Articles of interest

Clinical complexity and the effectiveness of an intervention for depressed diabetes patients

Piette JD, Valenstein M, Himle J, Duffy S, Torres T, Vogel M, Richardson C. Clinical complexity and the effectiveness of an intervention for depressed diabetes patients.Chronic Illness 2011; 7:267. DOI: 10.1177/1742395311409259

 

Abstract

Objectives:In a trial completed in 2010, US patients with diabetes and depression were randomized to usual care or telephone cognitive behavioural therapy that emphasized physical activity. Twelve-month intervention effects were observed for blood pressure, depression, and pedometer-measured step-counts. This study examined variation in intervention effects across patient subgroups defined by a measure of clinical complexity. Methods: Three groups of patients were identified at baseline using the Vector Model of Complexity that recognizes socioeconomic, biological, behavioural, and other determinants of treatment response. Complexity-by-intervention interactions were examined using regression model. Results: Intervention effects for blood pressure, depression, and step-counts differed across complexity levels. Effects on Beck Depression Inventory scores were greater in the low-complexity group (−8.8) than in the medium- (−3.2) or high-complexity groups (−2.7). Physical activity effects also were greatest in the low-complexity group (increase of 1498 steps per day). In contrast, systolic blood pressure effects were greater among intervention patients with high complexity (−8.5 mmHg).Conclusions: This intervention had varying impacts on physical and mental health depending on patients' clinical complexity. Physical activity and depressive symptom gains may be more likely among less complex patients, although more complex patients may achieve cardiovascular benefits through decreased blood pressures.

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Tenth Latin-MH Study Group

It's going to be held at August 22nd, 10am EST, our 10th Latin-MH Study Group with the theme "Digital Technology for Preventing Early Mortality Among People Living with Serious Mental Illnesses". This webinar will be presented by Dr. John A. Naslund, PhD from Dartmouth College, and will be held in English, online, via Adobe Connect. Come join and build capacity with us!

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Ninth Latin-MH Study Group

It was held on May 29th our 9th Latin-MH Study Group with the theme "New Technologies for Mental Health Assistance". This theme, our study group was tutored by Dr. Ines Hungerbühler, PhD from University of São Paulo. The webinar was held via Adobe Connect, and this edition was in English. Watch it right now!

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Eighth Latin-MH Study Group

It was held on March 30th our 8th Latin-MH Study Group with the theme "IntelliCare - Mobile Apps for Depression and Anxiety". This time, the speaker was Dr. Kenneth Weingardt, PhD from Northwestern University. The webinar was held online via Adobe Connect, and this edition was in English. Watch the video right now! 

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Seventh Study Group Reunion Latin-MH

Our 7th Study Group consisted in the debate "Primary-Care Professionals Mental Health: work-related factors" with Dr. Andréa Tenório, and it was held on February 31st. In this meeting we discussed the findings of The PANDORA-SP Study. This webinar was broadcasted online via Adobe Connect and it happened in two sessions: one in portuguese and one in english. The link to the videos may be found below!

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