Work And Social Adjustment Scale Research Articles

Comparing the effectiveness of behavioral activation in group vs. self-help format for reducing depression, repetitive thoughts, and enhancing performance of patients with major depressive disorder: a randomized clinical trial

BackgroundBehavioral activation has gained increasing attention as an effective treatment for depression. However, the effectiveness of Behavioral Activation Group Therapy (BAGT) in controlled conditions compared to its self-help programs requires more investigation. The present study aimed to compare their effectiveness on depressive symptoms, repetitive negative thinking (RNT), and performance in patients with major depressive disorder (MDD).MethodsIn this randomized clinical trial, 40 patients diagnosed with Major Depressive Disorder (MDD) were recruited based on a structured clinical interview for DSM-5 (SCID-5). Participants were allocated to BAGT (n = 20) and self-help behavioral activation (SBA; n = 20) groups. BAGT received ten weekly sessions (90 min), while the SBA group followed the same protocol as the self-help intervention. Participants were evaluated at pre-treatment, post-treatment, and the 2-month follow-up using the Beck Depression Inventory-II (BDI-II), repetitive thinking questionnaire (RTQ-31), and work and social adjustment scale (WSAS).ResultsThe results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, work, and social functioning post-treatment and at the 2-month follow-up. However, the SBA group did not show significant changes in any outcome. The study also found that, based on clinical significance, 68% of the BAGT participants were responsive to treatment, and 31% achieved a high final performance status at the 2-month follow-up.DiscussionBAGT was more effective than SBA in MDD patients. Participants’ engagement with self-help treatment is discussed.Trial registrationThe present trial has been registered in the Iranian Registry of Clinical Trials Center (IRCT ID: IRCT20181128041782N1|| http://www.irct.ir/) (Registration Date: 04/03/2019).

Platelet Levels of Brain-Derived Neurotrophic Factor in Adults with Autism Spectrum Disorder: Is There a Specific Association with Autism Spectrum Psychopathology?

To date, although several studies have investigated the circulating levels of brain-derived neurotrophic factor (BDNF) in children with autism spectrum disorder (ASD), only a few authors have addressed their evaluation in adults. Furthermore, an important limitation of these studies lies in the fact that circulating BDNF is stored in platelets and released into the circulation when needed. To the best of our knowledge, a very limited number of studies have related peripheral BDNF values to platelet counts, and yet no study has evaluated intra-platelet BDNF levels in adults with ASD. In this framework, the aim of the present work is to pave the way in this field and evaluate platelet BNDF levels in adult ASD patients, as well as their correlation with autistic symptoms and related psychopathological dimensions. We recruited 22 ASD and 22 healthy controls, evaluated with the Adult autism subthreshold spectrum (AdAS Spectrum), the Social Anxiety Spectrum-self report (SHY-SR), the Trauma and loss spectrum-self report (TALS-SR), the Work and Social Adjustment Scale (WSAS), and the Mood Spectrum-self report for suicidality. Intra-platelet BDNF levels were also assessed. The results highlighted lower BDNF levels in the ASD group; moreover, AdAS Spectrum and WSAS total score as well as AdAS Spectrum Restricted interest and rumination, WSAS Private leisure activities, TALS-SR Arousal, and SHY-SR Childhood domains were significant negative predictors of platelet BDNF levels.

Clinical effectiveness and cost-effectiveness of Structured Psychological Support for people with probable personality disorder in mental health services in England: study protocol for a randomised controlled trial

IntroductionEvidence-based psychological treatments for people with personality disorder usually involve attending group-based sessions over many months. Low-intensity psychological interventions of less than 6 months duration have been developed, but their...

Assessing functional impairment in university students: psychometric study of the Portuguese Work and Social Adjustment Scale in a help-seeking sample

Background: It has been advocated that higher education settings should promote a supporting environment devoted to improving several dimensions of well-being of their communities. Particularly in clinical services, the assessment of functional impairment is of outmost importance. Goals: The present study aimed at analysing factor structure and psychometric properties of the Work and Social Adjustment Scale (WSAS), a 5-item scale developed to assess the patients’ perceived functional impairment resulting from a health problem in five dimensions: work, social leisure activities, private leisure activities, and relationships with others. Methods: A sample of 207 university students that sought mental health support (22 years old of mean age; majority female and undergraduate) answered a set of self-report questionnaires including the WSAS and measures of anxiety, depression and quality of life. Results: Confirmatory factor analysis indicated an adequate fit to the single-factor structure, and the scale presented very good reliability. Concurrent, convergent and incremental validity were also found, and the WSAS differentiated groups with different levels of anxiety and depressive symptoms. Discussion: Overall, our results corroborate that WSAS is a brief, reliable and valid measure, useful in research and clinical settings. Further research is needed particularly regarding temporal stability, discriminative power between clinical and nonclinical populations, and within clinical samples between different diagnosis.

A web-based survey on the occurrence of emotional blunting in patients with major depressive disorder in Japan: Patient perceptions and attitudes.

To determine the prevalence and impact of emotional blunting (EB) in patients with major depressive disorder (MDD) in Japan, and identify treatment needs for EB using patients' perceptions and attitudes. Eligible patients in Japan (aged 18-59 years) who reported a diagnosis of MDD and antidepressant medication use for >3 months were eligible to complete an online survey. The primary outcome was the prevalence of EB, self-reported using a validated screening question. Secondary outcomes included the correlation between EB symptoms (measured by the Oxford Depression Questionnaire [ODQ]) and scores on the Patient Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Work and Social Adjustment Scale (WSAS), and the EuroQol 5-Dimension 5-Levels questionnaire (EQ-5D-5L). Descriptive questions were used to explore patients' perceptions and attitudes toward EB. In total, 3376 patients were included in the analysis (56% male; 48% aged 50-59 years). Overall, 67.1% of patients self-reported symptoms of EB, with 10% rating these as severe. The mean (SD) ODQ total score was 78.2 (21.5), which increased with worsening EB symptoms. There were correlations between ODQ total scores and the PHQ-9, GAD-7, WSAS, and EQ-5D-5L scores (correlation coefficients: 0.67, 0.55, 0.56, -0.51, respectively; all p < 0.0001). Descriptive analyses showed that one-third of patients reporting EB symptoms did not tell their physician, with two-thirds finding these symptoms distressing and likely to affect recovery. EB is an important clinical issue in Japan that needs to be considered alongside functional recovery when managing treatment of patients with MDD.

The association between trajectory of change in social functioning and psychological treatment outcome in university students: a growth mixture model analysis

IntroductionAttendance at university can result in social support network disruption. This can have a negative impact on the mental health of young people. Demand for mental health support continues to increase in universities, making identification of factors associated with poorer outcomes a priority. Although social functioning has a bi-directional relationship with mental health, its association with effectiveness of psychological treatments has yet to be explored.ObjectivesTo explore whether students showing different trajectories of change in social function over the course of treatment differed in eventual treatment outcome.Methods Growth mixture models were estimated on a sample of 5221 students treated in routine mental health services. Different trajectories of change in self-rated impairment in social leisure activities and close relationships (Work and Social Adjustment Scale (WSAS) items 3 and 5) during the course of treatment were identified. Associations between trajectory classes and treatment outcomes were explored through multinomial regression.Results Five trajectory classes were identified for social leisure activity impairment (Figure 1), and three classes were identified for close relationship impairment (Figure 2). For both measures the majority of students remained mildly impaired (Class 1). Other trajectories included severe impairment with limited improvement (Class 2), severe impairment with delayed improvement (Class 3), and, in social leisure activities only, rapid improvement (Class 4), and deterioration (Class 5). There was an association between trajectories of improvement in social functioning over time and positive treatment outcomes. Trajectories of worsening or stable severe impairment were associated with negative treatment outcomes.Image:Image 2:ConclusionsChanges in social functioning impairment are associated with psychological treatment outcomes in students, suggesting that these changes may be associated with treatment effectiveness or recovery experiences. Future research should look to establish whether a causal link exists to understand if additional benefit for students can be gained through integrating social support within psychological treatment.Disclosure of InterestNone Declared

Depression follow-up monitoring with the PHQ-9: an open cluster-randomised controlled trial.

Outcome monitoring of depression treatment is recommended but there is a lack of evidence on patient benefit in primary care. To test monitoring depression using the Patient Health Questionnaire (PHQ-9) with patient feedback. An open cluster-randomised controlled trial was undertaken in 141 group practices. Adults with new depressive episodes were recruited through record searches and opportunistically. The exclusion criteria were as follows: dementia; psychosis; substance misuse; and suicide risk. The PHQ-9 was administered soon after diagnosis, and 10-35 days later. The primary outcome was the Beck Depression Inventory (BDI-II) score at 12 weeks. The secondary outcomes were as follows: BDI-II at 26 weeks; Work and Social Adjustment Scale (WSAS) and EuroQol EQ-5D-5L quality of life at 12 and 26 weeks; antidepressant treatment; mental health and social service contacts; adverse events, and Medical Interview Satisfaction Scale (MISS) over 26 weeks. In total, 302 patients were recruited to the intervention arm and 227 to the controls. At 12 weeks, 254 (84.1%) and 199 (87.7%) were followed-up, respectively. Only 40.9% of patients in the intervention had a GP follow-up PHQ-9 recorded. There was no significant difference in BDI-II score at 12 weeks (mean difference -0.46; 95% confidence interval [CI] = -2.16 to 1.26; adjusted for baseline depression, baseline anxiety, sociodemographic factors, and clustering by practice). EQ-5D-5L quality-of-life scores were higher in the intervention arm at 26 weeks (adjusted mean difference 0.053; 95% CI = 0.013 to 0.093. A clinically significant difference in depression at 26 weeks could not be ruled out. No significant differences were found in social functioning, adverse events, or satisfaction. In a per-protocol analysis, antidepressant use and mental health contacts were significantly greater in patients in the intervention arm with a recorded follow-up PHQ-9 (P = 0.025 and P = 0.010, respectively). No evidence was found of improved depression outcome at 12 weeks from monitoring. The findings of possible benefits over 26 weeks warrant replication, investigating possible mechanisms, preferably with automated delivery of monitoring and more instructive feedback.

Longitudinal trajectories of psychosocial functioning in patients with pre-existing mental disorders after one year of COVID-19 pandemic

Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March–April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June–July 2021), and after 6 months from T1 (T2- November–December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p < .001), PHQ scores at baseline >10 (B = 2.89, p < .05), while not living alone was found to be a protective factor (B = −2.5, p < .05).Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies.

Validation of the Danish Version of the Overall Depression Severity and Impairment Scale (ODSIS): A Reliable Instrument for Assessing Depression Symptoms and Functional Impairment.

In psychotherapy, having a reliable tracking tool is vital for effective treatment. We have validated the Danish version of the 'Overall Depression Severity and Impairment Scale' (ODSIS), which is used in the Unified Protocol for Emotional Disorders (UP) and other cognitive behavioural therapies. This five-item self-rating scale is expected to correspond closely to the gold-standard Beck Depression Inventory-II (BDI-II), but also to self-rating scales addressing daily functioning and well-being. Internal consistency is assessed using Cronbach's alpha and McDonald's omega. Criterion validity is explored through Pearson's correlation coefficient with BDI-II, the Work and Social Adjustment Scale (WSAS), the Five-Item World Health Organization Well-Being Index (WHO-5) and scatter plots, and an optimal cut-off score is determined using a receiver operating characteristic curve. The study included 340 respondents: 234 from a recent clinical trial, 56 psychiatric patients from inpatient/outpatient units and 50 healthy volunteers. ODSIS demonstrates strong internal consistency (Cronbach's alpha: 0.887-0.956, McDonald's omega: 0.888-0.957). Correlations with BDI-II, WSAS and WHO-5 highlight its strong criterion validity (BDI-II: 0.847, WSAS: 0.751, WHO-5: 0.771). The optimal cut-off score (> 7.5) for detecting depression shows great sensitivity (0.862) and specificity (0.731). The Danish version of ODSIS proves to be a reliable instrument for quantification of a combination of depression level and functional impairment from the symptoms. Its high correlation with established BDI-II makes it a brief and handy tool for repeated measurement in clinical and research settings.

Post-traumatic Stress and Depressive Symptoms in Women With Ovarian Cancer 3-6 Months After Diagnosis.

The potentially traumatic role of severe life-threatening medical conditions is still debated in psychiatry and not yet recognized, particularly among post-traumatic stress disorders. However, increasing evidence suggests the psychopathological impact of severe medical conditions related to their poor prognosis, high lethality, treatments heaviness and invasiveness. Ovarian cancer (OC) is one of the malignancies with the highest mortality and the aim of this study was to investigate post-traumatic stress and depressive symptoms in women 3 to 6 months after diagnosis. A sample of 83 women diagnosed with OC at different stages (from AI to IV) was recruited and assessed by means of the: Structural Clinical Interview for Mental Disorders according to DSM-5 (SCID-5), Trauma and Loss Spectrum Self-Report (TALS-SR), Impact Event Scale-Revised (IES-R), Hamilton Rating Scale for Depression (HAM-D), Mood Spectrum-Self Report (MOOD-SR), Work and Social Adjustment Scale (WSAS). Full data on the psychiatric assessments were available for 45 patients: 13 (28.9%) patients reported a diagnosis of PTSD. Patients with PTSD reported statistically significant higher depressive symptoms and more severe impact on work and social functioning compared to those without PTSD. Our results highlight the need to carefully assess the potentially traumatic burden of a diagnosis of OC and its association with depressive symptoms for their impact on patients' global functioning, in order to provide appropriate preventive and therapeutic interventions.

First trans-diagnostic experiences with a novel micro-choice based concentrated group rehabilitation for patients with low back pain, long COVID, and type 2 diabetes: a pilot study

BackgroundThe health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses. Hence, novel high-capacity and cost-effective treatments with trans-diagnostic effects are warranted. In accordance with the protocol paper, we aimed to examine the acceptability, satisfaction, and effectiveness of an interdisciplinary micro-choice based concentrated group rehabilitation for patients with chronic low back pain, long COVID, and type 2 diabetes.MethodsPatients with low back pain > 4 months sick-leave, long COVID, or type 2 diabetes were included in this clinical trial with pre-post design and 3-month follow-up. The treatment consisted of three phases: (1) preparing for change, (2) the concentrated intervention for 3–4 days, and (3) integrating change into everyday life. Patients were taught and practiced how to monitor and target seemingly insignificant everyday micro-choices, in order to break the patterns where symptoms or habits contributed to decreased levels of functioning or increased health problems. The treatment was delivered to groups (max 10 people) with similar illnesses. Client Satisfaction Questionnaire (CSQ-8)) (1 week), Work and Social Adjustment Scale (WSAS), Brief Illness Perception Questionnaire (BIPQ), and self-rated health status (EQ-5D-5L) were registered at baseline and 3-month follow-up.ResultsOf the 241 included participants (57% women, mean age 48 years, range 19–84), 99% completed the concentrated treatment. Treatment satisfaction was high with a 28.9 (3.2) mean CSQ-8-score. WSAS improved significantly from baseline to follow-up across diagnoses 20.59 (0.56) to 15.76 (0.56). BIPQ improved from: 22.30 (0.43) to 14.88 (0.47) and EQ-5D-5L: 0.715 (0.01) to 0.779 (0.01)), all P<0.001.ConclusionsAcross disorders, the novel approach was associated with high acceptability and clinically important improvements in functional levels, illness perception, and health status. As the concentrated micro-choice based treatment format might have the potential to change the way we deliver rehabilitation across diagnoses, we suggest to proceed with a controlled trial.Trial registrationClinicalTrials.gov NCT05234281

How does cognitive behavior therapy for dissociative seizures work? A mediation analysis of the CODES trial.

We compared dissociative seizure specific cognitive behavior therapy (DS-CBT) plus standardized medical care (SMC) to SMC alone in a randomized controlled trial. DS-CBT resulted in better outcomes on several secondary trial outcome measures at the 12-month follow-up point. The purpose of this paper is to evaluate putative treatment mechanisms. We carried out a secondary mediation analysis of the CODES trial. 368 participants were recruited from the National Health Service in secondary / tertiary care in England, Scotland, and Wales. Sixteen mediation hypotheses corresponding to combinations of important trial outcomes and putative mediators were assessed. Twelve-month trial outcomes considered were final-month seizure frequency, Work and Social Adjustment Scale (WSAS), and the SF-12v2, a quality-of-life measure providing physical (PCS) and mental component summary (MCS) scores. Mediators chosen for analysis at six months (broadly corresponding to completion of DS-CBT) included: (a) beliefs about emotions, (b) a measure of avoidance behavior, (c) anxiety and (d) depression. All putative mediator variables except beliefs about emotions were found to be improved by DS-CBT. We found evidence for DS-CBT effect mediation for the outcome variables dissociative seizures (DS), WSAS and SF-12v2 MCS scores by improvements in target variables avoidance behavior, anxiety, and depression. The only variable to mediate the DS-CBT effect on the SF-12v2 PCS score was avoidance behavior. Our findings largely confirmed the logic model underlying the development of CBT for patients with DS. Interventions could be additionally developed to specifically address beliefs about emotions to assess whether it improves outcomes.

Evaluation of the Psychiatric Disorders among Amphetamine Addicts in Rehabilitation Centers: A Cross-Sectional Analysis.

People who are addicted to amphetamines have a much greater chance of developing psychosis compared to those who are not. It is essential to study the behavioral and psychological effects of amphetamines. Therefore, this research aimed to examine conditions such as depression, anxiety, mood, cognitive abilities at the workplace, and social responsibilities by using sociodemographic factors as useful tools in determining effective strategies for preventing, managing, and treating amphetamine addiction. A cross-sectional study among addicts hospitalized at two rehabilitation centers across Saudi Arabia between May and October 2023. A validated questionnaire consisting of psychiatric disorders assessment tools was distributed to healthcare professionals to start an interview with addicts to assess the abnormalities. The results were compared with healthy people (control). The assessment tools used are Hamilton Anxiety and Depression Rating Scale, Young Mania Rating Scale, and Work and Social Adjustment Scale. The data were analyzed using SPSS version 22.0. Pearson correlation coefficients (r) were employed. A total of 60 subjects participated in this study. The participants were divided into two groups (n = 60): group I was control (n = 25) healthy volunteers and group II was amphetamine abusers (n = 35), who were hospitalized for detoxification. The ages ranged from 18 to 60 years old with mean ages of 38.68 (±8.14) and 37.77 (±10.95) years in the control and amphetamine groups, respectively. Among the addicts, the mean severity dependence scale value was 10.46 (±1.82), which denotes high dependency on the illicit drug. The prevalence of high levels of anxiety, depression, and bipolar disorder was significantly higher among addicts when they were compared to healthy people (control). The assessment of the Work and Social Adjustment Scale (WSAS) reflected a higher impairment that minimized their ability to perform the work requirements, home management, social leisure, and relationships. The addiction to amphetamines was associated with high impairment of work performance and social obligations and a negative impact on the addict's mental health. The risk of suffering anxiety, depression, and bipolar is higher than in nonaddict people. These effects are attributed to brain damage, neurotoxicity, and neuronal inflammation, particularly when these substances are abused over extended periods and at higher doses.

The effectiveness of behavioral activation therapy on the symptoms of depression, rumination, and social-occupational functioning impairment among women with postpartum depression.

Postpartum depression is caused by a wide range of factors, and women in their postpartum period are highly vulnerable, either physically or emotionally. The present study aimed to investigate the effects of behavioral activation therapy on the symptoms of depression, rumination, and social-occupational functioning impairment among women with postpartum depression (PPD). This quasi-experimental research included a pre-test, a post-test, and a one-month follow-up, as well as experimental and control groups. The participants were screened using Edinburgh Postnatal Depression Scale (EDPS) in 2019. The research included 32 women who had visited Isfahan Healthcare Centers. They were selected using convenience sampling and then randomly divided into experimental (16 individuals) and control groups (16 individuals). Both groups answered the following questionnaires before, immediately after, and one month after the intervention: Beck Depression Inventory (BDI), Nelon, et al. Ruminative Response Scale, and Mundt et al. Work and Social Adjustment Scale (WSAS). The experimental group received behavioral activation therapy for nine 90-minute sessions once a week. The data were analyzed using the statistical method of multivariance analysis of covariance (MANCOVA). The results showed that behavioral activation therapy had a significant effect on the symptoms of depression (P = 0.001, F = 79.65), postpartum depression (P = 0.001, F = 220.359), rumination (P = 0.001, F = 121.765), and social-occupational functioning impairment (P = 0.001, F = 368.512) among women with postpartum depression. The effects of behavioral activation therapy also lasted in the follow-up stage of the study. According to the present research, behavioral activation therapy is an effective method that decreases the symptoms of depression, rumination, and occupational-social functioning impairment among women with postpartum depression. Therefore, behavioral activation therapy could be beneficial to intervention designs and treatment of postpartum depression.

Routine outcomes and evaluation of an 8-week outpatient multidisciplinary rehabilitative therapy program for functional neurological disorder

ObjectivesWe report routinely collected outcome data from an 8-week outpatient rehabilitative therapy program. The aims of the intervention were to (1) reduce symptom severity and (2) improve functional mobility in adults with functional neurological disorder (FND).MethodsThe program delivered individual physiotherapy, cognitive behavioral therapy (CBT) and self-management sessions, group physiotherapy, and psychoeducation. Outcome measures included the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Work and Social Adjustment Scale (WSAS), 10-Meter Walk Test (10MWT), Timed Up and Go (TUG), and Berg Balance Scale (BBS). Data were analyzed retrospectively in accordance with routine service evaluation. Wilcoxon signed-rank tests assessed changes in outcomes between weeks 1 and 8 for all patients completing treatment (n = 45). For patients who attended the 3-month follow-up (n = 31), Friedman’s ANOVA assessed overall change in outcomes over time. Post hoc Wilcoxon signed-rank tests compared pairs of time-points (Weeks 1, 8, and 3-month follow-up).ResultsAnalyses of patients completing the program revealed significant improvements in scores between week 1 and week 8. Excluding the BBS, there were statistically significant improvements in all outcomes between weeks 1 and 8 and between weeks 1 and 3-month follow-up.DiscussionThis outpatient therapy program provided effective treatment for FND. Patients reported reduced anxiety, depression, and functional impairment, as well as improved performance on most physiotherapy measures.

Utility of the Work and Social Adjustment Scale (WSAS) in predicting long-term sick-leave in Danish patients with emotional disorders

Background The Work and Social Adjustment Scale (WSAS) is a self-administered measure designed to assess the level of inability to function socially as a consequence of a defined problem or disorder. Methods A total of 230 patients with emotional disorders completed the Danish translation of the WSAS, measures of anxiety and depression, the Level of Personality Functioning Brief Form, the Personality Inventory for DSM-5 Short Form, and the World Health Organization Five-Item Well-Being Index (WHO-5). We conducted a confirmatory factor analysis of the previously suggested factor structure of the instrument. We furthermore evaluated the construct validity of the WSAS by means of its relationship with depression, anxiety, personality functioning, and overall well-being. Finally, we evaluated the utility of the WSAS to identify those on long-term sick-leave by conducting receiver operating characteristic (ROC) curves. Results The instrument had a poor to average fit with the previously reported single-factor structure, but a better fit to a modified single-factor structure. Cronbach’s alpha and McDonald’s omega showed good internal scale reliability (α = .79, ωtotal = .85). WSAS was positively correlated with measures of anxiety (r = .33), depression (r = .44), and personality functioning (r = .23 and r = .20), and negatively correlated with WHO-5 wellbeing (r = –.57). The optimal cut-off point in the ROC-analyses was 23, which yielded a sensitivity of 74% and a specificity of 55% in the prediction of sick-leave status. Discussion The Danish WSAS shows promising psychometric properties, but has limited external validity insofar as predicting long-term sick leave in psychiatric patients with emotional disorders.

Effectiveness of brief cognitive behavior therapy on symptoms severity in relation to social avoidance among patients with panic disorder: a randomized controlled trial

Background. Panic disorder is a debilitating condition characterized by severe symptoms and social avoidance. Due to insufficient knowledge, this study examined the effectiveness of brief cognitive behavioral therapy (CBT) on symptom severity and social avoidance in patients with panic disorder. Patients and Methods. In this randomized controlled trial (RCT), 44 patients were included in the Brief CBT group or the control group after addressing issues related to lost-to-follow-up. Panic disorder symptom severity (PDSS) and the work and social adjustment scale (WSAS) were used to assess symptom severity and social adjustment, respectively. Results. After one month of treatment, the total PDSS scores (1.79 vs. 4.47; P=0.0409) and WSAS scores (2.97 vs. 7.41; P=0.0015) in the brief CBT group were significantly lower compared to the control group. The study revealed that in the brief CBT group, the mean score of PDSS and WSAS significantly decreased from 21.53 to 1.79 (P&lt;0.0001) and from 24.63 to 2.95 (P&lt;0.0001), and in the control group from 19.59 to 4.47 (P&lt;0.0001) in PDSS and from 22.18 to 7.41 (P&lt;0.0001) in WSAS, respectively. Furthermore, the change in WSAS scores in the brief CBT group was independent of the decrease in PDSS. Conclusions. This study demonstrated that the application of brief CBT is an effective technique for reducing symptom severity and social avoidance in patients with panic disorder.

The subjective assessment of work and social adjustment impairments and associated psychopathologies in Japanese adult female patients with anorexia nervosa.

Patients with anorexia nervosa (AN) sometimes undergo a chronic course, and they hardly maintain social participation. Work and social adjustment impairments are generally significantly associated with the clinical symptoms of eating disorders. Psychopathologies associated with the subjective social difficulties of patients with AN have been unclear. This study examined the association between AN psychopathologies and work and social adjustment impairments in adult female patients with AN. This study included 36 Japanese adult female patients with AN who completed the Work and Social Adjustment Scale (WSAS) and the Eating Disorder Inventory-2 (EDI-2). Spearman's rank correlation coefficient was used to assess correlations between WSAS and EDI-2 or demographic variables. The mean age was 31.8 years, the mean current body mass index was 13.4 kg/m2, and the median illness duration was 5 years. Patients demonstrated social difficulties, especially in social leisure activities. The total WSAS scores were significantly correlated with EDI-2 "impulse regulation" and "asceticism." WSAS "social leisure" was significantly correlated with EDI-2 "bulimia," "interoceptive awareness," "impulse regulation," and "asceticism." Psychopathologies, such as impulse regulation, asceticism, and interoceptive awareness, may be related factors to social difficulties. Emotion regulation, such as impulse regulation and emotional awareness, could be an important realm of treatment not only for psychopathology but also for social functioning in patients with AN.

The Essential Network (TEN): engagement and mental health insights from a digital mental health assessment tool for Australian health professionals during COVID-19

BackgroundHealth professionals are at risk of poor mental health outcomes due to the COVID-19 pandemic. The Essential Network (TEN) is a blended care mental health support service for Australian health professionals, funded by the Australian Federal Department of Health. TEN comprises both digital and face-to-face components. We examined completed digital mental health assessments (Digital Mental Health Check-Up) to understand usage of TEN and the demographics and mental health of users.MethodsA total of 9889 completed assessments from a community sample of help-seeking health professionals who engaged with the Digital Mental Health Check-Up between May 2020 and December 2021 were examined. Users had the option to complete the Distress Questionnaire (DQ-5), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7), Oldenburg Burnout Inventory (OLBI-16), Work and Social Adjustment Scale (WSAS), Post-traumatic Stress Disorder Checklist (PCL-5), as well as provide demographic information on their gender, age, and profession.ResultsUsers were mostly women (85.7%) aged between 25 and 54 (73.7%). Nursing was the most reported profession (32.6%), followed by allied health (27.5%) and doctors (21.9%). Notably, 8.1% of users reported being in medical administration roles. Mental health measures were poor across all measures and professions and worse than would be expected from the general population. Disengagement (92.5%) from burnout and impaired social and occupational functioning (75%) were also notably high. Use of the DQ-5 as a screening tool in the Digital Mental Health Check-Up was confirmed through correlation with clinically significance scoring on all other measures and increased likelihood of opting to complete other optional measures following clinically significant scoring on the DQ-5.ConclusionsThe present study indicates good usage of the TEN digital components among Australian health professionals, with use across all professional categories. While self-selection bias is inherent in the sample, mental health measures were notably poor – particularly for burnout. Such findings highlight the continued need to provide mental health support to health professionals both during and after the eventual resolution of the COVID-19 pandemic, as well as to develop better support for health professionals experiencing burnout.

#3213 PATIENT ACTIVATION STATUS AND PATIENT PERCEIVED FUNCTION IMPAIRMENT IN CKD: A ROUTE TO OPTIMISING LIFE PARTICIPATION THROUGH ENHANCED SELF-MANAGEMENT?

Abstract Background and Aims Chronic kidney disease (CKD), even at earlier stages where kidney replacement therapy is not required, is associated with significant health and symptom burdens which negatively impact on an individual's functional status and ability to fully engage with work, leisure, and social activities. Life participation can be maximized with optimal day-to-day management of CKD. A strong partnership between the healthcare team and patient is required to support effective self-management. Central to this partnership is patient activation, defined as the knowledge, skills, and confidence to manage one's own health. Individuals who are highly activated take an active role in their health, whilst those with low activated have a more passive role. Higher activation is associated with better clinical outcomes. As part of a wider survey in people living with non-dialysis CKD (ND-CKD), we explored the relationship between patient activation and perceived functional impairment as a result of CKD. Method 14 hospital sites across England invited patients with ND-CKD to complete a survey on health and lifestyle factors including demographic and clinical information, the SF-12 health-related quality of life (QoL) questionnaire, Chalder Fatigue Scale, Patient Activation Measure (PAM-13), and Work and Social Adjustment Scale (WSAS). Participants were classified as having ‘low’ or ‘high’ activation based on their PAM-13 level (Levels 1&amp;2 ‘low’; 3&amp;4 ‘high’). Higher WSAS scores indicated greater perceived functional impairment due to CKD. To compare perceived impairment in WSAS domains between low and high activated participants, Mann-Whitney tests were conducted. To determine the relationship between participant characteristics (i.e., age, gender, ethnicity, eGFR, patient activation, fatigue, physical and mental QoL) and WSAS score, linear regression was performed. Results 828 ND-CKD patients completed the survey [mean age 67.9 (±13.8) years, 60% (n = 501) male, 92% White British (n = 771), eGFR 33.1 (±19.7) ml/min/1.732, total number of additional comorbidities 2.0 (±1.5)]. 64% (n = 529) of participants were classified as having ‘low’ activation. The mean WSAS score was 7.8 (±9.9) indicating mild functional impairment. Both high and low PAM groups perceived social and leisure activities (with other people e.g., outings/dating/parties) to be their most impaired functional activities, and close relationships with others as least impaired. Low activated participants perceived greater impairment on work (P = 0.035), home management (P&amp;lt;0.001), social leisure activities (P&amp;lt;0.001), private leisure activities (P&amp;lt;0.001) and close relationships (P&amp;lt;0.001) as a result of their CKD compared to those with higher activation. Individuals who perceived greater functional impairments were younger (P&amp;lt;0.001), had lower levels of activation (P = 0.036), poorer physical (P&amp;lt;0.001) and mental (P = 0.043) QoL, and greater levels of fatigue (P = 0.001). Conclusion People with lower patient activation perceived greater functional impairment to work, leisure, and social activities as a result of their CKD. Younger people may have greater expectations as to what they can functionally achieve and the marked impact in comparison to their peers without CKD may be greater and more prominent. Conversely, older individuals may be more likely to attribute functional impairments to other age-associated comorbidities or to the effects of aging itself than to CKD. Interventions designed to increase patient activation and improve psychosocial adjustment have the potential to help individuals manage their CKD and reduce the perceived impairment on life participation.