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Handouts & questionnaires for outcome tracking: depression, mania, side-effects, anxiety, worry, alcohol, sleep, gambling & more

Well, well, well ... what a lot of amazing information there is out there on the internet.  I was trawling to try to find the copyright position of the Panic Disorder Severity Scale (more on this soon in a future post) when I tumbled into Mark Zimmerman's "Outcome Tracker" website.  Mark is "Associate Professor of Psychiatry and Human Behavior at Brown University, the Director of Outpatient Psychiatry at Rhode Island Hospital, and Principal Investigator of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project."

Recent research: six studies on the long-term effects of abuse & deprivation

Here are half a dozen studies on the long-term effects of various forms of abuse & deprivation.  Paras et al systematically reviewed the association between a history of sexual abuse and a lifetime diagnosis of a somatic disorder.  They found significant links with functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain.  When analysis was restricted to studies where sexual abuse was defined as rape, they also found an association with fibromyalgia.  Abstracts and links, for this research paper and the further papers described, can be found lower down this page.   

Recent research: 3 studies on diet & (cardiovascular) health, 2 on fish oil, dementia & postpartum depression, and 1 on walnuts!

Here are half a dozen studies on diet (see below for all abstracts and links).  The first three are about the benefits of healthy lifestyle.  Trichopoulou & colleagues evaluated the contribution of nine widely accepted components of the Mediterranean diet (high intake of vegetables, fruits and nuts, legumes, fish, and cereals; low intake of meat and dairy; high ratio of monounsaturated to saturated lipids; and moderate intake of ethanol) in the inverse association of this diet with all cause mortality.  They concluded that "The dominant components of the Mediterranean diet score as a predictor of lower mortality are moderate consumption of ethanol, low consumption of meat and meat products, and high consumption of vegetables, fruits and nuts, olive oil, and legumes.

Recent research: 3 studies on internet-delivered therapy, 2 on speed of antidepressant response, and 1 on therapy effectiveness

Here are three studies (for all abstracts & links see below) highlighting the increasingly encouraging results being reported for internet-delivered psychological interventions.  Van't Hof, Cuijpers et al report on " ... a systematic review of meta-analyses on the efficacy of self-help interventions, including internet-guided therapy, for depression and anxiety disorders". They conclude that the 13 meta-analyses indicate "self-help methods are effective in a range of different disorders, including depression and anxiety disorders. Most meta-analyses found relatively large effect sizes for self-help treatments, independent of the type of self-help, and comparable to effect sizes for face-to-face treatments" (see below for abstracts and links to the six research papers mentioned).  Riper, Kramer et al describe how an experimental internet-delivered self-help alcohol reduction intervention transferred well to being made more generally available.  The authors conclude that " ...

Recent research: six papers relevant to psychotherapy

Here are six studies relevant to improving psychotherapy outcomes.  Brewin et al report on using imagery-based interventions to help people with depressioin.  Lydiard et al highlight the importance of sleep-related disturbances as a treatment target in PTSD.  McCrady and colleagues show that working with couples rather than just individuals seems more effective when using behavioural therapy to help women with alcohol use disorders.  Geerts et al describe rather amazing research investigating "The role of parental bonding and nonverbal communication in the short-term treatment response was investigated in 104 depressed outpatients. At baseline patients completed the Parental Bonding Instrument. We registered the nonverbal involvement behaviour of patients and interviewers from video recordings of baseline clinical interviews and calculated the convergence between patient-interviewer behaviour over the interview ... As hypothesized, low maternal care and high paternal overprotection predicted a poor response to an 8-week treatment.  Maternal care was positively correlated with nonverbal convergence. Moreover, convergence moderated the relationship between maternal care and the response to treatment: Lack of convergence between patients and interviewers turned out to annul the positive effects of maternal care on the treatment response.

Recent research: three depression papers that get me thinking

Looking back over relevant research papers that caught my attention last month, some stand out for me more than the others.  Here are three on depression that stood out and got me thinking.  The Fergusson et al paper looks at links between alcohol abuse and major depression.  There has been debate for years on whether alcohol dependence leads to depression or depression leads to alcohol dependence.  In this kind of debate, it's usually a good bet that both pathways contain some truth.  What this study adds is that often it is the alcohol dependence that is primary.  As the authors state " ... the associations between AAD (alcohol abuse or dependence) and MD (major depression) were best explained by a causal model in which problems with alcohol led to increased risk of MD as opposed to a self-medication model in which MD led to increased risk of AAD." 

Preventing cancer through life style choices

In 2001 the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) WCRF/AICR set themselves the task of systematically assessing all good research on diet, physical activity and cancer and publishing a report that would be the largest study of its kind with conclusions that would be best the evidence could demonstrate.  Over 100 scientists from 30 countries were involved.  An expert panel of 21 of these scientists worked for 5 years to produce the report "Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective."  The follow-up companion Policy Report "Policy and Action for Cancer Prevention"  was published a little over a month ago and has recommendations for a series of different groups and organizations including government, industry, the media, schools, and work places

Alcohol: know your limits and increase the price

A recent article in the British Medical Journal (Kmietowicz 2009) reports that "The chief medical officer for England has called for a minimum price of 50 pence (0.54; $0.70) to be charged for a unit of alcohol to reduce excessive drinking and its associated harms.  Liam Donaldson said that antisocial drinking should be targeted in the same way as smoking in public places so that being drunk is no longer an aim or socially acceptable.  ‘England has a drink problem and the whole of society bears the burden,' said Professor Donaldson at the launch of his 2008 annual report. ‘The passive effects of heavy drinking on innocent parties are easily underestimated and frequently ignored. The concept of passive drinking and the devastating collateral effect that alcohol can have on others must be addressed on a national scale.'  He said that evidence shows that price and access are the two key factors that can help to change drinking habits, as they were for tobacco."  

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