2020 |
Brehaut E, Neupane D, Levis B, Wu Y, Sun Y, Krishnan A, et al., 'Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis', Journal of Psychosomatic Research, 139 (2020) [C1]
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2020 |
Wu Y, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, et al., 'Erratum: Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis - ERRATUM (Psychological medicine (2020) 50 8 (1368-1380))', Psychological medicine, 50 2816 (2020)
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2020 |
Wu Y, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, et al., 'Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: A systematic review and individual participant data meta-analysis', Psychological Medicine, 50 1368-1380 (2020) [C1]
Copyright © Cambridge University Press 2019. Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it i... [more]
Copyright © Cambridge University Press 2019. Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.Methods We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.Results 16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).Conclusions PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
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2020 |
Levis B, Benedetti A, Ioannidis JPA, Sun Y, Negeri Z, He C, et al., 'Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis', Journal of Clinical Epidemiology, 122 115-128. (2020) [C1]
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2020 |
He C, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, et al., 'The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis', Psychotherapy and Psychosomatics, 89 25-37 (2020) [C1]
© 2019 S. Karger AG, Basel. All rights reserved. Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9... [more]
© 2019 S. Karger AG, Basel. All rights reserved. Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results. Objective: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of =10. Methods: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview. Results: Data were included for 54 of 72 identified eligible studies (n participants = 16,688, n cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22-0.24 lower compared to fully structured interviews and 0.06-0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of =10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82-0.92) and 0.86 (0.82-0.88). Conclusions: The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.
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2020 |
Wu Y, Levis B, Sun Y, Krishnan A, He C, Riehm KE, et al., 'Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale Depression subscale scores: An individual participant data meta-analysis of 73 primary studies', Journal of Psychosomatic Research, 129 (2020)
© 2019 Elsevier Inc. Objective: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people... [more]
© 2019 Elsevier Inc. Objective: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Methods: Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed. We fit binomial generalized linear mixed models to compare odds of major depression classification for the Structured Clinical Interview for DSM (SCID), Composite International Diagnostic Interview (CIDI), and Mini International Neuropsychiatric Interview (MINI), controlling for HADS-D scores and participant characteristics with and without an interaction term between interview and HADS-D scores. Results: There were 15,856 participants (1942 [12%] with major depression) from 73 studies, including 15,335 (97%) non-psychiatric medical patients, 164 (1%) partners of medical patients, and 357 (2%) healthy adults. The MINI (27 studies, 7345 participants, 1066 major depression cases) classified participants as having major depression more often than the CIDI (10 studies, 3023 participants, 269 cases) (adjusted odds ratio [aOR] = 1.70 (0.84, 3.43)) and the semi-structured SCID (36 studies, 5488 participants, 607 cases) (aOR = 1.52 (1.01, 2.30)). The odds ratio for major depression classification with the CIDI was less likely to increase as HADS-D scores increased than for the SCID (interaction aOR = 0.92 (0.88, 0.96)). Conclusion: Compared to the SCID, the MINI may diagnose more participants as having major depression, and the CIDI may be less responsive to symptom severity.
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2018 |
Levis B, Benedetti A, Riehm KE, Saadat N, Levis AW, Azar M, et al., 'Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews', BRITISH JOURNAL OF PSYCHIATRY, 212 377-385 (2018) [C1]
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2016 |
White J, Magin P, Attia J, Sturm J, McElduff P, Carter G, 'Predictors of health-related quality of life in community-dwelling stroke survivors: A cohort study', Family Practice, 33 382-387 (2016) [C1]
© The Author 2016. Published by Oxford University Press. All rights reserved. Background. Impaired health-related quality of life (HRQoL) post stroke is common, though prevalence ... [more]
© The Author 2016. Published by Oxford University Press. All rights reserved. Background. Impaired health-related quality of life (HRQoL) post stroke is common, though prevalence estimates vary considerably. Few longitudinal studies explore post-stroke patterns of HRQoL and factors contributing to their change over time. Accurately identifying HRQoL after stroke is essential to understanding the extent of stroke effects. Objectives. This study aimed to assess change in levels of, and identify independent predictors of, HRQoL over the first 12-months post-stroke. Methods. Design. A prospective cohort study. Setting and participants. Community-dwelling stroke survivors in metropolitan Newcastle, New South Wales (NSW), Australia. Consecutively recruited stroke patients (n = 134) participated in face-to-face interviews at baseline, 3, 6, 9 and 12 months. Outcome measure. HRQoL (measured using the Assessment Quality-of-life).Independent measures. Physical and psycho-social functioning, including depression and anxiety (measured via Hospital Anxiety and Depression Scale), disability (Modified Rankin Scale), social support (Multi-dimensional Scale Perceived Social Support) and community participation (Adelaide Activities Profile).Analyses. A linear mixed model was used to establish the predictors of, change in HRQoL over time. Results. On multivariable analysis, HRQOL did not change significantly with time post-stroke. Higher HRQoL scores were independently associated with higher baseline HRQoL (P = 0.03), younger age (P = 0.006), lower disability (P = 0.003), greater community participation (P = 0.001) and no history of depression (P = 0.03). Conclusion. These results contribute to an understanding of HRQoL in the first year post-stroke. Community participation and stroke-related disability are potentially modifiable risk factors affecting post-stroke HRQoL. Interventions aimed at addressing participation and disability post-stroke should be developed and tested.
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2016 |
Ward SK, Turner A, Hambridge JA, Halpin SA, Valentine ME, Sweetapple AL, et al., 'Group cognitive behavioural therapy for stroke survivors with depression and their carers', Topics in Stroke Rehabilitation, 23 358-365 (2016) [C1]
© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: Depression in stroke survivors is common, leads to poorer outcomes and often not treated. A group c... [more]
© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: Depression in stroke survivors is common, leads to poorer outcomes and often not treated. A group cognitive behavioural therapy (CBT) program (Brainstorm) for stroke survivors with depression, and their carers has been running as part of usual care since 2007. Objective: To evaluate the implementation and acceptability of Brainstorm, a closed group intervention consisting of up to 10 sessions of education, activity planning, problem solving and thought challenging. Methods: Participating stroke survivors and their carers complete assessment measures at baseline, posttreatment and 1-month and 6-months follow-up. A mixed models for repeated measures data was conducted with depression and anxiety scores for stroke survivors (Beck Depression Inventory-II; Hospital Anxiety and Depression Scale) and the assessment of depression, anxiety and carer burden for carers. Acceptability was assessed by session attendance and written and open participant feedback upon completion of the program. Results: Forty-eight community dwelling stroke survivors and 34 carers attended Brainstorm, with a median attendance of 88% of sessions. Follow-up assessments were completed by 77% (post-treatment), 46% (1-month) and 38% (6-month) of stroke survivors. Stroke survivors¿ depression scores decreased from baseline to posttreatment (p<.001); maintained at 1-month (p<.001) but not at 6-month (p=.056). Anxiety scores decreased between baseline and 1-month (p=.013). Carer burden, depression and anxiety scores at 1-month and 6-month follow-up, for carers, were all reduced when compared with baseline (p<.05). Conclusion: The Brainstorm group intervention for depression in stroke survivors appears to have been effectively implemented and is acceptable to stroke survivors and carers.
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2015 |
White JH, Bartley E, Janssen H, Jordan LA, Spratt N, 'Exploring stroke survivor experience of participation in an enriched environment: A qualitative study', Disability and Rehabilitation, 37 593-600 (2015) [C1]
© 2014 Informa UK Ltd. All rights reserved. Background: Data highlight the importance of undertaking intense and frequent repetition of activities within stroke rehabilitation to ... [more]
© 2014 Informa UK Ltd. All rights reserved. Background: Data highlight the importance of undertaking intense and frequent repetition of activities within stroke rehabilitation to maximise recovery. An enriched environment (EE) provides a medium in which these activities can be performed and enhanced recovery achieved. An EE has been shown to promote neuroplasticity in animal models of stroke, facilitating enhanced recovery of motor and cognitive function. However, the benefit of enriching the environment of stroke survivors remains unknown. Aim: To qualitatively explore stroke survivors' experience of implementation of exposure to an EE within a typical stroke rehabilitation setting, in order to identify facilitators and barriers to participation. Methods: Semi-structured interviews with 10 stroke survivors (7 females and 3 males, mean age of 70.5 years) exposed to an EE for a 2-week period following exposure to routine rehabilitation within a stroke rehabilitation ward. An inductive thematic approach was utilised to collect and analyse data. Results: Qualitative themes emerged concerning the environmental enrichment paradigm including: (1) "It got me moving"-perceived benefits of participation in an EE; (2) "You can be bored or you can be busy."-Attenuating factors influencing participation in an EE; (3) "I don't like to make the staff busier"-limitations to use of the EE. Conclusions: This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective. Reported benefits included (1) increased motor, cognitive and sensory stimulation, (2) increased social interaction, (3) alleviation of degree of boredom and (4) increased feelings of personal control. However, participants also identified a number of barriers affecting implementation of the EE. We have previously published findings on perceptions of nursing staff working with stroke survivors in this enriched rehabilitation environment who identified that patients benefited from having better access to physical, cognitive and social activities. Together, results contribute to valuable evidence for future implementation of an EE in stroke rehabilitation settings.Implications for RehabilitationStroke survivor access to an enriched environment (EE):Results identified that participation in both individual and communal forms of environment enrichment within the stroke rehabilitation ward resulted in increased access to activities providing increased opportunities for enhanced motor, cognitive and sensory stimulation.Increased access to and participation in activities of the environmental enrichment (individual and communal) interrupted the ongoing cycle of boredom and inactivity experienced by many participants.This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective.
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2015 |
White JH, Janssen H, Jordan L, Pollack M, 'Tablet technology during stroke recovery: A survivor's perspective', Disability and Rehabilitation, 37 1186-1192 (2015) [C1]
© 2014 Informa UK Ltd. All rights reserved. Background: Clinician interest in the role of tablet technology in commercially available tablet devices (i.e. iPads) following stroke ... [more]
© 2014 Informa UK Ltd. All rights reserved. Background: Clinician interest in the role of tablet technology in commercially available tablet devices (i.e. iPads) following stroke is rising. Tablets have the potential to encourage engagement in therapeutic activities. We aimed to explore stroke survivor acceptability of and experience of tablet use during the first three months of stroke recovery. Design: A qualitative study using an inductive thematic approach incorporating the process of constant comparison was utilized to collect and analyse data. Setting: Community dwelling stroke survivors in metropolitan Newcastle, New South Wales, Australia. Participants: Twelve stroke survivors (8 male, 4 female; median age of 73 (IQR 58-83) years). Main outcome measures: Qualitative outcomes were participants' perceptions using in-depth, semi-structured interviews. Results: Participants' found tablets easy to use and beneficial. Most stroke survivors used the tablet to engage in therapeutic and leisure activities on most days during the three months. Three key themes emerged: (1) Getting established on the iPad: "It just became easier and easier", (2) Technology as a means for increased stimulation: "Something to keep me interested", and (3) Personal experiences of access to an iPad: "It's been very helpful". Conclusions: Incorporating tablet technology into the delivery of stroke rehabilitation appears to be feasible and acceptable at a patient level. This process has the potential to improve participation in therapeutic and or leisure; however further evaluation towards the impact of tablet technology on patient outcome and quality of life is required.
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2014 |
White JH, Patterson K, Jordan L-A, Magin P, Attia J, Sturm JW, 'The experience of urinary incontinence in stroke survivors: A follow-up qualitative study', CANADIAN JOURNAL OF OCCUPATIONAL THERAPY-REVUE CANADIENNE D ERGOTHERAPIE, 81 124-134 (2014) [C1]
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2014 |
White J, Dickson A, Magin P, Tapley A, Attia J, Sturm J, Carter G, 'Exploring the experience of psychological morbidity and service access in community dwelling stroke survivors: a follow-up study', DISABILITY AND REHABILITATION, 36 1600-1607 (2014) [C1]
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2014 |
White JH, Attia J, Sturm J, Carter G, Magin P, 'Predictors of depression and anxiety in community dwelling stroke survivors: A cohort study', Disability and Rehabilitation, 36 1975-1982 (2014) [C1]
© 2014 Informa UK Ltd. Purpose: Few longitudinal studies explore post-stroke patterns of psychological morbidity and factors contributing to their change over time. We aimed to ex... [more]
© 2014 Informa UK Ltd. Purpose: Few longitudinal studies explore post-stroke patterns of psychological morbidity and factors contributing to their change over time. We aimed to explore predictors of post-stroke depression (PSD) and post-stroke anxiety over a 12-month period. Methods: A prospective cohort study. Consecutively recruited stroke patients (n=134) participated in face-to-face interviews at baseline, 3, 6, 9, and 12 months. Primary outcome measures were depression and anxiety (measured via Hospital Anxiety and Depression Scale). Independent variables included disability (Modified Rankin Scale), Quality-of-life (Assessment Quality-of-life), social support (Multi-dimensional Scale Perceived Social Support) and community participation (Adelaide Activities Profile (AAP)). Secondary outcomes were predictors of resolution and development of PSD and anxiety. Results: Anxiety (47%) was more common than depression (22%) at baseline. Anxiety (but not depression) scores improved over time. Anxiety post-stroke was positively associated with baseline PSD (p<0.0001), baseline anxiety (p<0.0001) and less disability (p=0.042). PSD was associated with baseline anxiety (p<0.0001), baseline depression (p=0.0057), low social support (p=0.0161) and low community participation (p<0.0001). The only baseline factor predicting the resolution of PSD (if depressed at baseline) was increased social support (p=0.0421). Factors that predicted the onset of depression (if not depressed at baseline) were low community participation (p=0.0015) and higher disability (p=0.0057). Conclusion: While more common than depression immediately post-stroke, anxiety attenuates while the burden of depression persists over 12 months. Clinical programs should assess anxiety and depression, provide treatment pathways for those identified, and address modifiable risk factors, especially social support and social engagement.Implications for RehabilitationPsychological distress post stroke is persisting.Multi-disciplinary teams that establish goals with patients promoting social and community engagement could assist in managing psychological morbidity.A shift towards promoting longer-term monitoring and management of stroke survivors must be undertaken, and should consider the factors that support and hinder psychological morbidity.
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2014 |
White JH, Alborough K, Janssen H, Spratt N, Jordan L, Pollack M, 'Exploring staff experience of an "enriched environment" within stroke rehabilitation: a qualitative sub-study.', Disabil Rehabil, 36 1783-1789 (2014) [C1]
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2013 |
White JH, Towers SE, Turner A, Hambridge J, 'Electronic Screening and Decision Support for Poststroke Depression: An Exploration of Doctors' and Patients' Perceptions of Acceptability', ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 94 788-790 (2013) [C1]
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2013 |
White JH, Bynon BL, Marquez J, Sweetapple A, Pollack M, ''Masterstroke: a pilot group stroke prevention program for community dwelling stroke survivors'', DISABILITY AND REHABILITATION, 35 931-938 (2013) [C1]
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2012 |
Turner A, Hambridge J, White JH, Carter GL, Clover K, Nelson LJ, Hackett M, 'Depression screening in stroke: A comparison of alternative measures with the structured diagnostic interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Major Depressive Episode) as criterion standard', Stroke, 43 1000-1005 (2012) [C1]
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2012 |
White JH, Gray KR, Magin PJ, Attia JR, Sturm J, Carter G, Pollack M, 'Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: A prospective qualitative study', Disability and Rehabilitation, 34 1376-1384 (2012) [C1]
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2012 |
White JH, Miller B, Magin PJ, Attia JR, Sturm J, Pollack M, 'Access and participation in the community: A prospective qualitative study of driving post-stroke', Disability and Rehabilitation, 34 831-838 (2012) [C1]
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2012 |
White JH, Magin PJ, Attia JR, Sturm J, Carter GL, Pollack M, 'Trajectories of psychological distress after stroke', Annals of Family Medicine, 10 435-442 (2012) [C1]
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2012 |
Janssen H, Ada L, Karayanidis F, Drysdale K, McElduff P, Pollack MR, et al., 'Translating the use of an enriched environment poststroke from bench to bedside: study design and protocol used to test the feasibility of environmental enrichment on stroke patients in rehabilitation', International Journal of Stroke, 7 521-526 (2012) [C3]
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2011 |
Beesley K, White JH, Alston MK, Sweetapple AL, Pollack M, 'Art after stroke: The qualitative experience of community dwelling stroke survivors in a group art programme', Disability and Rehabilitation, 33 2346-2355 (2011)
Purpose This study aimed to qualitatively explore the experience of community dwelling stroke survivors participation in an arts health group programme and possible health benefit... [more]
Purpose This study aimed to qualitatively explore the experience of community dwelling stroke survivors participation in an arts health group programme and possible health benefits to quality of life (QOL) and wellbeing. Method.Sixteen participants were conveniently sampled to participate in two group art programmes, both held weekly over a period of 8 weeks. Qualitative data were collected through two focus groups (n = 9) and individual interviews (n = 11). Qualitative analysis of the data was undertaken, using a grounded theory approach incorporating constant comparison. Results.Age ranged from 43 to 81 years. Four themes emerged including: experience of stroke, benefit of art, benefit for self and benefit of group experience. Participants experienced improved confidence, self-efficacy, QOL and community participation through involvement in an arts health programme. Conclusions.The implementation of an arts health programme after stroke made a substantial impact on well-being and QOL. Results from this study are promising and this is a model that warrants rigorous investigation regarding the impact of art on QOL and wellbeing. This study also highlighted the need for community resources to address community re-integration and service provision in the form of age appropriate, activity-based groups for stroke survivors. © 2011 Informa UK, Ltd.
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2010 |
Marsden D, Quinn R, Pond N, Golledge R, Neilson C, White J, et al., 'A multidisciplinary group programme in rural settings for community-dwelling chronic stroke survivors and their carers: A pilot randomized controlled trial', Clinical Rehabilitation, 24 328-341 (2010) [C1]
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2009 |
White JH, Magin PJ, Pollack MR, 'Stroke patients' experience with the Australian health system: A qualitative study', Canadian Journal of Occupational Therapy, 76 81-89 (2009) [C1]
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2008 |
White JH, Mackenzie LA, Magin PJ, Pollack MR, 'The occupational experience of stroke survivors in a community setting', OTJR: Occupation, Participation and Health, 28 160-167 (2008) [C1]
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2008 |
White JH, Magin PJ, Attia JR, Pollack MR, Sturm J, Levi CR, 'Exploring poststroke mood changes in community-dwelling stroke survivors: A qualitative study', Archives of Physical Medicine and Rehabilitation, 89 1701-1707 (2008) [C1]
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2007 |
White JH, Pollack M, Nair BR, D'Este C, 'Trends in post-stroke functional independence over a 5-year period: A pilot study', INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION, 14 404-407 (2007)
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2007 |
White JH, Alston MK, Marquez JL, Sweetapple AL, Pollack MR, Attia JR, et al., 'Community-Dwelling Stroke Survivors: Function Is Not the Whole Story With Quality of Life', Archives of Physical Medicine and Rehabilitation, 88 1140-1146 (2007) [C1]
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