-middle, and 44.1% in low/lower-middle income countries. A higher burden was reported by women than men, and for care of parents, spouses, and children than siblings. Conclusions: The uncompensated labor of family caregivers is associated with substantial objective and subjective burden worldwide. Given the growing public health importance of the family caregiving system, it is vital to develop effective interventions that support family caregivers. .

Response sets in self-report data and their associations with personality traits

Objective: With a strong reliance on the use of self-report questionnaires in psychiatric research, appropriate attention should be given to the existence and correlates of response sets. We studied the presence of response tendencies by using an old research paradigm from psychology. Methods: We administered response options without questions to a sample of 91 second-year medical students, together with two personality questionnaires. Results: The scores of the respondents demonstrated the willingness of respondents to fill in a content-free questionnaire and revealed the presence of a general tendency towards positive responses. In psychometric theory, this would be referred to as a ‘constant error’. More importantly, positive answers were significantly related to low neuroticism, high extraversion and high well-being. In psychometric theory, this would imply ‘response bias’ in which the self-reports are confounded by personality features. Conclusions: In the development and evaluation of questionnaires, researchers should be aware of the potential for this bias, particularly when asking questions about subjective health status (AU)

Predicción temprana de necesidades de intervención psicosocial especializada en pacientes con enfermedades pulmonares a partir de evaluaciones por enfermeras / Early prediction of psychosocial intervention needs in pneumology patients after nurses’ evaluation

FUNDAMENTO Y OBJETIVO: El objetivo del estudio ha sido verificar la hipótesis de que con el métodoINTERMED se identificará, en el momento del ingreso, a los pacientes neumológicos con riesgo de«complejidad» y necesidades de intervención psicosocial especializada.PACIENTES Y MÉTODO: Una enfermera entrenada en la versión española del método INTERMED (para detectarel riesgo de complejidad de cuidados médicos) entrevistó a una muestra aleatoria de 144 pacientesen el momento de su ingreso. Al alta se revaluó a los pacientes de modo ciego con versionesespañolas estandarizadas de instrumentos como la Hospital Anxiety and Depression Scale (HADS), yse documentaron independientemente las variables de enfermedad somática (incluido el Índice Acumulativode Enfermedad). Todas las variables se definieron de modo operativo y entre ellas figuraban:pacientes complejos (IM+; INTERMED > 20), pacientes no complejos (IM–) y probable necesidad deintervención psicosocial. Se realizó un análisis multivariante de regresión logística.RESULTADOS: El 9,6% de los pacientes tuvo un curso complejo y el 28,8% un alta compleja. Se documentaronproporciones significativamente mayores de ansiedad o depresión grave en los IM+ (12,1%)que en los IM– (0,9%), y también de necesidad de intervención psicosocial (el 24,2 frente al 6,3%,respectivamente). En el análisis de regresión multivariante, tras controlar las variables médicas y sociodemográficasde confusión, INTERMED se asoció significativamente con la variable necesidad deintervención psicosocial.CONCLUSIONES: En apoyo de la utilidad clínica de INTERMED en su versión española, se documenta porvez primera en la bibliografía internacional que con dicho método una enfermera preparada puedeidentificar en el momento del ingreso qué pacientes de planta médica necesitarán intervención psicosocialespecializada

BACKGROUND AND OBJETIVE: This study was aimed to verify whether it is possible to detect at hospital admission,by means of INTERMED, pneumonology patients at risk of «complexity» and of specializedpsychosocial intervention.PATIENTS AND METHOD: With the Spanish version of INTERMED (for detection of risk for complexity ofcare) 144 patients were interviewed at admission by a standardized nurse. At discharge, patients werereassessed blindly with standardized Spanish versions of instruments including the Hospital Anxietyand Depression Scale (HADS). Somatic illness variables were independently documented, and severitywas assessed by means of the Cummulative Illness Rating Scale. All variables were operationalized includingcomplex (IM+; INTERMED > 20) and non-complex patients (IM–), and probable need of psychosocialtreatment/intervention. Statistical analysis included multivariate logistic regression.RESULTS: A complex course was documented in 9.6% of patients, and 28.8% had complex discharge.Significantly higher proportions of severe anxiety and/or depression were documented in IM+ cases(12.1%) when compared to IM– cases (0.9%), and the need of psychosocial treatment/interventionwas also significantly more frequent among the former (24.2% versus 6.3% respectively). Furthermore,in the multivariate analysis and controlling for medical and sociodemographic confounders INTERMEDwas significantly associated with the variable need of psychosocial intervention.CONCLUSIONS: In support of the clinical utility of the INTERMED method (Spanish version), this is thefirst report in the international literature documenting that standardized nurses are able to detect atadmission those medical patients who will eventually need specialized psychosocial intervention