Trajectories of depression and anxiety symptom severity during psychological therapy for common mental health problems

BACKGROUND: There is substantial variation in patient symptoms following psychological therapy for depression and anxiety. However, reliance on endpoint outcomes ignores additional interindividual variation during therapy. Knowing a patient's likely symptom trajectories could guide clinical decisions. We aimed to identify latent classes of patients with similar symptom trajectories over the course of psychological therapy and explore associations between baseline variables and trajectory class. METHODS: Patients received high-intensity psychological treatment for common mental health problems at National Health Service Improving Access to Psychological Therapies services in South London (N = 16 258). To identify trajectories, we performed growth mixture modelling of depression and anxiety symptoms over 11 sessions. We then ran multinomial regressions to identify baseline variables associated with trajectory class membership. RESULTS: Trajectories of depression and anxiety symptoms were highly similar and best modelled by four classes. Three classes started with moderate-severe symptoms and showed (1) no change, (2) gradual improvement, and (3) fast improvement. A final class (4) showed initially mild symptoms and minimal improvement. Within the moderate-severe baseline symptom classes, patients in the two showing improvement as opposed to no change tended not to be prescribed psychotropic medication or report a disability and were in employment. Patients showing fast improvement additionally reported lower baseline functional impairment on average. CONCLUSIONS: Multiple trajectory classes of depression and anxiety symptoms were associated with baseline characteristics. Identifying the most likely trajectory for a patient at the start of treatment could inform decisions about the suitability and continuation of therapy, ultimately improving patient outcomes

Factors associated with anxiety disorder comorbidity

Background Anxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence. Methods Online, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data. Results Anxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found. Limitations Self-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered. Conclusions Anxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice

Patient characteristics associated with retrospectively self-reported treatment outcomes following psychological therapy for anxiety or depressive disorders - a cohort of GLAD study participants

Background: Progress towards stratified care for anxiety and depression will require the identification of new predictors. We collected data on retrospectively self-reported therapeutic outcomes in adults who received psychological therapy in the UK in the past ten years. We aimed to replicate factors associated with traditional treatment outcome measures from the literature. Methods: Participants were from the Genetic Links to Anxiety and Depression (GLAD) Study, a UK-based volunteer cohort study. We investigated associations between retrospectively self-reported outcomes following therapy, on a five-point scale (global rating of change; GRC) and a range of sociodemographic, clinical and therapy-related factors, using ordinal logistic regression models (n = 2890). Results: Four factors were associated with therapy outcomes (adjusted odds ratios, OR). One sociodemographic factor, having university-level education, was associated with favourable outcomes (OR = 1.37, 95%CI: 1.18, 1.59). Two clinical factors, greater number of reported episodes of illness (OR = 0.95, 95%CI: 0.92, 0.97) and higher levels of personality disorder symptoms (OR = 0.89, 95%CI: 0.87, 0.91), were associated with less favourable outcomes. Finally, reported regular use of additional therapeutic activities was associated with favourable outcomes (OR = 1.39, 95%CI: 1.19, 1.63). There were no statistically significant differences between fully adjusted multivariable and unadjusted univariable odds ratios. Conclusion: Therapy outcome data can be collected quickly and inexpensively using retrospectively self-reported measures in large observational cohorts. Retrospectively self-reported therapy outcomes were associated with four factors previously reported in the literature. Similar data collected in larger observational cohorts may enable detection of novel associations with therapy outcomes, to generate new hypotheses, which can be followed up in prospective studies

The Importance of Subjective Measurements in Child and Youth Well-Being Studies

Considering changing political landscapes and societies’ needs in Europe, we argue for establishing a European longitudinal study on child and youth well-being revealing new trends in a longterm perspective. As a part of an international research team, we worked on preparing this study, called EuroCohort. By doing so, we were concerned with choosing theoretical as well as measurement concepts to capture (child and youth) well-being in a way that is needed in order to shed light on Europe’s future generation. In this paper, we present our considerations on suitable theoretical approaches and their interrelation to measurement concepts. Thereby, our focus lies on the question how subjective measurement concepts can provide added value to child and youth well-being surveys. Although the relevance of subjective measures of well-being is recognised, so far hardly any comparative and longitudinal studies have incorporated corresponding indicators. This paper emphasises the need for implementing subjective measurements in studies on child and youth well-being, respecting their value for different well-being domains.2

Kultur der Ehre und Religion : gewaltakzeptierende Geschlechterrollenorientierungen muslimischer Jugendlicher

Anhand einer groß angelegten Schülerbefragung wird der Einfluss muslimischen Glaubens auf gewaltakzeptierende Geschlechterrollenorientierungen bei Jugendlichen untersucht. Im theoretischen Teil der Arbeit wird zunächst die Bedeutung einer religiösen Norm erörtert, die schriftlich kodifiziert ist: das Verbot von „Unzucht“ (zinā). Wir argumentieren auf Basis religionssoziologischer und anthropologischer Überlegungen, dass diese Norm zwar mit dem allgemeinen Ordnungsprinzip von Clans in nichtstaatlichen Gesellschaften zusammenhängt, nämlich der Kultur der Ehre. Infolge der Fixierung in den religiösen Schriften ist sie aber auch heute noch verhaltensrelevant. Empirisch wird auf Basis einer bundesweiten Schülerbefragung gezeigt, dass muslimische Religiosität auch nach Kontrolle zahlreicher einschlägiger Variablen einen robusten Effekt auf gewaltakzeptierende Geschlechterrollenorientierungen aufweist, der von den Indikatoren der „Kultur der Ehre“ unabhängig ist. Sodann wird für 52 Regionen die Segregation muslimischer Jugendlicher über Schulklassen hinweg berechnet und überprüft, ob gewaltfördernde Geschlechterrollenorientierungen umso schwächer ausgeprägt sind, je stärker muslimische Jugendliche potentiellen Kontakten mit Nichtmuslimen ausgesetzt sind

Análise comparativa entre perfis de ingressantes dos últimos três anos do Curso de Engenharia Agrícola da Universidade Federal de Pelotas.

Esse estudo tem como objetivo principal identificar o tipo de perfil do ingressante ao Curso de Engenharia Agrícola da UFPel nos últimos anos, que se matricularam nos primeiros semestres letivos de 2020, 2021 e 2022, e verificar que tipo de padrão pode existir