Jorge E. Palacios

Jorge E. Palacios
Trinity College Dublin | TCD · School of Psychology

MD, PhD

About

42
Publications
10,559
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653
Citations
Introduction
MD, PhD in Psychological Medicine from the Institute of Psychiatry, Psychology, and Neuroscience (IoPPN). Member of the e-mental health research group at Trinity College Dublin, School of Psychology. Current research focus on online interventions for mental health and long-term conditions.

Publications

Publications (42)
Article
Background As mortality from coronary heart disease (CHD) falls, years lived with disability increase. Depression and anxiety are known indicators of poor outcomes in CHD, but most research has measured distress symptoms at one time point, often following acute events. Here we consider the long-term trajectories of these symptoms in established CH...
Article
Full-text available
Background: Many university campuses have limited mental health services that cannot cope with the high demand. One alternative is to use internet-delivered cognitive behavioral therapy (iCBT) as a way of tackling barriers such as lack of availability and scheduling issues. Objective: This study aimed to assess feasibility, acceptability, effective...
Article
Full-text available
Background: Internet interventions can easily generate objective data about program usage. Increasingly, more studies explore the relationship between usage and outcomes, but they often report different metrics of use, and the findings are mixed. Thus, current evaluations fail to demonstrate which metrics should be considered and how these metrics...
Article
Background: Evidence suggests that somatic rather than cognitive depressive symptoms are risk factors for recurrent cardiac events in at-risk patients. However, this has never been explored using a time-dependent approach in a narrow time-frame, allowing for a cardiac event-free time-window. Methods: The analysis was performed on 595 participants (...
Article
Objective: To examine if chest pain increases the risk of depression and anxiety, or, on the other hand, depression and anxiety increase the risk of chest pain onset in patients with coronary heart disease (CHD). Design: Prospective clinical study. Setting: 16 general practices in the Greater London Primary Care Research Network. Participants...
Preprint
BACKGROUND Research suggests there is heterogeneity on treatment response for internet-delivered CBT (iCBT) users, but few studies have investigated the trajectory of individual symptom change across iCBT treatment. Large patient datasets using routine outcome measures provides an opportunity to investigate treatments effect over time, as well as t...
Article
Full-text available
Background: Clients independently applying Cognitive Behavior Therapy (CBT) skills is an important outcome of CBT-based treatments. The relationship between posttherapeutic CBT skills usage and clinical outcomes remains under-researched-especially after internet-delivered CBT (iCBT). Objective: Explore contemporaneous and lagged effects of postt...
Preprint
Full-text available
Background: Evidence-based treatments for depression exist but not all patients benefit from them. Efforts to develop predictive models that can assist clinicians in allocating treatments are ongoing, but there are major issues with acquiring the volume and breadth of data needed to train these models. We developed a protocol for internet-based dat...
Article
Full-text available
Objectives This study aimed to explore quality-adjusted life-year (QALY) and subsequent cost-effectiveness estimates based on the more physical health–focused EQ-5D 5-level version (EQ-5D-5L) value set for England or cross-walked EQ-5D 3-level version UK value set scores or more mental health recovery-focused Recovering Quality of Life Utility Inde...
Article
Full-text available
Purpose Generic health measures have been questioned for quantifying mental-health-related outcomes. In patients with anxiety and/or depression, our aim is to assess the psychometric properties of the preference-based EQ-5D-5L (generic health) and ReQoL-UI (recovery-focussed quality of life) for economic evaluation against the PHQ-9 (depression) an...
Article
Full-text available
Background Internet-delivered cognitive behavior therapy (iCBT) is effective in treating anxiety and depression. Research on how these interventions operate is scarce. This study explored whether emotion regulation skills and positive beliefs about rumination were affected by iCBT and if these constructs mediated changes in depression and anxiety....
Article
Full-text available
Background While the acquisition and application of Cognitive Behavior Therapy (CBT) skills is a core component and likely mechanism of effect maintenance in all CBT-based treatments, the extent of post-therapeutic CBT skills usage among internet-delivered CBT (iCBT) clients remains under-researched. Method Nested within a pragmatic randomized con...
Article
Background Depression is a well-known risk factor for recurrent cardiac events (RCEs) but findings are less consistent for anxiety, not previously reported on using a time-dependent approach. We aimed to study the prognostic effect of anxiety and depression symptom levels on RCEs. Methods Data ( N = 595) were drawn from the UPBEAT-UK heart disease...
Article
Full-text available
Introduction: The immediate impact of COVID-19 on morbidity and mortality has raised the need for accurate and real time data monitoring and communication. The aim of this study is to document initial observations from multiple digital services providers during the COVID-19 crisis, especially those related to mental health and wellbeing. Materials...
Article
Full-text available
Importance The mechanisms by which engagement with internet-delivered psychological interventions are associated with depression and anxiety symptoms are unclear. Objective To identify behavior types based on how people engage with an internet-based cognitive behavioral therapy (iCBT) intervention for symptoms of depression and anxiety. Design, S...
Article
Full-text available
Utilization of internet-delivered cognitive behavioural therapy (iCBT) for treating depression and anxiety disorders in stepped-care models, such as the UK’s Improving Access to Psychological Therapies (IAPT), is a potential solution for addressing the treatment gap in mental health. We investigated the effectiveness and cost-effectiveness of iCBT...
Article
Full-text available
Background: Depression and anxiety symptoms (termed distress) are common among coronary heart disease (CHD) patients and associated with poor outcomes. Illness perceptions predict distinct outcome trajectories in other long-term conditions, yet it is not known how they relate to distress trajectories in CHD. Purpose: This study aimed to examine...
Article
Depression frequently co-occurs with coronary heart disease (CHD), worsening clinical outcomes of both, and inflammation has been proposed as a biological link between these two disorders. The aim of the present study was to investigate the role of inflammation in the development of depression in CHD patients during a 3-year follow-up. We examined...
Article
Background:: Tamoxifen is an oral medication that has been proposed as a potential treatment for bipolar disorder. Tamoxifen acts to inhibit the intracellular action of protein kinase C, which is also an action of well-established treatments such as lithium and valproate. Here we aimed to identify randomised controlled trials (RCTs) of tamoxifen i...
Chapter
Full-text available
Introduction In recent years, computer-based and internet-delivered CBT (iCBT) has become an attractive and evidence-based alternative to face-to-face CBT, and in some cases, a significantly better option for some individuals. This chapter will discuss the origins of iCBT and the research that supports its efficacy and effectiveness, as well as the...
Preprint
Full-text available
BACKGROUND Internet interventions are able to easily generate objective data about program usage. Increasingly, more studies are exploring the relationship between usage and outcomes but they often report different metrics of use and the findings are mixed. Thus, current evaluations fail to demonstrate which metrics should be considered and if it i...
Preprint
Full-text available
BACKGROUND Many university campuses have limited mental health services that cannot cope with the high demand. One alternative is to use internet-delivered cognitive behavioral therapy (iCBT) as a way of tackling barriers such as lack of availability and scheduling issues. OBJECTIVE This study aimed to assess feasibility, acceptability, effectiven...
Article
Full-text available
Background Depression and anxiety are common mental health disorders worldwide. The UK’s Improving Access to Psychological Therapies (IAPT) programme is part of the National Health Service (NHS) designed to provide a stepped care approach to treating people with anxiety and depressive disorders. Cognitive Behavioural Therapy (CBT) is widely used, w...
Poster
Full-text available
Objective: To examine effectiveness and cost-effectiveness of internet-delivered interventions for depression and anxiety disorders against a waiting list control group at step 2 of IAPT. Method: A CONSORT compliant single-blinded, parallel-groups, randomised controlled trial design will be used. 360 patients will be randomized to the intervention...
Article
Introduction There is little information describing the trajectories of depression and anxiety symptomatology in the context of coronary heart disease (CHD), and their comparison according to sociodemographic and disability measures, cardiac risk factors, and health care costs. Methods Using a primary care cohort of 803 patients with a diagnosis o...
Article
Full-text available
Introduction: Coronary heart disease (CHD) is associated with significant morbidity and mortality, including mental health comorbidity, which is associated with poor outcomes. Self-management is key, but there is limited access to self-management support. Internet-delivered interventions may increase access. Objective: The aim of this study was...
Article
Full-text available
Objective To determine whether a one-off, baseline measure of depression and anxiety in a primary care, coronary heart disease (CHD) population predicts ongoing symptoms, costs, and quality of life across a 3-year follow-up. Design Longitudinal cohort study. Setting 16 General Practice surgeries across South-East London Participants 803 adults (...
Article
Full-text available
Depression is common in patients with coronary heart disease (CHD) but the relationship is uncertain. In the UK, general practitioners (GPs) have been remunerated for finding depression in CHD patients; however, it is unclear how to manage these patients. Objectives Our aim was to explore the relationship between CHD and depression in a GP populat...
Article
Full-text available
Background: Most research on interventions to counter stigma and discrimination has focused on short-term outcomes and has been conducted in high-income settings. Aims: To synthesise what is known globally about effective interventions to reduce mental illness-based stigma and discrimination, in relation first to effectiveness in the medium and...
Article
Background: There is a lack of evidence among longitudinal analysis than can accurately assess just how persistent symptoms of depression and anxiety are in the course of CHD, and whether an initial screen for these symptoms can predict this persistence. Currently, there is controversy surrounding the alleged benefits of screening for depression. W...
Article
Full-text available
Introduction In several countries, the number of candidates to enter Psychiatry is diminishing. In Mexico, the kind of factors that influence the preference for a medical specialty and the way the selection tendencies change across the years of the medical career is not well known. In this study we analyzed the specialty preferences in a representa...
Article
Full-text available
Introduction In several countries, the number of candidates to enter Psychiatry is diminishing. in Mexico, the kind of factors that influence the preference for a medical specialty and the way the selection tendencies change across the years of the medical career is riot well known. In this study we analyzed the specialty preferences in a represent...
Article
Introduction In several countries, the number of candidates to enter Psychiatry is diminishing. In Mexico, the kind of factors that influence the preference for a medical specialty and the way the selection tendencies change across the years of the medical career is not well known. In this study we analyzed the specialty preferences in a representa...

Projects

Projects (2)
Project
1. To measure the predictive value of a baseline measure of depression and anxiety on future and ongoing symptoms of depression and anxiety in CHD 2. To ascertain the effect of depression, anxiety, and other risk factors associated with long-term chest pain type and frequency in CHD 3. To identify the distinct trajectories of depression and anxiety symptoms in patients with CHD 4. To elucidate the specific symptoms and symptom clusters that best describe the association between depression, anxiety, and CHD