Effectiveness of supported housing versus residential care in severe mental illness: a multicenter, quasi-experimental study

Purpose Up to now there are only few studies and no RCT comparing efficacy or effectiveness of supported housing (SH) versus residential care (RC) in severe mental illness (SMI) without homelessness. Here we present an observational followup study in SMI subjects, who entered SH or RC, to compare clinical and functional outcomes 2 years later. Methods In this prospective study in more than 30 locations throughout a German federal state, we included SMI subjects, who entered SH (n= 153) or RC (n = 104). About one quarter suffered from each substance use, psychotic, affective, or other disorders. To avoid sampling bias, we used the propensity score matching method to establish a quasi-experimental design. Outcome measures were social functioning (SFS), the number of psychiatric hospitalisations, psychopathology (SCL-9-K), and quality of life (MANSA). Apart from descriptive methods we analysed primarily using repeated-measures ANOVAS. Results Our analyses revealed significant effects of time for all outcomes in both study groups. However, there were not any group differences of outcome measures, i.e., not any significant effects of group or interactional effects of group x time. Moreover, these results hold true for intent-to-treat and per-protocol sample analyses. Conclusion The results show, that SH and RC for non-homeless people with SMI achieve the same clinical and psychosocial outcomes across a 2-year period. Taking into account the users’ preferences, the present findings should give reason to ensure the availability of affordable housing and to support the expansion of upported housing approache

Are they just exaggerating? Differences between subjective and objective cognitive performance in patients with depression: Mounting evidence and open questions.

Dehn LB, Beblo T. Are they just exaggerating? Differences between subjective and objective cognitive performance in patients with depression: Mounting evidence and open questions. Journal of affective disorders. 2019;248:198-199

Patients with major depression show greater memory improvement if motivation is increased: An exploratory study under real-life-like conditions

Dehn LB, Driessen M, Beblo T. Patients with major depression show greater memory improvement if motivation is increased: An exploratory study under real-life-like conditions. JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY. 2020;42(3):307-318.Introduction: Loss of motivation is a core feature of major depression (MDD) and has been suggested to influence neuropsychological performance. However, previous studies have come to inconsistent results, but they were only done under laboratory test conditions. Thus, the aim of the present study is to experimentally investigate the influence of motivation on neurocognition under real-life-like conditions. Methods: Twenty-two inpatients with MDD (M = 42.5 years) and 27 demographically comparable healthy control subjects (HC) underwent a new memory paradigm under real-life-like conditions: To bridge the "waiting time" before a planned neuropsychological assessment, subjects were shown two videos on the waiting room TV with different motivational appeals. Video 1 (lower motivation) deals with factual information about the research department's history. Video 2 (higher motivation) consists of information about a current lottery. The video stories were developed by analogy to the established "Logical Memory" test. Subjective motivation was assessed by a short form of the Intrinsic Motivation Inventory. After 30 min, subjects had to perform an unexpected free recall and recognition of the video content during the intended test session. Results: MDD patients, different from HC subjects, rated their intrinsic motivation for the presentation of video 2 as higher compared to video 1. Two-way repeated measures analyses of variance as well as post-hoc tests showed a significant effect of motivation on the MDD patients' memory scores for video 2. Conclusions: The results provide support for an association between motivation and neurocognition in depressed patients and suggest that cognition under real-life-like conditions can be improved more in MDD patients relative to healthy controls with the use of motivational interventions

Preliminary Results

Dehn LB, Toepper M, Driessen M, Beblo T. Methodological Influences on the Association Between Self-Rated and Objective Memory Functioning. GeroPsych. 2017;30(4):177-178

Participating in Longitudinal Observational Research on Psychiatric Rehabilitation: Quantitative Results From a Patient Perspective Study

Background Longitudinal observational studies play on an important role for evidence-based research on health services and psychiatric rehabilitation. However, information is missing about the reasons, why patients participate in such studies, and how they evaluate their participation experience. Methods Subsequently to their final assessment in a 2-year follow-up study on supported housing for persons with severe mental illness, n = 182 patients answered a short questionnaire on their study participation experience (prior experiences, participation reasons, burden due to study assessments, intention to participate in studies again). Basic respondent characteristics as well as symptom severity (SCL-K9) were also included in the descriptive and analytical statistics. Results To help other people and curiosity were cited as the main initial reasons for study participation (>85%). Further motives were significantly associated with demographic and/or clinical variables. For instance, “relieve from boredom” was more frequently reported by men and patients with substance use disorders (compared to mood disorders), and participants ‘motive” to talk about illness” was associated with higher symptom severity at study entry. Furthermore, only a small proportion of respondents indicated significant burdens by study participation and about 87% would also participate in future studies. Conclusions The respondents gave an overall positive evaluation regarding their participation experience in an observational study on psychiatric rehabilitation. The results additionally suggest that health and social care professionals should be responsive to the expectations and needs of patients with mental illness regarding participation in research

Everyday memory in patients with depression: An explorative pilot study using an ecological assessment paradigm

People with major depressive disorder (MDD) often experience significant memory problems in their daily lives, which, however, frequently do not correspond to standardized memory test (SMT) results. The present pilot study aimed to examine the everyday memory performance of people with MDD by means of an ecological assessment paradigm (EAP). Participants were unexpectedly called one week after their neuropsychological test assessment and asked about their memories of specific details of the former test situation. Associations of this EAP with SMT, subjective everyday memory problems, and symptom coping were exploratively analyzed. The study involved 22 MDD inpatients (M = 42.5 years, 64% female) and 22 comparable healthy control persons. MDD patients showed a significantly reduced performance in the EAP as well as in the SMT and they reported more memory problems in their daily lives. However, the EAP was not related to SMT results assessed a week before. Moreover, only the EAP was significantly associated with subjective daily memory problems and (distraction) coping style in the MDD group. The EAP appears to better reflect the everyday memory problems of persons with depression than standardized test procedures. However, the findings need to be validated by further research with larger samples.</p

Training in a comprehensive everyday-like virtual reality environment compared to computerized cognitive training for patients with depression

Dehn LB, Kater L, Piefke M, Botsch M, Driessen M, Beblo T. Training in a comprehensive everyday-like virtual reality environment compared to computerized cognitive training for patients with depression. Computers in Human Behavior. 2018;79:40-52

Cognitive training in an everyday-like virtual reality enhances visual-spatial memory capacities in stroke survivors with visual field defects

Dehn LB, Piefke M, Toepper M, et al. Cognitive training in an everyday-like virtual reality enhances visual-spatial memory capacities in stroke survivors with visual field defects. Topics in Stroke Rehabilitation. 2020:1-11