Gradations of clinical severity and sensitivity to change assessed with the Beck Depression Inventory-II in Japanese patients with depression.
ABSTRACT Knowledge of what constitutes a minimal clinically important difference and change on a psychiatric rating scale is essential in interpreting its scores. The present study examines the Beck Depression Inventory-II (BDI-II), a recently revised successor to the world's most popular self-rating instrument for depression. BDI-II was administered to 85 patients with major depression, diagnosed with DSM-IV along with its severity specifiers. It was again administered to 40 first-visit patients from the original sample when they returned 14 or more days later. The Clinical Global Impression-Change Scale was rated at the same time. All the ratings were done independent of each other. The BDI-II was able to distinguish between all grades of depression severity. An approximate 10-point difference existed between each severity specifier. The BDI-II was also sensitive to change in depression: a 5-point difference corresponded to a minimally important clinical difference, 10-19 points to a moderate difference, and 20 or more points to a large difference. Given the already established high reliability, content validity, construct validity and factorial validity, and the high sensitivity to between-subject differences and within-subject changes demonstrated in the present study, the BDI-II promises to continue to be a leading self-rating instrument to assess depression severity worldwide.
- [Show abstract] [Hide abstract]
ABSTRACT: Purpose Depressive symptoms have been identified as a significant risk factor for prolonged disability, however, little is known about the process by which depression impacts recovery following work-related musculoskeletal disorders (WRMDs). The primary objective of this study was to examine whether recovery expectancies mediate the relation between depression and return-to-work (RTW) status in individuals with WRMDs. Methods A sample of 109 patients with WRMDs were recruited from 1 of 6 primary care physiotherapy clinics. Participants completed measures of pain severity, depression and recovery expectancies. RTW status was assessed by telephone interview 1 year after the initial assessment. Results Consistent with previous research, more severe depressive symptoms and lower recovery expectancies were associated with a lower probability of RTW. Logistic regression analyses revealed that recovery expectancies completely mediated the relation between depression and RTW status at 1-year follow-up. Conclusion The results suggest that interventions specifically targeting recovery expectancies in individuals with WRMDs and depressive symptoms might improve RTW outcomes.Journal of Occupational Rehabilitation 09/2014; 25(2). DOI:10.1007/s10926-014-9543-4 · 2.80 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To determine the effectiveness and cost-effectiveness of non-invasive interventions for temporomandibular disorders (TMD). We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central register from 1990 to 2014 for effectiveness studies and the Cochrane Health Technology Assessment Database, EconLit, NHS Economic Evaluation Database, and Tufts Medical Center Cost-effectiveness Analysis Register from 1990 to 2014 for cost-effectiveness studies. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Evidence from eligible studies was synthesized using best-evidence synthesis methodology. Our search for effectiveness studies yielded 16,995 citations; 31 were relevant and seven RCTs (published in 8 articles) had a low risk of bias. We found no relevant cost-effectiveness studies. The evidence suggests that for persistent TMD: (1) cognitive behavioural therapy and self-care management lead to similar improvements in pain and disability but cognitive behavioural therapy is more effective for activity interference and depressive symptoms; (2) cognitive behavioral therapy combined with usual treatment provides short-term benefits in pain and ability to control pain compared to usual treatment alone; (3) intraoral myofascial therapy may reduce pain and improve jaw opening; and (4) structured self-care management may be more effective than usual treatment. The evidence suggests that occlusal devices may not be effective in reducing pain and improving motion for TMD of variable duration. Evidence on the effectiveness of biofeedback is inconclusive. The available evidence suggests that cognitive behavioral therapy, intraoral myofascial therapy and self-care management are therapeutic options for persistent TMD.The Clinical journal of pain 04/2015; DOI:10.1097/AJP.0000000000000247 · 2.70 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Empirical support for cognitive behavioral therapy (CBT) for treating Japanese patients with major depression is lacking, therefore, a feasibility study of CBT for depression in Japanese clinical settings is urgently required. A culturally adapted, 16-week manualized individual CBT program for Japanese patients with major depressive disorder was developed. A total of 27 patients with major depression were enrolled in a single-group study with the purpose of testing the feasibility of the program. Twenty six patients (96%) completed the study. The mean total score on the Beck Depression Inventory-II (BDI-II) for all patients (Intention-to-treat sample) improved from 32.6 to 11.7, with a mean change of 20.8 (95% confidence interval: 17.0 to 24.8). Within-group effect size at the endpoint assessment was 2.64 (Cohen's d). Twenty-one patients (77.7%) showed treatment response and 17 patients (63.0%) achieved remission at the end of the program. Significant improvement was observed in measurement of subjective and objective depression severity (assessed by BDI-II, Quick Inventory of Depressive Symptomatology-Self Rated, and Hamilton Depression Rating Scale), dysfunctional attitude (assessed by Dysfunctional Attitude Scale), global functioning (assessed by Global Assessment of Functioning of DSM-IV) and subjective well-being (assessed by WHO Subjective Well-being Inventory) (all p values < 0.001). Our manualized treatment comprised of a 16-week individual CBT program for major depression appears feasible and may achieve favorable treatment outcomes among Japanese patients with major depression. Further research involving a larger sample in a randomized, controlled trial design is warranted. UMIN-CTR UMIN000002542.BMC Research Notes 06/2010; 3:160. DOI:10.1186/1756-0500-3-160