Adverse effects and treatment satisfaction among online users of four antidepressants.

Adverse effects (AEs) are an important factor in antidepressant treatment decision-making, though common AE profiles from clinical trial research highlight physical AEs to the neglect of emotional and behavioral AEs. First-hand accounts of antidepressant users on the Internet can supplement AE profiles with information gained from real-world treatment experiences. We examined online user reviews of two older (escitalopram; duloxetine) and two newer (vilazodone; vortioxetine) antidepressants for differences in their AE profiles and determined which categories of AEs were associated with users' satisfaction. A codebook of 60 physical, emotional, and behavioral AEs was used for line-by-line coding of effects reported among 3243 user reviews from three popular health websites. Emotional and behavioral effects were commonly reported (41%), followed by sleep (31.9%) and gastrointestinal (25.0%) effects. Specific AEs statistically significantly varied across drugs, creating potentially meaningful differences in AE profiles. Users of newer drugs more often reported emotional instability, while users of older drugs reported more emotional blunting. Emotional and behavioral AEs demonstrated moderate to substantial relationships with users' satisfaction, whereas gastrointestinal, metabolic, or sexual AEs were minimally related. More specific and systematic assessment of a broader range of AEs is needed in both research and practice.

Strategies for Working with Asian Americans in Mental Health: Community Members' Policy Perspectives and Recommendations.

This qualitative study used snowball sampling of individuals known to provide informal assistance to Asian American community members with their mental health problems in a locality in the South where there has been an exponential increase of the Asian American population. The major themes found include: (1) the existence of cultural, language, knowledge, and transportation barriers and the importance of policy in addressing them; (2) the impact of the model minority myth and the need for inclusive policymaking; and (3) the unique service and policy needs of immigrants. Findings demonstrate the importance and value of including diverse Asian American individuals in mental health policymaking efforts.

Self-directed care: participants' service utilization and outcomes.

OBJECTIVE: Self-directed care (SDC) is a mental health service delivery model in which participants budget the state dollars allotted for their care to purchase the goods and services they deem most appropriate for achieving their recovery goals. This study examines the demographic characteristics, service utilization patterns, and outcomes of individuals enrolled in the Florida Self-Directed Care (FloridaSDC) program, which is the oldest and most established SDC program in the United States for individuals diagnosed with a severe and persistent mental illness. METHOD: This is a naturalistic descriptive study in which demographic, service utilization, and outcome data (i.e., Functional Assessment Rating Scale (FARS) scores, days in the community, days worked, monthly income, discharge status) were collected from the clinical and fiscal records of 136 FloridaSDC participants. RESULTS: Key findings suggest that FloridaSDC participants had very little income and largely utilized their budgets to subsidize their living expenses. Though most participants did not work or earn income and very few left the program due to employment, participants' FARS scores improved modestly and nearly all participants remained in the community throughout the study period. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Participants' service purchases were rational given the poverty in which they live, and their outcomes did not suffer when they controlled decisions regarding their service needs. These findings highlight the utility and value of the personalized budgeting and individualized planning components of SDC. Findings also point to the need for practitioners to implement innovative strategies to enhance participants' employment readiness and supported employment opportunities. (PsycINFO Database Record

Measurement in abstinence education. Critique and recommendations.

The purpose of this article is to identify, assess, and offer solutions to common measurement errors found in sexual abstinence education evaluation. A critical review of the methodology of adolescent sexuality research was performed. "Gold standards" of their measurement strategy were derived and applied against 14 selected studies. Many of the articles reviewed had substantial limitations in their measurement strategies. However, several articles demonstrated excellence and serve as models for future efforts. Sexual abstinence education evaluation is plagued by the inherent weaknesses of self-report and health outcome measures. However, with careful adherence to the gold standards proposed, it is possible to limit the threat from these weaknesses, maximizing the benefit of self-report surveys and county-level health indicators.