30 research outputs found

    Can a One-Item Mood Scale Do the Trick? Predicting Relapse over 5.5-Years in Recurrent Depression

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    To examine whether a simple Visual Analogue Mood Scale (VAMS) is able to predict time to relapse over 5.5-years.187 remitted recurrently depressed out-patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the 17-item Hamilton Depression rating scale (HAM-D) to verify remission status (HAM-D <10). All patients rated their current mood with the help of a Visual Analogue Mood Scale (VAMS) at baseline and at a follow-up assessment three months later. Relapse over 5.5-years was assessed by the SCID-I. Cox regression revealed that both the VAMS at baseline and three months later significantly predicted time to relapse over 5.5-years. Baseline VAMS even predicted time to relapse when the number of previous depressive episodes and HAM-D scores were controlled for. The baseline VAMS explained 6.3% of variance in time to relapse, comparable to the HAM-D interview.Sad mood after remission appears to play a pivotal role in the course of depression. Since a simple VAMS predicted time to relapse, the VAMS might be an easy and time-effective way to monitor mood and risk of early relapse, and offers possibilities for daily monitoring using e-mail and SMS.International Standard Randomized Controlled Trial Register Identifier: ISRCTN68246470

    Садово-парковые ансамбли как часть культурного ландшафта крымского Южнобережья

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    Целью данной статьи является определение места и значения садово-парковых ансамблей в культурном ландшафте ЮБК. Основными задачами для ее достижения являются: рассмотреть и выделить территорию Южного Берега Крыма в рамках «культурного ландшафта»; исследовать и проанализировать роль садово-парковых ансамблей в формировании современного культурного ландшафта Южнобережья

    Полиция Таврической губернии на спаде революции (1906-1907 гг.)

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    Настоящая проблема до сего дня не стала предметом исторических исследований, а наша работа является лишь первым прикосновением к ней. Новизна статьи заключается в задействовании новых исторических источников. Изучение опыта прошлого века по сохранению в крае политической стабильности и гражданского спокойствия бесспорно актуально и вызывает живой интерес

    A cognitive remediation training for young adults with psychotic disorders to support their participation in education - study protocol for a pilot randomized controlled trial

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    Background: Most severe mental disorders have their onset between the age of 17 and 27, a time when many young adults begin participating in secondary or post-secondary education. The cognitive deficits typically associated with psychiatric disorders, especially psychotic disorders, increase the risk of leaving school early, which can lead to a reduction in employment opportunities later on in life and, in turn, a poorer long-term prognosis. Therefore, specific interventions aiming to improve these cognitive functions are needed. Cognitive remediation (CR) aims to improve cognitive functioning and may increase real-world functioning in educational performance. This study aims to examine the feasibility and applicability of a CR training named Mindset for students with psychotic disorders in the Netherlands. Methods/design: Sixty students diagnosed with a psychotic disorder and currently reporting cognitive deficits will be included from four Dutch Mental Health Care institutes. Half of the participants (N = 30) will be randomly assigned to the CR training consisting of twelve, individual, weekly 1-h meetings. The other half will be assigned to an active control condition consisting of twelve weekly assignments that will be sent by email aiming to improve school performance. Students will be evaluated at baseline (T0), directly after finishing the CR training or control intervention (T1), and 6 months later (T2). Treatment feasibility will be the primary outcome, using evaluation forms, interviews with trainers and participants, number of study drop outs, and patient eligibility and recruitment rates. School functioning, cognitive functioning, and strategy use will also be assessed to get a preliminary idea of the potential effectiveness of the intervention. Discussion: The CR training in this study will provide real-world examples and exercises aimed to teach useful strategies to cope with the cognitive deficits experienced by students with psychotic disorders. Furthermore, since students with other psychiatric disorders might also experience cognitive deficits, the results of this study may also provide some further implications for future studies on the effect of this CR training for students with these disorders. Trial registration: The study was registered with Trialregister.nl, no. NL6590 (NTR6764), date registered: September 7, 2017. Register name: Mindset. A cognitive rehabilitation training for young adults with psychotic spectrum disorder in an educational setting: A pilot study.Protocol version: 3, date December 23, 2019

    Селянська реформа 1861 р. в контексті протиріч національних інтересів в Правобережній Україні

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    В статті розглядається взаємозалежний вплив реформи 1861 р. та процесів, що відбувалися в житті російської громадськості за умов лібералізму в політиці Олександра ІІ. Зокрема, конфронтація польсько-російсько-українських національних інтересів в Правобережній Україні.В статье рассматривается взаимозависимое влияние реформы 1861 г. и процессов, происходящих в жизни российской общественности в условиях либерализма в политике Александра II. В частности, конфронтация польско-российско-украинских национальных интересов в Правобережной Украине.The article considers the interdependent influence of the reform of 1861 and the processes, which occurred in the life of the Russian society in the conditions of liberalism in Alexander’s II policy. In particular, the confrontation of Polish-Russian-Ukrainian national interests in the Right-bank Ukraine is observed

    Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

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    Background: Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.Methods/design: Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.Discussion: This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.Trial registration: Netherlands Trial Register (NTR): NTR1907

    Depression vulnerability: is it really what you think?: understanding the impact of emotion and cognition on the course of depression

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    Depression is a recurrent disorder. Given the high risk of relapse it is important to study how patients relapse in depression. This thesis, which focused on recurrent depression specifically, showed that it is not so much mood activated dysfunctional thinking patterns that predict relapse in depression, but rather mood itself. Moreover, Preventive Cognitive Therapy, an effective treatment to prevent relapse in depression, did not appear to work through reduction of activation of mood-linked thinking patterns. However, we have to keep the restrictions of our statistical analysis in mind. Currently we still do not know how preventive interventions exert their effects. Having remitted patients rate their own mood by marking a cross on a 10-centimeter line was able to predict relapse in depression over 5.5 years, with patients scoring higher being more vulnerable for relapse. This ‘emotion meter’ was also able to predict current depression status quite accurately, although it somewhat overestimated the number of patients truly having a current depression (false positives). It appeared to be the case that remitted patients who had a higher number of previous depressive episodes had higher levels of sad mood after remission. Possible, an ‘emotional scar’ is formed in terms of sad mood that remains after exposure to more previous depressive episodes. With our design we can however not exclude an alternative explanation, being that high levels of sadness prior to first-episode onset exposed these patients to higher risk of developing recurrent depression to begin with. This should be examined more closely. Finally, daily hassles also predicted depressive symptomatology later in time. Having a comorbid personality disorder was also related to characteristics that we know make patients vulnerable to relapse in depression

    Communicating diagnoses to individuals with a first episode psychosis:A qualitative study of individuals perspectives

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    Background: Receiving the label of a psychotic disorder influences self-perception and may result in negative outcomes such as self-stigma and decreased self-esteem. The way the diagnosis is communicated to individuals may affect these outcomes. Aims: This study aims to explore the experiences and needs of individuals after a first episode of psychosis with regard to the way in which information about diagnosis, treatment options and prognosis is communicated with them. Design and methods: A descriptive interpretative phenomenological approach was used. Fifteen individuals who experienced a first episode of psychosis participated in individual semi-structured open-ended interviews on their experiences and needs regarding the process of providing information about diagnosis, treatment options and prognosis. Inductive thematic analysis was used to analyze the interviews. Results: Four recurring themes where identified (1) timing (when); (2) content (what); and (3) the way information is provided (how). Individuals also reported that the provided information could elicit an emotional reaction, for which they would require specific attention, therefore the fourth theme is (4) reactions and feelings. Conclusion: This study provides new insights into the experiences and specific information needed by individuals with a first episode of psychosis. Results suggest that individuals have different needs regarding the type of (what), how and when to receive information about diagnosis and treatment options. This requires a tailor-made process of communicating diagnosis. A guideline on when, how and what to inform, as well as providing personalized written information regarding the diagnosis and treatment options, is recommended.</p

    Communicating diagnoses to individuals with a first episode psychosis:A qualitative study of individuals perspectives

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    Background: Receiving the label of a psychotic disorder influences self-perception and may result in negative outcomes such as self-stigma and decreased self-esteem. The way the diagnosis is communicated to individuals may affect these outcomes. Aims: This study aims to explore the experiences and needs of individuals after a first episode of psychosis with regard to the way in which information about diagnosis, treatment options and prognosis is communicated with them. Design and methods: A descriptive interpretative phenomenological approach was used. Fifteen individuals who experienced a first episode of psychosis participated in individual semi-structured open-ended interviews on their experiences and needs regarding the process of providing information about diagnosis, treatment options and prognosis. Inductive thematic analysis was used to analyze the interviews. Results: Four recurring themes where identified (1) timing (when); (2) content (what); and (3) the way information is provided (how). Individuals also reported that the provided information could elicit an emotional reaction, for which they would require specific attention, therefore the fourth theme is (4) reactions and feelings. Conclusion: This study provides new insights into the experiences and specific information needed by individuals with a first episode of psychosis. Results suggest that individuals have different needs regarding the type of (what), how and when to receive information about diagnosis and treatment options. This requires a tailor-made process of communicating diagnosis. A guideline on when, how and what to inform, as well as providing personalized written information regarding the diagnosis and treatment options, is recommended.</p
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