Approaches to Understanding and Addressing Treatment-Resistant Depression: A Scoping Review

Treatment-resistant depression is associated with significant disability and, due to its high prevalence, results in substantive economic and societal burden at a population level. The objective of this study is to synthesize extant literature on approaches currently being applied to understand and address this condition. It is hoped that the findings can be used to inform practitioners and guide future research. A scoping review of the scientific literature was conducted with findings categorized and charted by underlying research paradigm. Currently, the vast majority of research stems from a biological paradigm (81%). Research on treatment-resistant depression would benefit from a broadened field of study. Given that multiple etiological mechanisms likely contribute to treatment-resistant depression and current efforts at prevention and treatment have substantial room for improvement, an expanded research agenda could more effectively address this significant public health issue

Quality Indicators for International Benchmarking of Mental Health Care

Objective. To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data. Design. An international expert panel employed a consensus development process to select important, sound, and feasible measures based on a framework that balances these priorities with the additional goal of assessing the breadth of mental health care across key dimensions. Participants. Six countries and one international organization nominated seven panelists consisting of mental health administrators, clinicians, and services researchers with expertise in quality of care, epidemiology, public health, and public policy. Measures. Measures with a final median score of at least 7.0 for both importance and soundness, and data availability rated as ‘possible’ or better in at least half of participating countries, were included in the final set. Measures with median scores ≤3.0 or data availability rated as ‘unlikely’ were excluded. Measures with intermediate scores were subject to further discussion by the panel, leading to their adoption or rejection on a case-by-case basis. Results. From an initial set of 134 candidate measures, the panel identified 12 measures that achieved moderate to high scores on desired attributes. Conclusions. Although limited, the proposed measure set provides a starting point for international benchmarking of mental health care. It addresses known quality problems and achieves some breadth across diverse dimensions of mental health care

Positive Coping with Health Conditions

Positive Coping with Health Conditions, A Self-Care Workbook (Dan Bilsker, PhD, RPsych, Joti Samra, PhD, RPsych, Elliot Goldner, MD, FRC(P), MHSc) is a self-care manual authored by scientist-practitioners with expertise in issues relating to coping with health conditions.  This manual is designed for individuals who deal with health conditions, including patients, physicians, psychologists, nurses, rehabilitation professionals and researchers

Health Service Patterns Indicate Potential Benefit of Supported Self-Management for Depression in Primary Care

Objective: To examine health service delivery in a Canadian province (British Columbia) toconsider how Canadian health care services might be developed to best address the large numberof individuals with mildly to moderately severe depressive illnesses.Method: We used provincial administrative data to describe patterns of medical servicesprovided to individuals suffering from depression during 3 different time periods (1991–1992,1995–1996, and 2000–2001) and to determine the frequency with which depression patientsreceive treatment from primary care physicians and psychiatrists. We then used these findings toconsider the feasibility and potential applicability of the various approaches that have beendescribed to decrease the burden of disease related to depression.Results: In the fiscal year 1991–1992, the “treated prevalence” rate was 7.7%; in 1995–1996, itwas 8.7%; and in 2000–2001, it was 9.5%. In each cohort over the 10-year period, theproportion of individuals who received a diagnosis of depression and who were then treated byprimary care physicians alone (no psychiatric services were provided) remained constant at 92%.Conclusions: Supported self-management is identified as a promising intervention that could beintegrated into primary health care within the context of the Canadian health care system. Itconstitutes a feasible and practical approach to enhance the role of family physicians in thedelivery of services to individuals with milder forms of depression and promotes the activeengagement of individuals in their recovery and in prevention of future episodes

Poster Introductions III--Antipsychotic Utilization in British Columbia from 1997 to 2006

This study examined the prevalent use of antipsychotic medication in British Columbia from 1997 to 2006 among individuals aged 20 and above. Utilization data were obtained from BC’s PharmaNet system – a provincially maintained database that contains prescription dispensation records and demographic information for individuals residing in BC. Using the American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification, claim records for Antipsychotics, Atypical Antipsychotics, Butyrophenones, Phenotiazines, Thioxanthenes, and Miscellaneous Antipsychotics were identified in the PharmaNet dataset. Individuals who filled at least 1 antipsychotic prescription in a given year were counted as prevalent users. Results were examined across gender and several age groupings. Preliminary analyses of the results provide evidence for increasing prevalent use from 1997 to 2006. Similarly, initial results suggest prevalent use increases with age, with older age groups (75 and above) exhibiting dramatic jumps in utilization. Results will be discussed in light of the various indications for the use of antipsychotic medications and the various health concerns associated with its prolonged use, particularly among the elderly. Joseph H. Puyat is an MSc student in the School of Population and Public Health (SPPH), Faculty of Medicine, University of British Columbia. He was a project manager and researcher at the Center for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University where he worked on various projects including the analysis of the BC provincial prescription database to examine the pharmacoepidemiology of psychotropic drugs, and, the development of supported self-management strategies for the treatment of mood disorders. Before joining CARMHA, he conducted studies on aggression and violence among students groups and wrote research reports examining social psychological processes shaping the Filipino youth\u27s self-concept

Selection of Depression Measures for Use among Vietnamese Populations in Primary Care Settings: A Scoping Review

Depression is an important and growing contributor to the burden of disease around the world and evidence suggests the experience of depression varies cross-culturally. Efforts to improve the integration of services for depression in primary care are increasing globally, meaning that culturally valid measures that are acceptable for use in primary care settings are needed. We conducted a scoping review of 27 studies that validated or used 10 measures of depression in Vietnamese populations. We reviewed the validity of the instruments as reported in the studies and qualitatively assessed cultural validity and acceptability for use in primary care. We found much variation in the methods used to validate the measures, with an emphasis on criterion validity and reliability. Enhanced evaluation of content and construct validity is needed to ensure validity within diverse cultural contexts such as Vietnam. For effective use in primary care, measures must be further evaluated for their brevity and ease of use. To identify appropriate measures for use in primary care in diverse populations, assessment must balance standard validity testing with enhanced testing for appropriateness in terms of culture, language, and gender and for acceptability for use in primary care

Electroconvulsive Therapy - Guidelines for Health Authorities in British Columbia

The purpose of these guidelines for electroconvulsive therapy (ECT Guidelines) is to standardize the delivery of electroconvulsive therapy services across British Columbia. There will be differences in the way care is delivered according to local resources, but good basic care must be available wherever ECT is provided. These guidelines cover patient and family education, clinical applications of ECT by physicians, nurses, and anesthetists, as well as suggestions for charting, professional education, and quality assurance programs. Disclaimer: This document appears here with permission from the UBC Department of Psychiatry and the BC Ministry of Health. The material is only current to the date of initial publication. New, more accurate, information may be available. For completeness, please investigate the most recent details on this topic

Approaches to Understanding and Addressing Treatment-Resistant Depression: A Scoping Review

Treatment-resistant depression is associated with significant disability and, due to its high prevalence, results in substantive economic and societal burden at a population level. The objective of this study is to synthesize extant literature on approaches currently being applied to understand and address this condition. It is hoped that the findings can be used to inform practitioners and guide future research. A scoping review of the scientific literature was conducted with findings categorized and charted by underlying research paradigm. Currently, the vast majority of research stems from a biological paradigm (81%). Research on treatment-resistant depression would benefit from a broadened field of study. Given that multiple etiological mechanisms likely contribute to treatment-resistant depression and current efforts at prevention and treatment have substantial room for improvement, an expanded research agenda could more effectively address this significant public health issue

Relaxation Method Audio

Listen to the the Relaxation Method Audio - a three part exercise in releasing tension and relaxation. 18mi