Usefulness of a single-item measure of depression to predict mortality: the GAZEL prospective cohort study.: single-item of depression and mortality

International audienceBACKGROUND: It remains unknown whether short measures of depression perform as well as long measures in predicting adverse outcomes such as mortality. The present study aims to examine the predictive value of a single-item measure of depression for mortality. METHODS: A total of 14,185 participants of the GAZEL cohort completed the 20-item Center-for-Epidemiologic-Studies-Depression (CES-D) scale in 1996. One of these items (I felt depressed) was used as a single-item measure of depression. All-cause mortality data were available until 30 September 2009, a mean follow-up period of 12.7 years with a total of 650 deaths. RESULTS: In Cox regression model adjusted for baseline socio-demographic characteristics, a one-unit increase in the single-item score (range 0-3) was associated with a 25% higher risk of all-cause mortality (95% CI: 13-37%, P<0.001). Further adjustment for health-related behaviours and physical chronic diseases reduced this risk by 36% and 8%, respectively. After adjustment for all these variables, every one-unit increase in the single-item score predicted a 15% increased risk of death (95% CI: 5-27%, P<0.01). There is also an evidence of a dose-reponse relationship between reponse scores on the single-item measure of depression and mortality. CONCLUSION: This study shows that a single-item measure of depression is associated with an increased risk of death. Given its simplicity and ease of administration, a very simple single-item measure of depression might be useful for identifying middle-aged adults at risk for elevated depressive symptoms in large epidemiological studies and clinical settings

Studying the Hurdles of Insulin Prescription (SHIP©): development, scoring and initial validation of a new self-administered questionnaire

<p>Abstract</p> <p>Background</p> <p>Although insulin therapy is well-accepted by symptomatic diabetic patients, it is still often delayed in less severe patients, in whom injectable insulin remains under-used. A better understanding of patients' perception of insulin would eventually help physicians to adopt the most appropriate dialogue when having to motivate patients to initiate or to intensify insulin injection.</p> <p>Methods</p> <p>The 'Studying the Hurdles of Insulin Prescription' (SHIP) questionnaire was developed based on a list of concepts derived from three diabetic patients' focus groups, and was included into two cross-sectional studies with similar design: SHIP Oral study and SHIP Premix study. Diabetic patients treated with oral hypoglycaemic agents (OHA; n = 1,494) and patients already treated with insulin (n = 1,150) completed the questionnaire at baseline, 6- and 12 months. Psychometric properties were assessed: 1) structure analysis by Principal Component Analysis (PCA) with Varimax rotation, 2) internal consistency reliability (Cronbach's alpha), and 3) concurrent validity (Spearman correlation coefficients with the Fear of Self-Injecting (FSI) score of the Diabetes Fear of Injecting and Self-testing Questionnaire. Reluctance/motivation towards insulin was assessed. Scores' ability to predict patients' insulin injection reluctance/motivation and initiation/intensification was evaluated with the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC).</p> <p>Results</p> <p>PCA analysis confirmed the structure of the 14 items grouped into 3 dimensions: 'acceptance and motivation', 'fear and constraints', and 'restraints and barriers' towards insulin injection. Internal consistency reliability was excellent (Cronbach's alpha > 0.70); concurrent validity was good. The three scores were significantly predictive of patients' reluctance/motivation towards insulin injection initiation, as they were of patients' actual switch, except for the 'restraints and barriers' dimension. 'Acceptance and motivation' and 'fears and constraints' dimensions were also significantly predictive of patients' reluctance/motivation towards insulin intensification. By the end of the 12-month study, 179 of the initially OHA-treated patients had started insulin injections; 186 of the patients already treated with insulin had increased their injections.</p> <p>Conclusion</p> <p>The SHIP questionnaire provides reliable and valid assessment of diabetic patients' attitude towards insulin and injections. The predictive power of scores for patients' reluctance/motivation and actual treatment decisions demonstrates encouraging potential for further application in clinical practice.</p

The multinational second Diabetes, Attitudes, Wishes and Needs study: results of the French survey

International audienceAIM:The second Diabetes, Attitudes, Wishes and Needs (DAWN2™) multinational cross-sectional study was aimed at generating insights to facilitate innovative efforts by people with diabetes (PWD), family members (FMs), and health care professionals (HCPs) to improve self-management and psychosocial support in diabetes. Here, the French data from the DAWN2™ study are described.METHODS:In France, 500 PWD (80 with type 1 diabetes [T1] and 420 with type 2 diabetes [T2]), 120 FMs, and 288 HCPs were recruited. The questionnaires assessed the impact of diabetes on quality of life and mood, self-management, attitudes/beliefs, and care/support.RESULTS:Diabetes negatively impacted the emotional well-being of 59% of people with T1 versus 45% of people with T2 (P<0.05) and about half of FMs. A high level of distress was felt by about half of PWD and FMs. About half of HCPs reported assessing depression in their patients. Sixty-two percent of FMs considered managing diabetes to be a burden. Hypoglycemia was a source of concern for 64% of people with T1 and 73% of FMs of insulin users. About two-thirds of non-insulin-medicated people with T2 agreed to start insulin if prescribed, while half of HCPs preferred to delay insulin initiation. A discrepancy between HCPs' perceptions of their interactions with their patients and PWD's recollection of these interactions with regard to patients' personal needs and distress was also observed.CONCLUSION:While distress remains under-assessed by HCPs, the negative impact of diabetes on the lives of PWD and FMs clearly induces distress on both groups. These findings provide new understanding of barriers precluding optimal management of diabetes. Developing strategies to overcome these barriers is now warranted

Et pourquoi pas aussi un « sens de la non-observance » ? (Commentaire)

Consoli Silla. Et pourquoi pas aussi un « sens de la non-observance » ? (Commentaire). In: Sciences sociales et santé. Volume 25, n°2, 2007. pp. 37-41

LES ENFANTS ET ADOLESCENTS DONT UN PARENT EST ATTEINT DE CANCER (ENJEUX ET DIFFICULTES PSYCHOLOGIQUES, RECOMMANDATIONS POUR UNE MEILLEURE PRISE EN CHARGE)

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

Un exemple d'utilisation du Rorschach en pathologie somatique : le phénomène de Raynaud

Baudin Marianne L., Consoli Silla M. Un exemple d'utilisation du Rorschach en pathologie somatique : le phénomène de Raynaud. In: Bulletin de psychologie, tome 43 n°396, 1990. Rorschach et T.A.T. pp. 802-814

Psychologie de liaison et relaxation thérapeutique en chirurgie cardiaque

La pratique de la relaxation en chirurgie cardiaque représente une expérience originale de psychologie de liaison à l’hôpital général, de par la brièveté du nombre de séances dans un tel contexte et la rareté de son utilisation de nos jours. C’est en suivant pas à pas le déroulement de ses rencontres avec M. E., âgé de 51 ans et hospitalisé en suite d’un double pontage, que l’auteur se propose de mettre en relief les spécificités de la relaxation en chirurgie cardiaque et d’ouvrir une réflexion théorique autour de l’effet restructurant que peut avoir dans un tel contexte cette technique thérapeutique. Cela n’est cependant possible que si le thérapeute ne s’enferme pas dans une attitude trop intellectuelle et parvient, dans une certaine mesure, à établir ou rétablir des liens entre le patient et l’équipe, entre l’avant et l’après opération, sans être obnubilé par le temps compté.Clément-Hryniewicz Nathalie, Consoli Silla M., Berebi Alain, Meimoun Patrick. Psychologie de liaison et relaxation thérapeutique en chirurgie cardiaque. In: Bulletin de psychologie, tome 56 n°463, 2003. pp. 89-94