WHO-5 Well-being Scale Research Articles

Association of type 2 diabetes with family history of diabetes, diabetes biomarkers, mental and physical disorders in a Kenyan setting

This study aimed to determine the degree of family relations and associated socio-demographics characteristics, clinical/physical and mental disorders in type 2 diabetes mellitus in a Kenyan diabetes clinic. This study was part of a large multicentre study whose protocol and results had been published. It took place at the outpatient diabetes clinic at a County Teaching and Referral Hospital in South East Kenya involving 182 participants. We used a socio-demographic questionnaire, the Hamilton Depression (HAM-D) and PHQ-9 rating scales for depression, the MINI International Neuropsychiatric Interview (MINI; V5 or V6) for DSM-5 diagnoses, the WHO-5 Well-being scale and Problem Areas in Diabetes Scale (PAID). We extracted from the notes all physical conditions. We enquired about similar conditions in 1st and 2nd degree relatives. Descriptive, Chi-square test, Fisher’s exact test, one way ANOVA, and Multinomial logistic regression analysis were conducted to test achievements of our specific aims. Of the 182 patients who participated in the study, 45.1% (82/182) reported a family history of diabetes. Conditions significantly (p < 0.05) associated with a degree of family history of diabetes were retinopathy, duration of diabetes (years), hypertension, and depressive disorder. On average 11.5% (21/182) scored severe depression (≥ 10) on PHQ-9 and 85.2% (115/182) scored good well-being (≥ 13 points). All DSM-5 psychiatric conditions were found in the 182 patients in varying prevalence regardless of relations. In addition, amongst the 182 patients, the highest prevalence was poor well-being on the WHO quality of life tool. This was followed by post-traumatic disorders (current), suicidality, and psychotic lifetime on DSM-5. The least prevalent on DSM-5 was eating disorders. Some type 2 diabetes mellitus physical disorders and depression have increased incidence in closely related patients. Overall, for all the patients, the prevalence of all DSM-5 diagnoses varied from 0.5 to 9.9%.

Quality of life and well-being of dermatology patients: Influence of associated anxiety and depression in relation to satisfaction of care

ABSTRACT Background: Many patients attending dermatology clinics have mental health problems which may affect their well-being. Aims: It was intended to study the influence of anxiety and depression on well-being and quality of life (QOL) in relation to satisfaction of dermatological care in an out-patient setting. Materials and Methods: In a cross-sectional study, dermatological patients were assessed for well-being (WHO-5 Well-Being scale), overall QOL, anxiety (General Anxiety Disorder, GAD-7), and depression (Patient health questionnaire, PHQ-9). Satisfaction of care in the dermatology clinic (1: not at all satisfied to 10: very satisfied) and the likelihood of recommending it (1: not at all likely to 10: very likely) were assessed on a 1 to 10 scale. Demographic and clinical variables were also collected. Results: The sample (n = 150) covered a range of dermatological diagnoses including allergy/eczema (53.3%), inflammatory/infective diseases (19.3%), sexually transmitted diseases (10.0%), psycho-somatic diseases (9.3%), and auto-immune diseases (7.3%). A clinically relevant level (moderate degree or above) of depression (12.7%) and anxiety (8.0%) was present in considerable proportions of patients, suggesting that overall 18.7% of patients had anxiety, depression, or both. The satisfaction and recommendation scores were at an appreciable level; however, they did not influence the anxiety and depression scores. Anxiety and depression were negatively correlated with well-being and overall QOL. Conclusion: Anxiety and depression present in a considerable proportion of dermatological patients significantly impaired their well-being and QOL despite high satisfaction and likelihood of recommendation of care in the dermatology clinic. Identifying and supporting psychiatric problems of dermatological patients are needed.

Child Sexual Abuse and Wellbeing Among LGBTQ + Individuals: The Role of Family in Healing

The present study was undertaken to understand the prevalence of child sexual abuse and its association with the wellbeing of a sample of LGBTQ + individuals in India. A total of 206 respondents took part in the study. The WHO-5 wellbeing scale developed by the World Health Organization was used to assess the wellbeing of the respondents. The prevalence of child sexual abuse among the respondents was high (46.1 per cent). In general, the level of wellbeing of the respondents was found to be below average. Among those who had experienced child sexual abuse, the majority of the respondents were cisgender women. Cisgender women respondents were also more likely to have a much lower mean rank of wellbeing compared to the other groups and similarly, respondents who identified as lesbians were also found to have a lower level of wellbeing compared to respondents who identified themselves as bisexual, pansexual, and gay. Other associated factors have been discussed in the full paper. The role of family in supporting and helping the individuals heal, has also been discussed in detail. There is a need for families to be more empathetic toward the victims.

Are TNF-α and IL-1β Independently Associated with Depression in Axial Spondyloarthritis Patients? A Case-Control Study

Objectives: The aim of this study was to investigate whether serum TNF-α and IL-1β levels are independent risk factors for depression in axSpA patients. Methods: All axSpA patients with BASDAI ≥4 were invited consecutively between March 2021 and August 2021 to participate. Depression was evaluated with the WHO-5 Well-Being scale. Disease activity was assessed using BASDAI (0–10), ASDAS-CRP (0.61–7.22), ASDAS-ESR (0.29–7.61), and health status by ASAS-HI (0–17). Serum TNF-α and IL-1β levels were measured by ELISA. An association between depression and cytokine levels was investigated with Spearman’s rank correlation coefficient test. Results: A total of 252 axSpA patients (155 men) could be included; of these, 123 (48.81%) were depressed, and of these, 75 were male. Serum TNF-α and IL-1β were not significantly associated with depression (r −0.041 and 0.110, respectively). Serum TNF-α levels were higher in depressed female axSpA patients (20.05 vs. 17.87; p = 0.03). Differences between depressed and non-depressed patients were respectively: TNF-α (19.7 vs.18.0; p= 0.84), IL-1β (32.3 vs. 21.2; p= 0.04), BASDAI (5.47 vs. 4.77; p = 0.000), ASDAS-CRP (4.17 vs. 3.78; p = 0.000), ASDAS-ESR (3.86 vs. 3.39; p = 0.000), CRP (48.43 vs. 37.93 mg/L; p = 0.000), and ASAS-HI (13.37 vs. 10.24; p = 0.000). Factors associated with depression were: peripheral joint involvement (OR = 1.073, 95% CI 1.012–1.138), BASDAI (OR = 1.534, 95% CI 1.011–2.335), and ASAS-HI (OR = 1.39, 95% CI 1.239–1.557). Only in depressed patients with peripheral SPA were higher IL-1β levels found, though the differences were probably not clinically relevant. Conclusions: Serum TNF-α and IL-1β were not independently related to depression in axSpA patients. Disease activity, peripheral joint involvement, and reduced health status showed the highest association with depression.

Validity of the Capacity to Work Index: Development of an Instrument to Measure Work Capacity in Relation to Depression and Anxiety in the General Working Population

PurposeTo develop an index to assess capacity to work in relation to common mental disorders (CMDs) in the general working population and field test its psychometric properties.MethodsContent analysis of three qualitative studies on people (n = 49) with their own experiences of working with CMD guided the items selected for the index. Face and content validity and test-retest reliability were performed. The index was field tested in two versions with 26 and 17 items, respectively, among health care professionals regarding internal reliability, component structure and concurrent validity.ResultsThe final version of the Capacity to Work Index (C2WI; 17 items) was normally distributed in the field test with high internal reliability (Cronbach’s alpha, 0.84). Missing responses were randomly distributed and nonspecific. Principal component analysis showed one clear component with negatively framed items. Concurrent validity showed high correlation with the WHO-5 Well-Being Scale (Pearson’s r, 0.68), but lower correlation for the general health question (r, − 0.44), one item of the Work Ability Index (r, − 0.33), and the Stress of Conscience constructs (r, 0.44).ConclusionThe C2WI showed promising psychometric qualities. Low and negative correlation with the item from Work Ability Index suggests that the C2WI measures additional dimensions, but further testing in larger and more diverse samples is required.

Roles of the interaction with children and families in mediating the association between digital health literacy and well-being of early childhood teachers in Portugal: A cross-sectional study.

To analyze the associations between early childhood education (ECE) teachers´ digital health literacy (DHL) and well-being, and to determine whether the ECE teachers´ interaction with children and family mediated these associations. A total of 853 early childhood teachers, predominantly women (99.4%) participated in this cross-sectional study. The participants had a mean age of 39.9 years (standard deviation SD = 8.2). Data was collected through an online survey. DHL was assessed using five subscales adapted to the new coronavirus context, and the professionals´ well-being was measured using the WHO-5 well-being scale. Binary logistic regression and mediation analysis were used to analyze the data. ECE teachers' DHL in dimensions of "information searching" and "determining relevance" had both direct and indirect effect on their well-being. Specifically, higher DHL in these dimensions was associated with better well-being. The dimension "evaluating reliability" had an indirect positive effect on well-being by promoting interaction with children. These findings suggest that improving ECE teachers´ DHL could have a positive effect on their well-being and their interactions with children. Therefore, it is recommended to develop health promotion practices aimed at enhancing DHL among ECE teachers. Additionally, integrating DHL contents and competencies more prominently into the qualification, further education and training of ECE teachers may help equip them with the necessary skills to access and apply health information effectively. This, in turn, can enhance interactions with children and contribute to their overall well-being.

The mediating role of ontological well-being in the relationship between psychological resilience, psychological well-being, and depression in refugee women

This study aims to investigate the mediating role of ontological well-being in the relationship between resilience, psychological well-being, and depression in refugee women. It is known that most refugee women experience different types of stress factors. It is assumed that refugees will feel depressed when they encounter negative situations and their psychological well-being will decrease. However, when the resilience levels of refugees are high, it is expected that their ontological welfare will increase and they will see their whole life as a project that includes past, present, and future time components. The sample of the study consisted of 288 refugee women. Demographic Information Form, Connor-Davidson Resilience Scale, Major Depression Inventory, Ontological Well-Beilng Scale, and WHO-5 Well-Being Scale were used as assessment tools. The data were tested using structural equation modeling. This study showed that the relationship between psychological resilience and well-being was fully mediated by the effect of ontological well-being on refugee women. It was also found that ontological well-being had a partial mediation effect on the relationship between resilience and depression.

Living Alone, Cognitive Function, and Well-Being of Japanese Older Men and Women: A Cross-Sectional Study

This study examined the interaction of living alone and cognitive decline in relation to the well-being of older men and women. We analyzed the data from a cross-sectional, self-administered questionnaire survey of community-dwelling older adults in Tokyo, who were aged 65+ and not on long-term care. The questionnaire included the 10-item self-administered dementia checklist (SDC), the WHO-5 Well-Being Scale, a question on their living arrangement, and participants’ baseline characteristics and social support and social contact. The analyses were stratified by sex and fitted with linear regression models with interaction. A total of 34,255 men and 41,056 women participated. Sample mean age was 73.5 (SD 6.1) for men and 73.6 (SD 6.0) for women, and 18.5% and 26.0% lived alone. The distribution of SDC scores indicated 95.9% and 97.0% had a cognitive status varying from intact to possible mild dementia. Cognitive decline showed a linear association with lower well-being in men (beta −0.53; 95% CI −0.58, −0.48; p &lt; 0.001 ) and women (beta −0.38; 95% CI −0.42, −0.34; p &lt; 0.001 ). Compared to men and women living with others, those living alone experienced lower well-being as their cognitive function declined, and the interactions (living arrangements ∗ SDC) were statistically significant. After controlling participants’ characteristics and social support and social contact, the interaction was significant in men ( p &lt; 0.001 ) but not in women ( p = 0.46 ). Our findings support that older men and women living alone experience a slightly steeper downward trajectory of cognitive decline and poor well-being than their counterparts living with others. The unequivocal effects of controlling confounding factors between men and women indicate the need for gendered countermeasures by welfare services.

Validation of the WHO-5 Well-Being Scale among Adolescents in Ghana: Evidence-Based Assessment of the Internal and External Structure of the Measure.

The WHO-5 well-being measure happens to be one of the most renowned measures of subjective well-being across the globe. Although the instrument has been calibrated in different countries, its psychometric properties and applicability in Africa, especially in Ghana, are not known. In this study, the WHO-5 well-being scale was validated among adolescents in Ghana by assessing the validity evidence of the measure based on the internal and external structure. In particular, the study examined the (1) dimensionality of the WHO-5 well-being scale, (2) quality of the items (including the scale functioning) for the measure, and (3) criterion validity of the well-being measure. Using a survey approach, 997 adolescents were recruited in secondary schools across the northern belt of Ghana. The study found a one-factor structure of the scale, which supports the factor solution of the original measure. The items were found to be of high quality, except for one item. The WHO-5 well-being measure was found to have sufficient evidence regarding convergent and divergent validity. The outcome of this validation study provides support for the validity and reliability of the WHO-5 well-being scale’s utility and use among adolescents in Ghana. The study encourages further validation studies to be conducted in Ghana to widen the reproducibility of the WHO-5 well-being measure.

Psychological Well-Being and Coping Strategies among Pakistani Heads of Households during COVID-19 Pandemic: An Online Survey.

Background: Coronavirus Disease (COVID-19) pandemic can affect mental health. Heads of the household are at higher risk of this effect because of their financial and social responsibilities. This study aimed to assess the psychological well-being and its associated factors during the COVID-19 pandemic among heads of households in Pakistan. Methods: We conducted an online survey in May 2020. A convenience sampling strategy was used to enroll the heads of the households from all regions of Pakistan. A validated English and Urdu version of the WHO-5 well-being scale was used to assess well-being. The prevalence of poor well-being and its associated factors among heads of the households was measured using logistic regression. Results: A total of 509 heads of households participated in the survey. About 35% of the participants were dependent on financial sources other than salary. The news was considered a source of fear as 70% assumed that avoiding such news may reduce the fear. The most common coping strategies used during lockdown were; spending quality time with family, eating healthy foods, adequate sleep and talking to friends on the phone. The prevalence of poor well-being was found to be 41% (95% CI: 36.62-45.51). Individuals with any chronic illness were at a higher risk of poor wellbeing adjusted odds ratio of 1.64 (95% CI: 1.04–2.59). Worriedness was also found to be associated with a higher risk of poor wellbeing adjusted OR 1.13 (95% CI: 1.06–1.19). Reading books showed a protective association with poor mental wellbeing adjusted OR 0.64 (95% CI: 0.42–0.98). Conclusion: There was a high prevalence of poor mental wellbeing among heads of households in Pakistan. Worriedness related to the pandemic and having chronic illness were significant predictors of poor psychological wellbeing. Actions are required in the form of targeted mass psychological support systems for the heads of the families to improve their mental health during the COVID-19 crises.

Exploratory Study on the Clinical use of EEG for the People with Chronic Stroke and Their Correlation with the Neuropsychological Outcome.

Objective. To measure the EEG signals of the people with chronic stroke in eyes-closed and eyes-open condition and study their relationship with the cognitive function and mental wellbeing. Methods. The investigators would conduct cognitive and mental wellbeing tests on recruited subjects. Their EEG signal was acquired by the 16-channel EEG system. The absolute power under different frequency bands and EEG indices (delta alpha ratio and pairwise derived brain symmetry index) in different eye conditions was calculated. Pearson's correlation was conducted to investigate the association between the clinical tests and the EEG index. Results. 32 subjects were recruited for the study. There was a significant correlation between the pairwise derived brain symmetry index (pdBSI) in eyes-open condition with the Stroop Test (p = .002), Paced Auditory Serial Addition Test-3 s (p = .008)/2 s (p = .002) and WHO-5 well-being scale (p = .023). Conclusions. There is a significant correlation between the brain symmetry index and the cognitive and wellbeing assessment. Brain symmetry index over the delta frequency has been found to be the most useful parameter relating to the clinical score.Significance:It is recommended to use EEG as an adjunctive neuropsychological assessment in clinics for people with chronic stroke, especially for clients who could not undertake conventional assessments (eg aphasia, attention problem).Highlights: There is a significant correlation between the EEG index and the clinical neuropsychological assessmentPairwise Derived Brain Symmetry index in delta frequency range correlated with most of the neuropsychological outcome.It is feasible for us to adopt EEG as an adjunctive assessment in clinical settings.

Reliability and Validity of Gujarati Version of WHO-5 Well-being Index in Community-dwelling Older Individuals: A Cross-sectional Study

Introduction: Major mental health issues like depression are not yet acknowledged as considerable public health challenges. The World Health Organization (WHO-5) well-being index is a simple concise questionnaire consisting of five basic questions that evaluate respondents’ subjective well-being. The scale’s internal and external validity are good for assessing depression in older individuals. This scale serves as an essential tool to evaluate various mental health-related issues as part of regular health check-ups. Thus, there was a need to translate and validate the WHO-5 well-being index in the Gujarati language. Aim: To find out the validity and reliability of the Gujarati version of the WHO-5 well-being index in the community-dwelling older individuals. Materials and Methods: This cross-sectional study was conducted among various community-dwelling older individuals in Ahmedabad, Gujarat, India, from March 2022 to August 2022. Permission was taken from the developer of the original scale and translation and validation of the scale were done according to suggestions given by the developer. A total of 60 participants and eight professionals with a mean experience of 13.5 years in the field of psychology, physiotherapy and healthcare area were involved in the examination of each item of the Gujarati version of WHO-5. The Statistical Package for the Social Sciences (SPSS) version 26.0 was used for the statistical analysis. Results: The mean age of the participants was 67.02±4.77 years. The content validity ratio of all items of the Gujarati WHO-5 well-being scale was 1. Internal consistency of the Gujarati WHO-5 well-being scale was calculated through Cronbach’s alpha (α=0.89) suggesting high internal consistency. Test-retest reliability of the Gujarati WHO-5 well-being scale was calculated through the Interclass Correlation Coefficient (ICC=0.89) suggesting excellent test-retest reliability. Conclusion: Gujarati WHO-5 well-being scale is a simple, accurate and reliable measure for evaluating psychological well-being and mental health status.

Validity and Reliability of the Self-administered Psycho-TherApy-SystemS (SELFPASS) Item Pool for the Daily Mood Tracking of Depressive Symptoms: Cross-sectional Web-Based Survey.

Backgrounde-Mental health apps targeting depression have gained increased attention in mental health care. Daily self-assessment is an essential part of e-mental health apps. The Self-administered Psycho-TherApy-SystemS (SELFPASS) app is a self-management app to manage depressive and comorbid anxiety symptoms of patients with a depression diagnosis. A self-developed item pool with 40 depression items and 12 anxiety items is included to provide symptom-specific suggestions for interventions. However, the psychometric properties of the item pool have not yet been evaluated.ObjectiveThe aim of this study is to investigate the validity and reliability of the SELFPASS item pool.MethodsA weblink with the SELFPASS item pool and validated mood assessment scales was distributed to healthy subjects and patients who had received a diagnosis of a depressive disorder within the last year. Two scores were derived from the SELFPASS item pool: SELFPASS depression (SP-D) and SELFPASS anxiety (SP-A). Reliability was examined using Cronbach α. Construct validity was assessed through Pearson correlations with the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder Scale-7 (GAD-7), and the WHO-5-Wellbeing-Scale (WHO-5). Logistic regression analysis was performed as an indicator for concurrent criterion validity of SP-D and SP-A. Factor analysis was performed to provide information about the underlying factor structure of the item pool. Item-scale correlations were calculated in order to determine item quality.ResultsA total of 284 participants were included, with 192 (67.6%) healthy subjects and 92 (32.4%) patients. Cronbach α was set to .94 for SP-D and α=.88 for SP-A. We found significant positive correlations between SP-D and PHQ-9 scores (r=0.87; P<.001) and between SP-A and GAD-7 scores (r=0.80; P<.001), and negative correlations between SP-D and WHO-5 scores (r=–0.80; P<.001) and between SP-A and WHO-5 scores (r=–0.69; P<.001). Increasing scores of SP-D and SP-A led to increased odds of belonging to the patient group (SP-D: odds ratio 1.03, 95% CI 1.01-1.05; P<.001; SP-A: 1.05, 1.05-1.01; P=.01). The item pool yielded 2 factors: one that consisted of mood-related items and another with somatic-related items.ConclusionsThe SELFPASS item pool showed good psychometric properties in terms of reliability, construct, and criterion validity. The item pool is an appropriate source for daily mood tracking in future e-mental health apps among patients with depression. Our study provides general recommendations for future developments as well as recommendations within the item pool.

Investigating Self-Care Agency and Well-Being of Elderly People

ABSTRACT The purpose of this study is to investigate the relationships between self-care agency and well-being perceptions of elderly people and to reveal whether or not self-care agency and well-being differ based on some socio-demographic characteristics. In the study, the data were collected by using Self-Care Agency Scale and WHO-5 Well-Being Scale from 394 elderly individuals residing in the city center of Burdur province between November and December 2019. In data analysis, descriptive statistical methods, one-way analysis of variance, two independent groups t-test, reliability analysis, correlation analysis and regression analysis were used. The correlation analysis results of the study indicated that there was a positive and moderate correlation between self-care agency and well-being of the participants (r = 0.41). According to the regression analysis, participants’ perception on self-care agency accounted for 17.3% of total variance on well-being. According to this, increasing perceptions on self-care agency statistically increased well-being perceptions (t = 9.069; p < .001). In addition to, it was determined in the study, while participants’ well-being scores showed significant differences in terms of age groups, and their’ self-care agency and well-being scores showed statistically significant differences according to the educational level.

The WHO-5 well-being scale and its correlation to depressive and manic symptoms among outpatients with bipolar disorder or unipolar depression

IntroductionThere is a lack of longitudinal studies of patients with bipolar disorder (BD) or unipolar depression (UD) in terms of psychological well-being as measured by the WHO-5 and the correlation to symptom scores. It is of interest to investigate whether the WHO-5 is useful in monitoring patients with mood disorders over time, as a tool in measurement-based care, and as a supplement to other psychometric measures.ObjectivesIn this study we investigate the correlation at baseline between the depressive symptom scores according to the 6-item Hamilton Depression Score (HDS-6) and the WHO-5 scores in outpatients treated for BD or UD. Furthermore, in patients with BD we investigate correlations between manic symptom scores according to the modified Bech-Rafaelsen Mania Scale (MAS-M) and the WHO-5 scores. Lastly, in patients with BD or UD, we investigate the correlations between endpoint-baseline change in WHO-5 and change in MAS-M and HDS-6.MethodsA longitudinal study of 200 outpatients diagnosed and treated for either BD or UD. Patients will be measured at baseline and at least four weeks later. Baseline data are presented as frequencies, means and standard deviations or medians with interquartile ranges as appropriate. All correlations are presented as scatter plots and a Spearman correlation analysisResultsThe study is ongoing, but the results will be available for presentation at the EPA in 2021.ConclusionsThe WHO-5 may represent a relevant outcome measure in the treatment of BD and UD.DisclosureNo significant relationships.

Physical and Mental Health Status of Adolescents of Government Juvenile Development Centers in Bangladesh

Gradual rising of crime among adolescents is now a social and public health concern worldwide. A total of 1.9 million children getting incarcerated worldwide yearly where in Bangladesh, 1.3 million of children engaged in hazardous job most of them involved in crime. Again, physical and mental well-being is the legal and constitutional rights of the every adolescent including detained adolescent of Juvenile Development Centers. This is a cross-sectional study conducted to assess the physical and mental health status as well as socio-demographic status of adolescents of two Government Juvenile Development Center, Tongi and Konabari, Gazipur from January to December 2017. 191 adolescents were selected purposively (male: female=1.41:1). Data were collected by face to face interview and record review and height and weight of the respondents were measured. The mental health status was measured by WHO-5 Well-being Scale. The age range was from 13 to 17 years. Age of the respondents were significantly correlated with score of the WHO-5 well-being scale (p=0.028). The study observed higher score among respondents who had detained here for more than 2 months which was highly significant (p&lt;0.001). Most of the respondents (75.9%) belong to poor family. The mean score of the WHO-5 well-being scale of the respondent was 52.20±10.0, where 35.1% had good and 64.9% had poor psychological well-being status and higher among male respondents (52.92±10.40) than the female respondents (51.29±9.45). The respondents who were employee prior to this institution had significantly high score (p=0.024). A significant relationship was observed between type of crime and the score of WHO-5 well-being scale (p=0.003). The mean body mass index was 20.26±1.27 kg/m2. Almost every respondent (92.7%) belongs to normal nutritional category. Well-being score of the respondents was significantly increased with the body mass index (p=0.005). This study revealed score of WHO-5 well-being scale was significantly associated with duration of stay of the respondents (p&lt;0.001, R=0.540). Thus this study provides prevalence of mental health status and nutritional status as well as socio-demographic condition of adolescents of Government Juvenile Development Centre in Bangladesh which may provide the Government, sociologists and psychologists valid and reliable data for making plans and policies for improving or updating the living conditions of detainee of Juvenile development Centre.&#x0D; Bangladesh Med J. 2018 May; 47 (2): 7-11

Testimonial Therapy: Impact on social participation and emotional wellbeing among Indian survivors of torture and organized violence

Traumatizing events, such as torture, cause considerable impairments in psycho-social functioning. In developing countries, where torture is often perpetrated, few resources exist for the provision of therapeutic or rehabilitating interventions. The current study investigated the effectiveness of Testimonial Therapy (TT) as a brief psycho-social intervention to ameliorate the distress of Indian survivors of torture and related violence. Three outcome measures (the WHO-5 Well-Being Scale, Social Participation-Scale and Pain and Anger Analogue) were compared before and after receiving TT, and semi structured interviews were conducted with survivors who had previously received TT. Participants showed significant improvements in emotional well-being, social participation, and self-perceived pain and anger. Furthermore, three qualitative interviews with survivors indicated that TT had a positive impact at the community level. Although the study was conducted without a control group for comparison, TT appeared to be an effective method for improving well-being and ameliorating distress among survivors of torture. Furthermore, TT can potentially promote community empowerment. However, more research on this aspect is needed.

Psychological concomitants of crossfit training

The research aimed at studying relationships between characteristics of CrossFit training (time elapsed from starting with training, weekly session frequency) and indicators of well-being, self-esteem, body awareness, satisfaction with body image, and perceived body competence. Participants, 186 Norwegian individuals (57.5% female; mean age: 28.9±7.81 years) regularly participating in CrossFit, completed online surveys (WHO-5 Well-being Scale, PANAS, Rosenberg Self-Esteem Scale, Body Awareness Questionnaire, Body Image Ideals Questionnaire, Body Competence Scale, motivations for doing CrossFit). Weekly frequency of CrossFit sessions was not connected with positive affect (Kendall tau_b=-.02, p=.766), negative affect (-.01, p=.861), or well-being (.10, p=.068) in the correlation analysis. Similarly, overall CrossFit experience (duration x frequency) was not related to global self-esteem (Kendall tau_b=.01, p=.778), body awareness (-.04, p=.379), body image dissatisfaction (.04, p=.423), and body competence (-.07, p=.184). In the regression analysis, well-being was connected with male gender (β=-.205, p&amp;lt;.01), time elapsed from starting with CrossFit (β=-0.178, p&amp;lt;.05), dissatisfaction with body image (β=-.218, p&amp;lt;.01), and body awareness (β=.149, p&amp;lt;.05). Global self-esteem was related to age (β=.164, p&amp;lt;.05), body competence (β=.152, p&amp;lt;.05), and body image dissatisfaction (β=-.276, p&amp;lt;.001). CrossFit training was not connected with higher levels of psychological functioning (well-being, affect, body awareness, and self-esteem) and satisfaction with body image.

Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression: a randomized, double-blind controlled study.

To evaluate to what extent a twice daily dose of Transcranial Pulsating ElectroMagnetic Fields (T-PEMF) was superior to once daily in patients with treatment-resistant depression as to obtaining symptom remission after 8 weeks of augmentation therapy. A self-treatment set-up of the T-PEMF device was used allowing self-administration by patients in own homes. All patients were treated for 30 min per T-PEMF session. The antidepressant medication the patients were receiving at baseline remained unchanged during the trial. The patients were randomised to either one T-PEMF dose (active dose in the morning and sham in the afternoon) or two T-PEMF doses (active dose both morning and afternoon) in a double-blind procedure. A score of 7 or less on the Hamilton Depression Scale (HAM-D17) was the criterion of remission. In total 34 patients received active T-PEMF once a day and 31 patients twice daily. After 5 weeks of therapy remission was obtained in 26.5% and 32.3% on one dose and two doses of T-PEMF, respectively. After 8 weeks the rate of remission was 73.5% and 67.7%, respectively. The side effects as measured by the Udvalget for Kliniske Undersøgelser scale showed a better toleration of the antidepresssive medication in both treatment groups, which was reflected by the WHO-5 well-being scale with increased scores in both groups of patients. The high remission rate obtained by the T-PEMF augmentation was not a dose effect (one versus two daily T-PEMF sessions) but was explained by the extension of the treatment period from 5 to 8 weeks.

Intensive Transitional Post-discharge Service for Patients with Depression

Introduction: Psychiatric treatment for depression initiated during admission is often planned to be continued after discharge, yet outpatient follow-up service frequently fails to meet even modest standards for service regarding timeliness and frequency of contact. Here we present data from a newly designed transitional, day-to-day, CBTbased psychiatric aftercare service. Methods: The program consisted of at least one psychiatric consultation, week-day telephone outreach and CBT-based individual therapy twice a week (in total five times), followed by group therapy twice a week for four weeks. In individual therapy, focus was on collaborative goal setting and next-of-kin participation. The group format was open, trans-diagnostic and highly structured. Self-ratings (WHO-5 Well-Being Scale (WHO-5); Becks Depression Inventory - II (BDI)) were obtained at the first day, at the end of individual therapy (after 3 weeks) and at end of group therapy (after 6-10 weeks). User evaluations were obtained at the latter two time points. Descriptive data is presented and ratings are analysed in an intention-to-treat design. Results: In 23 months 189 patients with unipolar depression were referred to the aftercare program. 165 patients completed the initial questionnaires, which showed a high level of depression symptoms (BDI 30.9 (STD 11.4 N=166) the first day of the program (right after discharge). 114 patients continued in group therapy. 11 (5.8 %) patients were re-admitted, 74 (39.2%) patients continued treatment in regional mental health clinics and 89 (47.1%) patients were discharged to primary sector service. BDI scores improved at each time point. Overall user satisfaction, measured with Client Satisfaction Questionnaire (CSQ), was high. Conclusion: Symptom reduction was evident during the aftercare program, and patients were satisfied with the service content. However, the results have to be interpreted with caution as we lack data from a comparable patient group receiving no service or a different type of post-discharge aftercare.