TY - JOUR A1 - Ladwig, Simon A1 - Zhou, Zien A1 - Xu, Ying A1 - Wang, Xia A1 - Chow, Clara K. A1 - Werheid, Katja A1 - Hackett, Maree L. T1 - Comparison of treatment rates of depression after stroke versus myocardial infarction BT - a systematic review and meta-analysis of observational data JF - Psychosomatic medicine N2 - Objective Depression after stroke and myocardial infarction (MI) is common but often assumed to be undertreated without reliable evidence being available. Thus, we aimed to determine treatment rates and investigate the application of guidelines in these conditions. Methods Databases MEDLINE, EMBASE, PsycInfo, Web of Science, CINAHL, and Scopus were systematically searched without language restriction from inception to June 30, 2017. Prospective observational studies with consecutive recruitment reporting any antidepressant treatment in adults with depression after stroke or MI were included. Random-effects models were used to calculate pooled estimates of treatment rates. Results Fifty-five studies reported 32 stroke cohorts (n = 8938; pooled frequency of depression = 34%, 95% confidence interval [CI] = 29%-38%) and 17 MI cohorts (n = 10,767; pooled frequency of depression = 24%, 95% CI = 20%-28%). In 29 stroke cohorts, 24% (95% CI = 20%-27%) of 2280 depressed people used antidepressant medication. In 15 MI cohorts, 14% (95% CI = 8%-19%) of 2381 depressed people used antidepressant medication indicating a lower treatment rate than in stroke. Two studies reported use of psychosocial interventions, indicating that less than 10% of participants were treated. Conclusions Despite the high frequency of depression after stroke and MI and the existence of efficacious treatment strategies, people often remain untreated. Innovative strategies are needed to increase the use of effective antidepressive interventions in patients with cardiovascular disease. KW - depression KW - myocardial infarction KW - pharmacoepidemiology KW - stroke KW - treatment Y1 - 2018 U6 - https://doi.org/10.1097/PSY.0000000000000632 SN - 0033-3174 SN - 1534-7796 VL - 80 IS - 8 SP - 754 EP - 763 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Kangas, Maria A1 - Heissel, Andreas T1 - Mental health literacy, treatment preferences and the lived experience of mental health problems in an Australian cancer sample JF - Psycho-oncology N2 - Objectives: The prevalence rates for mental health (MH) problems in cancer patients is high, although reduced uptake of services may be influenced by mental health literacy (MHL). The objective of this study was to investigate the MHL for depression and panic disorder (PD), including treatment preferences in Australian adults who had been diagnosed and treated for cancer, and whether MHL and treatment preferences was influenced by sex, age, and individuals' lived MH experience. Method: A total of 421 cancer survivors (n = 378 females) completed a self-report survey. Participants were asked to specify whether they had a lived experience with anxiety and/or depression, and to indicate treatment preferences for managing cancer-related distress. Two vignettes were administered to assess MHL for depression and PD. Results: The MHL accuracy for depression was higher than PD. Accuracy rates were higher for females with a lived experience with anxiety and/or depression; although the accuracy rate for PD was significantly lower in males. A high proportion of individuals preferred exercise and in-person counselling to manage depression and PD. Internet-based therapies were not strongly preferred for managing MH problems. Conclusions: The MHL for depression and PD is moderate for adult cancer survivors, with higher levels indicated for individuals with a personal lived experience with anxiety and/or depression. Public health campaigns for enhancing MHL should broaden to include individuals experiencing comorbid physical health conditions. Health providers also need to take into account client preferences for evidence-based therapies. KW - anxiety KW - cancer KW - exercise KW - major depression KW - mental health KW - preferences KW - psycho-oncology KW - treatment Y1 - 2020 U6 - https://doi.org/10.1002/pon.5520 SN - 1057-9249 SN - 1099-1611 VL - 29 IS - 11 SP - 1883 EP - 1894 PB - Wiley CY - New York, NY ER - TY - THES A1 - Pietrek, Anou F. T1 - Basic psychological needs and depression in the context of health and exercise N2 - Depressive Erkrankungen gehen mit verminderter Lebenszufriedenheit und reduzierter Arbeitsfähigkeit einher. Die Wartezeit für eine Psychotherapie beträgt in Deutschland derzeit zwischen drei und sechs Monaten. Demnach besteht Bedarf an alternativen, gleichwertigen evidenzbasierten Behandlungsmöglichkeiten, die den Betroffenen niedrigschwellig zugänglich gemacht werden. Eine Vielzahl an empirischen Studien belegt die Wirksamkeit von Sport bei leichten und mittelschweren Depressionen. Zur weiterführenden Konzeption und Qualitätssicherung von Sport als Behandlungsoption ist es notwendig die konkreten Wirkmechanismen zu verstehen. Neben physiologischen spielen auch psychologische Faktoren eine Rolle im Wirkungsgeschehen. Als Metatheorie menschlichen Erlebens und Verhaltens bietet die Selbstbestimmungstheorie (engl.: Self-Determination Theory; SDT) einen nützlichen Bezugsrahmen zum Verständnis psychologischer Wirkmechanismen mit konkreten Ableitungen für die Behandlungspraktik. Die konzeptionelle Erweiterung der SDT um die Frustration psychologischer Grundbedürfnisse erweist sich neben der Bedürfnisbefriedigung zunehmend als hilfreich bei der Untersuchung von psychischen Erkrankungen. Der erste Teil dieser Dissertation besteht aus zwei Publikationen, die relevante Messinstrumente in dem genannten Kontext validieren. Der erste Fragebogen misst das Ausmaß an allgemein erlebter Befriedigung und Frustration der psychologischen Grundbedürfnisse nach Autonomie, Kompetenz und sozialer Eingebundenheit. Der zweite Fragebogen erhebt die erlebte Bedürfnisbefriedigung durch die anleitende Person (hier: Sporttherapeut*in). Der zweite Teil der Dissertation umfasst zwei Publikationen, welche die Befriedigung und Frustration der psychologischen Grundbedürfnisse bei depressiven Symptomen untersuchen und einordnen. Es werden die Unterschiede im Ausmaß an Bedürfnisbefriedigung und Bedürfnisfrustration zwischen einer Stichprobe mit Depression mit einer Stichprobe ohne depressive Symptome untersucht. Der Zusammenhang zwischen Bedürfnisfrustration und depressiven Symptomen wird im Kontext etablierter pathologischer Prozesse (Emotionsdysregulation, Rumination) eingeordnet. Die Hauptergebnisse dieser Arbeiten zeigen, dass die SDT durch die Erweiterung der Basic Psychological Needs Theory um die Dimension der Bedürfnisfrustration ein nun breiteres Spektrum auf dem Gesundheit-Krankheit-Kontinuum abbildet. Dabei fokussiert die SDT auf die psychologische Wirkung von sozialen Umwelten. Neben der Nichterfüllung der psychologischen Grundbedürfnisse ist es vor allem die Bedürfnisfrustration, die einen allgemeinen Vulnerabilitätsfaktor für das Vorkommen psychologischer Erkrankungen darstellt. Zudem weist die unausgewogene Befriedigung der psychologischen Grundbedürfnisse möglicherweise auf ein konflikthaftes Erleben zwischen den Bedürfnissen hin. Für die Behandlungspraktik abzuleiten ist, dass eine autonomieunterstützende Atmosphäre, die die ausgewogene Befriedigung aller drei Bedürfnisse ermöglicht, zentral für den Behandlungserfolg ist. N2 - Depressive disorders are associated with reduced life satisfaction and ability to work. The waiting time for psychotherapy in Germany is currently between three and six months. Accordingly, there is a need for alternative, evidence-based treatment options that are made accessible to patients at a low threshold. A large number of empirical studies prove the effectiveness of exercise in mild and moderate depression. For further conceptualization and quality assurance of exercise as a treatment option, it is necessary to understand the concrete mechanisms of action. In addition to physiological factors, psychological factors also play a role in the effect. As a meta-theory of human experience and behavior, Self-Determination Theory (SDT) provides a useful frame for understanding psychological mechanisms of action with concrete implications for treatment practice. The conceptual extension of SDT to include the frustration of basic psychological needs in addition to need satisfaction is proving useful in the study of mental illness. The first part of this dissertation consists of two publications that validate relevant measurement instruments in this context. The first questionnaire measures the extent of generally experienced satisfaction and frustration of the basic psychological needs for autonomy, competence, and relatedness. The second questionnaire measures the experienced satisfaction of needs by the instructor (here: exercise therapist). The second part of the dissertation includes two publications that examine and classify the satisfaction and frustration of basic psychological needs in depressive symptoms. Differences in the extent of need satisfaction and need frustration between a sample with depression and a sample without depressive symptoms are examined. Further, the relationship between need frustration and depressive symptoms is placed in the context of established pathological processes (emotional dysregulation, rumination). The main findings of this work show that by adding the dimension of need frustration to Basic Psychological Needs Theory, SDT now covers a broader spectrum on the health-disease continuum. In doing so, SDT focuses on the psychological impact of social environments. In addition to the nonfulfillment of basic psychological needs, it is primarily experienced need frustration that is a general vulnerability factor for the occurrence of psychological illness. Moreover, the unbalanced satisfaction of basic psychological needs possibly indicates a conflicting experience between the needs. For the treatment practice it can be deduced that an autonomy-supporting atmosphere, which enables the balanced satisfaction of all three needs, is central for the treatment success. T2 - Psychologische Grundbedürfnisse und Depression im Kontext von Gesundheit und Sport KW - basic psychological needs KW - depression KW - exercise KW - autonomy support KW - treatment KW - psychologische Grundbedürfnisse KW - Depression KW - Sport KW - Autonomieunterstützung KW - Behandlung Y1 - 2023 ER -