Abstract:
BACKGROUND:Improving the quality of mental health care requires integrating successful research interventions into 'real-world' practice settings. Coordinated Anxiety Learning and Management (CALM) is a treatment-delivery model for anxiety disorders encountered in primary care. CALM offers cognitive behavioral therapy (CBT), medication, or both; non-expert care managers assisting primary care clinicians with adherence promotion and medication optimization; computer-assisted CBT delivery; and outcome monitoring. This study describes incremental benefits, costs and net benefits of CALM versus usual care (UC). METHOD:The CALM randomized, controlled effectiveness trial was conducted in 17 primary care clinics in four US cities from 2006 to 2009. Of 1062 eligible patients, 1004 English- or Spanish-speaking patients aged 18-75 years with panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD) and/or post-traumatic stress disorder (PTSD) with or without major depression were randomized. Anxiety-free days (AFDs), quality-adjusted life years (QALYs) and expenditures for out-patient visits, emergency room (ER) visits, in-patient stays and psychiatric medications were estimated based on blinded telephone assessments at baseline, 6, 12 and 18 months. RESULTS:Over 18 months, CALM participants, on average, experienced 57.1 more AFDs [95% confidence interval (CI) 31-83] and $245 additional medical expenses (95% CI $-733 to $1223). The mean incremental net benefit (INB) of CALM versus UC was positive when an AFD was valued ≥$4. For QALYs based on the Short-Form Health Survey-12 (SF-12) and the EuroQol EQ-5D, the mean INB was positive at ≥$5000. CONCLUSIONS:Compared with UC, CALM provides significant benefits with modest increases in health-care expenditures.
journal_name
Psychol Medjournal_title
Psychological medicineauthors
Joesch JM,Sherbourne CD,Sullivan G,Stein MB,Craske MG,Roy-Byrne Pdoi
10.1017/S0033291711002893subject
Has Abstractpub_date
2012-09-01 00:00:00pages
1937-48issue
9eissn
0033-2917issn
1469-8978pii
S0033291711002893journal_volume
42pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Schizophrenia is associated with perceptual organization deficits and abnormal neuronal connectivity has been described in early visual areas. The purpose of this study was to investigate the functional integrity of lateral connections in early visual areas of patients with schizophrenia and type I bipolar d...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291705004381
更新日期:2005-07-01 00:00:00
abstract::The validity and reliability of an empirically defined fatigue syndrome were tested in a prospective cohort study of 245 primary care patients, with glandular fever or an upper respiratory tract infection. Subjects were interviewed three times in the 6 months after onset. Subjects with the empirically defined fatigue ...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291700037405
更新日期:1995-09-01 00:00:00
abstract::Recent studies have suggested that expanded CAG/CTG repeats contribute to the genetic aetiology of schizophrenia and bipolar disorder. However, the nature of this contribution is uncertain and difficult to predict from other known trinucleotide repeat diseases that display much simpler patterns of inheritance. We have...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291700035868
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Recent studies have suggested that major depressive disorders are associated with a breakdown in the organization of ultradian rhythm in sleep EEG. The present study used cross-spectral analysis of sleep EEG to confirm this finding, in a larger-scale study, evaluating the influence of gender and age on ultra...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291799001300
更新日期:1999-11-01 00:00:00
abstract::In constructing a new self-report questionnaire for measuring self esteem, the aim has been to satisfy psychometric requirements without sacrificing the intuitive meaning of the concept. Self esteem is seen as a composite, and examination of its components may have more analytic or predictive value than 'global' score...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s003329170001254x
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Sternberg's Memory Scanning Test (MST) is a useful paradigm for evaluating the speed and efficiency of information processing in working memory. Unfortunately, the classical MST has major drawbacks for use in applied settings such as the clinic. For example, its administration time is long and the test is to...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291707000360
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:A dysfunctional network of prefrontal and (para-)limbic brain region has been suggested to underlie emotional dysregulation in borderline personality disorder (BPD). Abnormal activity in this network may be due to structural alterations in white-matter tracts connecting prefrontal and (para-)limbic brain reg...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291715001142
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Although a substantial body of research points to a link between psychological distress and inflammatory responses in middle-aged and older adults, particularly those with cardiovascular disease, the relationship between inflammation and distress in young, healthy individuals has not been established. This s...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291710000267
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Few population studies have investigated the functional disabilities that accompany specific psychiatric diagnoses. This study assesses the nature and strength of current and residual impairments in various functional domains of life. METHODS:Data were derived from the Netherlands Mental Health Survey and I...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291799001841
更新日期:2000-05-01 00:00:00
abstract::The prevalence of culture-bound syndromes such as eating disorders in the countries of Central and Eastern Europe is unclear and comparative epidemiological studies are lacking. Before the political changes in 1989 we therefore investigated eating disorders, eating attitudes and psychological health in two Eastern Eur...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291700037521
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Previous studies on assortment for psychiatric disorders have reported discrepant findings. We aimed to test whether there is a significant association for psychiatric diagnoses, including alcoholism, generalized anxiety disorder, major depressive disorder, panic disorder and phobias between husbands and wiv...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291798007326
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Low IQ is a risk factor for psychosis, but the effect of high IQ is more controversial. The aim was to explore the association of childhood school success with prodromal symptoms in adolescence and psychoses in adulthood. METHODS:In the general population-based Northern Finland Birth Cohort 1986 (n = 8 229)...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291719000825
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Hypochondriasis is recognized as an important disorder in clinical populations, associated with increased health care utilization, disability and psychiatric co-morbidity. Few studies have investigated hypochondriasis in the community. We report on the broader concept of illness worry in a community populati...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291701003737
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Early life maltreatment (ELM), borderline personality disorder (BPD), and major depressive disorder (MDD) have been associated with empathy deficits in different domains. Lack of maternal empathy has also been related to child behavioral problems. As ELM, BPD, and MDD often co-occur, we aimed to identify dis...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291719001107
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Compassion-focused therapy (CFT) is a relatively novel form of psychotherapy that was developed for people who have mental health problems primarily linked to high shame and self-criticism. The aim of this early systematic review was to draw together the current research evidence of the effectiveness of CFT ...
journal_title:Psychological medicine
pub_type: 杂志文章,评审
doi:10.1017/S0033291714002141
更新日期:2015-04-01 00:00:00
abstract::Because of the potential importance of prolonged action neuroleptics for the delivery of care to schizophrenic patients, and because of the availability of new, extensive data from clinical trials on the utility of these drugs, a workshop conference was convened by the United States National Institute of Mental Health...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291700030907
更新日期:1979-05-01 00:00:00
abstract::The CANTAB battery of neuropsychological tests was used to compare the performance of 28 patients with unipolar depression with that of 22 age and IQ matched controls. The patients were impaired on almost all tests studied with deficits in pattern and spatial recognition memory, matching to sample, spatial span, spati...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291700035303
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Patient satisfaction is a key indicator of inpatient care quality and is associated with clinical outcomes following admission. Different patient characteristics have been inconsistently linked with satisfaction. This study aims to overcome previous limitations by assessing which patient characteristics are ...
journal_title:Psychological medicine
pub_type: 杂志文章,多中心研究
doi:10.1017/S0033291719000011
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Discontinuation of antipsychotics predisposes patients with remitted/stable first-episode psychosis (FEP) to a higher risk of relapse, but it remains unclear how long discontinuation increases the relapse rate in these patients compared with maintenance. METHODS:This meta-analysis of randomized controlled t...
journal_title:Psychological medicine
pub_type: 杂志文章,meta分析
doi:10.1017/S0033291718001393
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Mental stress is associated with higher mortality, but it remains controversial whether the association is causal or a consequence of a higher physical disease burden in those with a high mental stress load. Understanding causality is important when developing targeted interventions. We aimed to estimate the...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291717002380
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Impaired emotion regulation may underlie exaggerated emotional reactivity in patients with obsessive compulsive disorder (OCD), yet instructed emotion regulation has never been studied in the disorder. METHOD:This study aimed to assess the neural correlates of emotion processing and regulation in 43 medicat...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291715001026
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Many studies have reported an increased incidence of psychiatric disorder (particularly psychotic disorders) among first generation adult immigrants, along with an increasing risk for ethnic minorities living in low-minority concentration neighborhoods. These studies have depended mostly on European case-bas...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291711000213
更新日期:2011-10-01 00:00:00
abstract::Age and sex-adjusted first admission rates for operationally-defined schizophrenia and other non-affective psychosis in different ethnic groups were calculated over the period 1988-1992 in a defined catchment area in South London. Standardized rates for schizophrenia, corrected for age- and gender-related under-report...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291700033845
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Maternal depressive symptoms (MDSs) are negatively associated with children's academic performance, with stronger effects sometimes reported in boys. However, few studies have tested the mechanisms of this association. We examined the mediating role of school engagement and peer victimization in this associa...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291720004298
更新日期:2020-12-04 00:00:00
abstract:BACKGROUND:Several conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the five-factor model (FFM), the schedule for nonadaptive and adaptive personality (SNAP), ...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291711002601
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Agitated patients constitute 10% of all emergency psychiatric treatment. Management guidelines, the preferred treatment of clinicians differ in opinion and practice. In Lebanon, the use of the triple therapy haloperidol plus promethazine plus chlorpromazine (HPC) is frequently used but no studies involving t...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291720004869
更新日期:2021-01-06 00:00:00
abstract:BACKGROUND:Death by suicide is often preceded by attempted suicide, suicidal ideation and non-suicidal self-injury. These extreme thoughts and behaviours have been considered in terms of a continuum of suicidality. Little known research, however, has considered a suicide continuum that extends beyond these extreme thou...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291718003562
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Recent neurobiological models provide a possible mechanism of daily life stress directly affecting the intensity of psychotic experiences in vulnerable individuals. In order to validate such a mechanism, the impact of daily life stress on psychosis intensity was investigated in two groups at increased risk o...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s0033291704004179
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Chronic fatigue syndrome (CFS) patients often complain that they are more susceptible to acute mental fatigue. It is important to determine whether this is observed using objective tests of sustained attention and responding. METHODS:Sixty-seven patients who fulfilled the criteria for CFS proposed by Sharpe...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/s003329179800748x
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Neuroimaging studies have shown variance in brain response to emotional faces predicts cognitive behavioral therapy (CBT) outcome. An important next step is to determine if individual differences in neural predictors of CBT response represent distinct patient groups. METHODS:In total, 90 patients with inter...
journal_title:Psychological medicine
pub_type: 杂志文章
doi:10.1017/S0033291720003979
更新日期:2020-11-10 00:00:00