RESUMEN
BACKGROUND: Self-help may reduce the risk of depression, and risk perception of depression may influence initiating self-help. It is unknown how risk perception is associated with self-help behaviours. The objectives of this study are to (1) describe the self-help strategies used by high-risk Canadians in relation to the accuracy of perceived depression risk, by sex, and (2) identify demographic and clinical factors associated with self-help behaviours. METHODS: Baseline data from a randomized controlled trial including 358 men and 356 women at high-risk of developing depression were used. Following methods used in cancer research, risk perception accuracy was determined by comparing the participant's self-perceived and objective risk of developing depression and classifying as accurate, over-estimation and under-estimation based on a ± 10% threshold. The participant's objective depression risk was assessed using sex-specific multivariable risk predictive algorithms. Frequency of using 14 self-help strategies was assessed. One-way ANOVA testing was used to detect if differences in risk perception accuracy groups existed, stratified by sex. Linear regression was used to investigate the clinical and demographic factors associated with self-help behaviours, also stratified. RESULTS: Compared to accurate-estimators, male over-estimators were less likely to "leave the house daily," and "participate in activities they enjoy." Male under-estimators were also less likely to "participate in activities they enjoy." Both male 'inaccurate' perception groups were more likely to 'create lists of strategies which have worked for feelings of depression in the past and use them'. There were no significant differences between self-help behaviours and risk perception accuracy in women. Regression modeling showed negative relationships between self-rated health and self-help scores, irrespective of sex. In women, self-help score was positively associated with age and educational attainment, and negatively associated with perceived risk. In men, a positive relationship with unemployment was also seen. CONCLUSIONS: Sex differences exist in the factors associated with self-help. Risk perception accuracy, work status, and self-rated health is associated with self-help behaviours in high-risk men. In women, factors related to self-help included age, education, self-rated health status, and perceived risk. More research is needed to replicate findings. TRIAL REGISTRATION: Prospectively registered at ClinicalTrials.gov (NCT02943876) as of 10/21/16.
Asunto(s)
Depresión/psicología , Conductas Relacionadas con la Salud , Conducta de Reducción del Riesgo , Autoimagen , Factores Sexuales , Adulto , Análisis de Varianza , Canadá , Estudios Transversales , Depresión/etiología , Autoevaluación Diagnóstica , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
BACKGROUND: Prevention and early detection of depression is a top public health priority. Accurate perception of depression risk may play an important role in health behavior change and prevention of depression. However, the way in which people in the community perceive their risk of developing depression is currently unknown. METHODS: We analyzed the baseline data from a randomized controlled trial in 358 men and 356 women who are at high risk of having a major depressive episode (MDE). The predicted risk was assessed by sex-specific multivariable risk predictive algorithms for MDE. We compared participants' perceived risk and their predicted risk. Accurate risk perception was defined as perceived risk is in the range of predicted risk ± 10%. RESULTS: In men, 29.7% perceived their risk accurately; 47.5% overestimated their risk; 22.8% underestimated their risk. In women, the proportions were 21.7%, 59.6% and 18.7%, respectively. Compared to men, women were more likely to overestimate their risk and less likely to be accurate. Regression modeling revealed that poor self-rated health and higher predicted depression risk were associated with inaccuracy of risk perception in men; a family history of MDE, higher psychological distress and lower predicted risk were associated with inaccuracy of risk perception in women. CONCLUSIONS: Individuals who are at high risk of developing depression tend to overestimate their risk, especially women. Inaccurate depression risk perception is related to people's health status. Educational interventions are needed to enhance the accuracy of risk perception to encourage positive behavior change and uptake of preventive strategies.
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Trastorno Depresivo Mayor , Canadá/epidemiología , Depresión , Trastorno Depresivo Mayor/epidemiología , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , PercepciónRESUMEN
OBJECTIVE: The objective was to identify helpful, feasible strategies that can be implemented by working men to decrease work-related stress. METHODS: An international Delphi consensus study was conducted with four panels of stakeholders. Three rounds of surveys were sent to panellists who rated the helpfulness and feasibility of strategies. Strategies were considered to have reached consensus if 80+% of at least three panels "agreed" or "strongly agreed" that the strategies were helpful or feasible. RESULTS: Eighty-one strategies reached consensus out of a total 127 for helpfulness in decreasing work-related stress. Eleven strategies did not reach consensus in any of the vignettes. Only two strategies reached consensus for feasibility. CONCLUSION: While many strategies are perceived as helpful for decreasing workplace stress, the feasibility of the strategies likely depends on an individual's particular needs and context.
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Estrés Laboral/prevención & control , Adulto , Consenso , Técnica Delphi , Humanos , Estrés Laboral/epidemiología , Encuestas y CuestionariosRESUMEN
BACKGROUND: Major depressive episodes (MDEs) are prevalent in the workplace and affect workers' health and productivity. Therefore, there is a pressing need for innovation in the prevention of MDEs in the workplace. Electronic mental (e-mental) health programs are a cost-effective approach toward the self-management of stress and emotional issues. E-mental health dropout rate, MDE prevalence, and symptoms greatly vary by sex and age. Thus, the development and implementation of e-mental health programs for the prevention of MDEs need to be examined through a sex and age lens to enhance program use and effectiveness. OBJECTIVE: This study aimed to examine design feature preferences based on sex and age for an e-mental health program targeted toward depression prevention. METHODS: Household residents across Canada were contacted using the random digit dialing method. 500 women and 511 men who were 18 years and older and who were at high risk of having MDEs were interviewed. Internet use was assessed using questions from the 2012 Canadian Internet Use Survey conducted by Statistics Canada, and preferred design features of e-mental health program questions were developed by the BroMatters team members. The proportions of likely use of specific features of e-mental health programs in women were estimated and compared with those in men using chi-square tests. The comparisons were made overall and by age groups. RESULTS: Men (181/511, 35.4%) and women (211/500, 42.2%) differed significantly in their likelihood of using an e-mental health program. Compared with men (307/489, 62.8%), women (408/479, 85.2%) were more likely to use the internet for medical or health-related information. Women were more likely to use the following design features: practices and exercises to help reduce symptoms of stress and depression (350/500, 70.7%), a self-help interactive program that provides information about stress and work problems (302/500, 61.8%), the ability to ask questions and receive answers from mental health professionals via email or text message (294/500, 59.9%), and to receive printed materials by mail (215/500, 43.4%). Men preferred to receive information in a video game format (156/511, 30.7%). Younger men (46/73, 63%) and younger women (49/60, 81%) were more likely to access a program through a mobile phone or an app, and younger men preferred having access to information in a video game format. CONCLUSIONS: Factors such as sex and age influenced design feature preferences for an e-mental health program. Working women who are at high risk for MDEs preferred interactive programs incorporating practice and exercise for reducing stress, quality information about work stress, and some guidance from professionals. This suggests that sex and age should be taken into account when designing e-mental health programs to meet the needs of individuals seeking help via Web-based mental health programs and to enhance their use.
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Trastorno Depresivo Mayor/terapia , Salud Mental/normas , Adulto , Femenino , Humanos , Internet , Masculino , Encuestas y CuestionariosRESUMEN
Common mental health problems (CMHPs), such as depression, anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) are internalizing disorders with high comorbidity. University and college students are under many stressors and transitional events, and students fall within the age range when CMHPs are at their developmental peak. Compared to the expanded effort to explore and treat CMHPs, there has been no a meta-analysis that comprehensively reviewed the interventions for CMHPs and examined the effects of interventions for CMHPs in college students. The objective of this review is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining interventions for CMHPs among university and college students and to estimate their post-intervention effect size (ES), as well as follow-up ES, for depression, anxiety disorder, OCD and PTSD separately. Meta-analytic procedures were conducted in accordance with PRISMA guidelines. We reviewed 7768 abstracts from which 331 full-text articles were reviewed and 51 RCTs were included in the analysis. We found moderate effect sizes for both depression (Hedges' gâ¯=â¯-0.60) and anxiety disorder (Hedges' gâ¯=â¯-0.48). There was no evidence that existing interventions for OCD or PTSD were effective in this population. For interventions with high number of papers, we performed subgroup analysis and found that cognitive behavioral therapy (CBT) and mindfulness-based interventions were effective for both depression and generalized anxiety disorder (GAD), and attention/perception modification was effective for GAD; other interventions (i.e. art, exercise and peer support) had the highest ES for both depression and GAD among university and college students.
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Trastornos de Ansiedad/terapia , Trastorno Depresivo/terapia , Psicoterapia/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/terapia , Estudiantes , Universidades , Humanos , Psicoterapia/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Universidades/estadística & datos numéricosRESUMEN
Binge eating disorder is the most common eating disorder, but its underlying etiology is poorly understood. Both humans and animals exhibit binge-like intake of highly-palatable food, suggesting that the behavior is driven by the rewarding properties of food, rather than homeostatic signals. Food reward is regulated, in part, by endogenous opioid mechanisms which, themselves, may be altered by excessive eating. We examined this hypothesis by testing whether binge-like sucrose intake modifies the subsequent development of a conditioned place preference (CPP) to sucrose and morphine in both female and male adult rats. Separate groups were given intermittent (12h) or continuous (24â¯h) access to a sweet solution (10% sucrose or 0.1% saccharin) and food in their home cage over 28â¯days. Intermittent sucrose access induced binge-like intake, defined as increased consumption within the first hour; importantly, daily sucrose intake was similar for continuous and intermittent access groups. In a later test, all rats developed a conditioned place preference (CPP) to 15% sucrose with the exception of female and male rats given 12-h intermittent access to sucrose. In a separate experiment, all groups displayed a CPP to morphine (4â¯mg/kg). These findings demonstrate that binge-like sucrose intake, not just increased consumption, disrupts reward processing without affecting stimulus-reward learning. This fits with clinical evidence of hypo-reward responsivity in patients with binge eating disorder.
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Condicionamiento Psicológico/efectos de los fármacos , Conducta Alimentaria/efectos de los fármacos , Recompensa , Sacarosa/farmacología , Animales , Femenino , Masculino , Morfina/farmacología , RatasRESUMEN
OBJECTIVES: The National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) was released in 2013. The objectives of this study were to 1) estimate the proportion of Canadian employers who were aware of the Standard, 2) examine the extent to which the Standard has been implemented, and 3) describe perceived barriers to implementing the Standard in Canadian organizations. METHODS: A cross-sectional survey in Canadian employers was conducted between February 2015 and January 2017. A random sample of Canadian employers was selected, and the individuals who were knowledgeable about the occupational health policies of the organizations were interviewed by telephone. The participants answered questions about the awareness, implementation, perceived effects, and barriers to implementation. Descriptive statistics and chi-square tests were used to characterize the results. RESULTS: A total of 1010 companies participated in the study. Overall, 17.0% reported that they were aware of the Standard; 1.7% and 20.3% reported that their organizations had implemented the entirety or elements of the Standard, respectively; and 71.4% of participants believed that elements of the Standard would be implemented within the next year. The perceived effects associated with implementation of the Standard included increased job satisfaction and employee retention while the greatest barrier to implementing the Standard was the belief that psychological health and safety are irrelevant in the workplace. CONCLUSIONS: Many Canadian employers are still unaware of the Standard's existence; however, most Canadian employers are positively inclined toward the Standard in its potential to help employee productivity and job satisfaction.