Search results for ‘Subject term:"mental health problems"’ Sort:
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Deployment-related stress and trauma in Dutch soldiers returning from Iraq: prospective study
- Authors:
- ENGLEHARD Iris M., et al
- Journal article citation:
- British Journal of Psychiatry, 191(8), August 2007, pp.140-145.
- Publisher:
- Cambridge University Press
Some questionnaire studies have shown increased mental health problems, including probable post-traumatic stress disorder (PTSD), in soldiers deployed to Iraq. The aim was to test prospectively whether such problems change over time and whether questionnaires provide accurate estimates of deployment-related PTSD compared with a clinical interview. Dutch infantry troops from three cohorts completed questionnaires before deployment to Iraq (n=479), and about 5 months (n=382, 80%) and 15 months (n=331, 69%) thereafter. Post-traumatic stress disorder was evaluated by questionnaire and clinical interview. There were no group changes for general distress symptoms. The rates of PTSD for each cohort were 21, 4 and 6% based on questionnaires at 5 months. The deployment-related rates of PTSD based on the clinical interview were 4, 3 and 3%. There was a specific effect of deployment on mental health for a small minority. Questionnaires eliciting stress symptoms gave substantial overestimations of the rate of PTSD.
Experiences of service users with a mild intellectual disability or borderline intellectual functioning with Flexible Assertive Community Treatment: a qualitative study
- Authors:
- NEIJMEIJER Laura, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 33(5), 2020, pp.1005-1015.
- Publisher:
- Wiley
Background: In the Netherlands, Flexible Assertive Community Treatment (FACT) teams have been established for people with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and mental health problems or challenging behaviour. Little is known yet about service users’ experiences with FACT. Method: An inductive grounded theory approach was used to explore how service users valued the treatment and their own functioning, and which factors were perceived as supportive. Semi‐structured interviews were held with 15 service users. Results: Most service users highly appreciated the contact with the staff and the practical and emotional support. Persistent involvement, availability and humanity, and respect for autonomy were distinguished as core values in the relationship with the staff. Most service users experienced improvement in time and attributed this to intrapersonal changes and/or less stress in life. Conclusions: From the perspective of service users with MID/BIF, FACT appears to have an added value. (Edited publisher abstract)
To preserve or not to preserve: That is the question. Decision-making about family preservation among families in multi-problem situations
- Authors:
- VISCHER Anne-Fleur W.K., et al
- Journal article citation:
- Children and Youth Services Review, 99, 2019, pp.441-450.
- Publisher:
- Elsevier
High rates of failed reunification indicate that family preservation (FP) does not necessarily lead to permanency for children. It could be argued that, in such failed cases, the decision-making process leading to the preservation of the family was inadequate. In order to gain insight into the role that decision-making plays in family preservation practice, the authors studied decision-making within an FP-intervention programme provided by the Expertise Center. The Expertise Center explicitly combines treatment and decision-making in an assessment-based intervention that is provided to families seeking either to be reunited with their young child (0–2) or to avoid an out-of-home placement of the child. In addition, at least one of the parents has psychiatric problems. The authors attempted to a) map decision-making trajectories in practice and b) provide feedback about Expertise Center decision-making based on evidence regarding the – sometimes evolving – quality of parental behaviour as observed in the participants. They used a descriptive design (n = 100) as well as a one-group repeated measures design (n = 28) to examine parental behaviour using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE). The authors hypothesized that a negative recommendation regarding family preservation would manifest itself in the display of more frequent and more severe atypical parental behaviour. The results indicate that the Expertise Center succeeded in contributing broadly to timely decision-making in the context of permanency planning, and that implementation of the Decision-making Continuum potentially improved the quality of clinical decision-making. Furthermore, the authors' hypothesis was confirmed by four out of five measurements of parental behaviour that have been proven to be significant for children's attachment security. Since these are promising results, the Expertise Center program could serve as an inspiration for the practice field. (Edited publisher abstract)
Quality of diagnosis and treatment plans after using the ‘diagnostic guideline for anxiety and challenging behaviours’ in people with intellectual disabilities: a comparative multiple case study design
- Authors:
- PRUIJSSERS Addy, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(4), 2016, pp.305-316.
- Publisher:
- Wiley
Background: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. Materials and Methods: A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. Results: The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Conclusions: Working with the ‘Diagnostic Guideline for Anxiety and CB’ leads to improved diagnoses and treatment plans compared with care as usual. (Publisher abstract)
Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial
- Authors:
- van’t VEER-TAZELAAR Petronella, et al
- Journal article citation:
- British Journal of Psychiatry, 196(4), April 2010, pp.319-325.
- Publisher:
- Cambridge University Press
An urgent need exists for the development of cost-effective preventive strategies to reduce the onset of mental disorders. This paper, aiming to establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with standard primary care, evaluated the financial implications of stepped care preventive intervention in comparison to a randomised controlled trial. One hundred and seventy consenting individuals, aged 75 years or greater, with sub-threshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme or to routine primary care. Results showed that the intervention was successful in halving the incidence rate of depression and anxiety at 563 Euros (£412) per patient and 4367 Euros (£3196) per disorder-free year gained, compared with routine primary care, the latter representing good value for money if there is a willingness to pay for a disorder-free year at levels of at least 5000 Euros. In conclusion, the prevention programme generated depression and anxiety-free survival years in the older population at affordable cost.
From a ‘state mental Hospital' to new homes in the city: longitudinal research into the use of intramural facilities by long-stay care-dependent psychiatric clients in Amsterdam
- Authors:
- DUURKOOP Pim, VAN DYCK Richard
- Journal article citation:
- Community Mental Health Journal, 39(1), February 2003, pp.77-92.
- Publisher:
- Springer
In 1986, the traditional psychiatric hospital where 70% of Amsterdam's intramural treatment took place, was closed down. The progress of two groups of long-stay patients was followed for five years after their transferral to new small-scale facilities in Amsterdam. The ADL (activities of daily living) functioning of the most severely impaired clients improved and their psychiatric symptoms decreased, while no improvement was seen in the functioning of the more independent clients. This evaluation makes clear that the improvement of the severely disabled patients depends on the intensity of care given. The improvement in the new facilities is no guarantee for a further development into a less care-intensive environment. The more independent clients, however, could more easily be transferred to less care-intensive facilities.