Dissemination of effective mental health treatment procedures: Maximizing the return on a significant investment

While much is known about the efficacy of evidence-based practices, it is currently less clear how to implement these practices into the broader mental health system. Dissemination and implementation research will play a critical role in addressing this uncertainty. This commentary reviews the most recent and compelling research related to these topics while advocating a broader and more defined perspective of dissemination for future research. Three of the authors' most pressing questions are proposed and explored.     

A Longitudinal Study of Coping Strategies and Quality of Life Among People with Multiple Sclerosis

The current study was designed to examine the role of coping strategies on quality of life (QOL) of people with multiple sclerosis (MS) over a period of 12 months. Respondents were 321 people with MS and 239 people from the general population who completed measures of QOL on two occasions, 12 months apart. People with MS also completed measures of how they coped with their illness. The results demonstrated that people with MS experienced lower levels of QOL at both points in time. For people with MS, QOL domains strongly predicted other QOL domains at both time 1 and time 2. The coping strategies of social support, focusing on the positive and wishful thinking were consistent predictors of physical QOL, psychological QOL, social QOL and environmental QOL. These findings indicate that coping strategies play an important role in predicting the QOL of people with MS.     

Cognition,daily living,and health-related quality of life in 85-year-olds in Sweden

ABSTRACT

This study investigates how cognition influences activities of daily living and health-related quality of life in 85-year-olds in Sweden (n?=?373). Data collection included a postal questionnaire comprising demographics and health-related quality of life measured by the EQ-5D. The ability to perform personal activities of daily living (PADL) was assessed during a home visit that included administering the Mini Mental State Examination (MMSE). Cognitive impairment was shown in 108 individuals (29%). The majority were independent with respect to PADL. A larger number of participants with cognitive impairment reported that they needed assistance in instrumental activities of daily living (IADL) compared to the group without cognitive impairment. Impaired cognition was significantly related to problems with IADL. Significant but low correlations were found between cognition and health-related quality of life – higher ratings on perceived quality of life correlated with higher results on the MMSE.     

Quality of life: A Psychological analysis

Quality of life (QOL) is an amorphous concept; it is normative and value laden. Economists’ emphasis on the standard of living brings into focus the value of growth, expansion and acceleration. Financial status is important but has limited impact on feelings of happiness. The subjective experiences (e.g. wellbeing, cheerfulness, satisfaction, contentment, empathy, faith, wisdom and purpose in life) complement the economist’s concept of standard of living. The criteria for determining the QOL may relate to adaptive mechanisms one employs in everyday life. Dispositions of altruism, sublimation, humor, empathy, optimism, and wisdom also contribute to the QOL. It appears that QOL is essentially a cultural concept overflowing both economics and psychology. Non-Western approaches such as Chinese, Buddhist, Hindu thought, have proposed balancing as a key factor in QOL. The highest quality of life is one in which one transcends dualism in life, namely happiness — sorrow, pleasure — pain, love — hate, etc and cultivate the capacity to remain unassailed by the dualities, rather than that of balance. We need to attend to the views of humanistic disciplines and examine the issue of QOL in the context of the world view one holds.     

Changes in health status after one year for persons at-risk for and with HIV infection

Abstract

Health status is an important component of the evaluation of patient outcome in HIV infection where disease is chronic, progressive, and debilitating. This paper compares patient self-report for 9 dimensions of health status for patients followed in ATHOS (AIDS Time-Oriented Health Outcome Study). We compared changes in functioning after 12 months for 1, 524 patients with varying HIV disease severity: 238 asymptomatic, 447 symptomatic, 441 AIDS, and 398 HIV-negative individuals who are at-risk for infection.

Declines in health status were observed for all HIV-infected persons, including also asymptomatic patients. Individuals with symptomatic disease or AIDS had significant declines (p < 0.001) in physical functioning, energy, global health, pain, and increased disease symptoms, but no significant declines in health distress, cognition, or mental health. Persons with AIDS had greater declines than those with symptomatic disease. All HIV-infected individuals reported significantly fewer hours at work and more disability days than HIV-negative patients from similar risk pools. The adverse impact that HIV infection has on the health status of HIV-positive asymptomatic individuals is striking; HIV-negative individuals are more similar to HIV-positive individuals than to the general population.     

Vers une prise en charge des troubles cognitifs des patients atteints de cancer

Cancer and its treatments can have deleterious effects on cognitive function and a negative impact on the patient's quality of life. This work proposed a review of the different studies that have been implemented to deal with or prevent cognitive impairment in patients suffering from cancer. Two dissociated but complementary approaches emerge in patients support: a pharmacological approach and a psychological approach, in the form of cognitive rehabilitation. Despite a growing interest of researchers in this issue, we note that many practical and methodological problems persist; results remain therefore difficult to generalize. We hope that our reflections on the support of cognitive disorders in oncology will help the development of new research in this field considered very important by patients.     

Personal and appearance-based rejection sensitivity in body dysmorphic disorder

Although rejection sensitivity may be an important feature of body dysmorphic disorder (BDD), no studies have examined rejection sensitivity in a clinical sample and compared types of rejection sensitivity in individuals with BDD. Personal and appearance-based rejection sensitivity scores in forty-six patients diagnosed with BDD were compared with published norms. Associations between rejection sensitivity, BDD severity, and other clinical variables were examined. Personal and appearance-based rejection sensitivity scores were 0.6 and 1.1 standard deviation units above published norms, respectively. Greater personal rejection sensitivity was associated with more severe BDD and depressive symptoms, poorer mental health, general health, and physical and social functioning. Greater appearance-based rejection sensitivity was associated with more severe BDD and depressive symptoms, and poorer general health. Appearance-based rejection sensitivity contributed more unique variance to BDD severity than personal rejection sensitivity did; however, personal rejection sensitivity contributed more unique variance to general health than appearance-based rejection sensitivity did.     

Predictive factors of quality of life in acquired brain injury

Background/ObjectiveThe sequelae and the disability and dependence that follow an acquired brain injury (ABI) may result in a significant reduction in the quality of life (QoL) of those affected. The objective was to assess the QoL of a sample of Spanish patients with an ABI and analyze the influence of certain sociodemographic and injury-related variables on their QoL. Method: The sample comprised 421 adults (60% male; M_age = 53.12; SD = 14.87). Professionals and relatives assessed the patients’ QoL through the CAVIDACE scale, an ABI-specific tool based on the eight-domain QoL model. Results: Univariate analyses showed statistically significant differences in the QoL scores in several sociodemographic (age, civil status, education level, prior employment status, type of home, level of supports, loss of legal capacity, recognized dependence, and degree of dependence) and injury-related (time since the injury, location of the injury, and presence of post-traumatic amnesia) variables. The multiple linear regression showed that loss of legal capacity, time since the injury, prior employment status, location of the injury, and degree of dependence were significant QoL predictors. Conclusions: These findings provide knowledge for the development of programs aimed at reducing the negative impact of ABI on QoL.