Browsing by Author "Patten, Scott"
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- ItemOpen Access2022 (35th Annual) Sebastian K. Littmann Research Day Abstracts(University of Calgary, 2022-03-04) Patten, ScottAbstracts from the 35th annual Sebatian K. Littmann Research Day.
- ItemOpen AccessA randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol(2019-09-18) Wang, JianLi; MacQueen, Glenda; Patten, Scott; Manuel, Douglas; Lashewicz, Bonnie; Schmitz, NorbertAbstract Background Major depressive disorder is one of the most prevalent and disabling forms of mental illness in the general population. One public health strategy that may reduce the disease burden is early identification and prevention - identifying people who are at high risk and intervening to prevent symptoms from progressing into a major depressive episode (MDE). Multivariable risk predictive algorithms (MVRP) have been developed to estimate personalized risk (probability) of an MDE. The purpose of this trial is to answer the questions: (1) Does disclosure of personalized depression risk information promote high-risk individuals to take preventive actions? (2) Will disclosure of personalized depression risk information negatively affect the mental health of those at high risk? Methods We are recruiting 350 high-risk men and 350 high-risk women across the country. Individuals are eligible, if they: (1) are 18 years or older, (2) have not had a depressive episode in the past two months, (3) are at high risk of MDE based on the MVRPs (predicted risk of 6.5% + for men and of 11.2% + for women), (4) can communicate in either English or French, and (5) agree to be contacted for follow-up interviews. The MVRPs were developed and validated using longitudinal data from over 10,000 Canadians across the country. Eligible participants are randomized into (1) the control group, and (2) the group receiving personalized depression risk information. The participants are assessed at baseline, 6 and 12 months regarding accuracy of risk perception, use of self-help strategies and changes in psychological distress and functioning. Qualitative interviews are conducted in sub-samples of the intervention groups to explore how the personalized information affects risk perception, self-help behaviors and mental health. Discussion MVRPs can be used for risk stratification and planning preventive actions. The personalized risk information produced by MVRPs may also empower users to actively engage in self-management. This trial will contribute to the knowledge base about the potential health benefits and psychological harms associated with the provision of personalized depression risk information that will inform future implementation and patient-physician communication in the clinical settings. Trial registration NCT02943876 . Date of trial registration: October 21st, 2016.
- ItemOpen AccessControlled trial of the impact of a BC adult mental health practice support program (AMHPSP) on primary health care professionals’ management of depression(2018-11-28) Lauria-Horner, Bianca; Beaulieu, Tara; Knaak, Stephanie; Weinerman, Rivian; Campbell, Helen; Patten, ScottAbstract Background Depression affects over 400 million people globally. The majority are seen in primary care. Barriers in providing adequate care are not solely related to physicians’ knowledge/skills deficits, but also time constraints, lack of confidence/avoidance, which need to be addressed in mental health-care redesign. We hypothesized that family physician (FP) training in the Adult Mental Health Practice Support Program (AMHPSP) would lead to greater improvements in patient depressive symptom ratings (a priori primary outcome) compared to treatment as usual. Methods From October 2013 to May 2015, in a controlled trial 77 FP practices were stratified on the total number of physicians/practice as well as urban/rural setting, and randomized to the British Columbia AMHPSP⎯a multi-component contact-based training to enhance FPs’ comfort/skills in treating mild-moderate depression (intervention), or no training (control) by an investigator not operationally involved in the trial. FPs with a valid license to practice in NS were eligible. FPs from both groups were asked to identify 3–4 consecutive patients > 18 years old, diagnosis of depression, Patient Health Questionnaire (PHQ-9) score ≥ 10, able to read English, intact cognitive functioning. Exclusion criteria: antidepressants within 5 weeks and psychotherapy within 3 months of enrollment, and clinically judged urgent/emergent medical/psychiatric condition. Patients were assigned to the same arm as their physician. Thirty-six practices recruited patients (intervention n = 23; control n = 13). The study was prematurely terminated at 6 months of enrollment start-date due to concomitant primary health-care transformation by health-system leaders which resulted in increased in-office demands, and recruitment failure. We used the PHQ-9 to assess between-group differences at baseline, 1, 2, 3, and 6 months follow-up. Outcome collectors and assessors were blind to group assignment. Results One hundred-and-twenty-nine patients (intervention n = 72; control n = 57) were analysed. A significant improvement in depression scores among intervention group patients emerged between 3 and 6 months, time by treatment interaction, likelihood ratio test (LR) chi2(3) = 7.96, p = .047. Conclusions This novel skill-based program shows promise in translating increased FP comfort and skills managing depressed patients into improved patient clinical outcomes⎯even in absence of mental health specialists availability. Trial registration #NCT01975948 .
- ItemOpen AccessDepression and Neurological Conditions in Canada(2014-12-03) Fiest, Kirsten; Patten, Scott; Jette, Nathalie; Lavorato, Dina; Williams, Jeanne
- ItemOpen AccessDepression in Epilepsy(2014-05-02) Fiest, Kirsten; Patten, Scott; Jetté, NathalieA relationship between depression and epilepsy has been consistently reported in the literature. Most of this research has estimated the proportion of people with depression in epilepsy. More recently, research has focused on determining fast and accurate methods of diagnosing depression in clinical samples. In contrast, there is a relative dearth of research into the treatment of depression in epilepsy using both pharmacological and non-pharmacological methods. Despite this research, there are still gaps in the knowledge base of this association. The literature on depression in epilepsy has not been reviewed and summarized. Screening tools for identifying depression in epilepsy have either not been validated, or have not been validated with a gold standard tool. Finally, patterns of pharmacological and non-pharmacological treatment of depression in epilepsy have not been well characterized. The work reported in this dissertation addresses each of these three knowledge gaps. Based on a systematic review, the overall pooled prevalence of active depression in persons with epilepsy was found to be 23.1% (95% Confidence Interval (CI): 20.6%-28.3%), and the overall odds ratio of active depression in those with epilepsy, relative to those without, was 2.77 (95% CI: 2.09-3.67). Three depression screening tools, one of which was previously not validated, and new cut-points for scoring were explored in a group of 185 persons with epilepsy. Compared to a gold-standard diagnostic interview, the tools with the best overall balance of sensitivity and specificity were the Hospital Anxiety and Depression Scale at a cut-point of seven and the Patient Health Questionnaire with a cut-point of nine. Newly suggested cut-points for scoring performed better than those cut-points recommended for use in the general population. Considering both pharmacological and non- pharmacological treatments for depression in persons with epilepsy, the majority of persons (70.3%) with current depression were not receiving depression-related therapy. Of those treated, ii most were receiving non-pharmacological treatments for depression. More persons with a past history of depression (37.2%) were receiving treatment, of which the majority was by pharmacological management. The results of these studies characterize the identification and management of depression, addressing knowledge gaps and providing direction for future research.
- ItemOpen AccessDeterminants of Depression in Multiple Sclerosis(2014-08-25) Berzins, Sandra; Patten, Scott; Bulloch, AndrewMultiple sclerosis (MS) is considered the most common disabling neurological condition in young people, and it can significantly affect the quality of life of those living with the condition. Mental illness is an important dimension of MS (Feinstein, 2004; Rodgers & Bland, 1996). People with MS have an elevated prevalence of anxiety disorders (Korostil & Feinstein, 2007), psychotic and mood disorders (Patten, Svenson, & Metz, 2005b). The objectives of this study were to estimate the incidence and to conduct an exploratory analysis on the potential determinants of incidence of depression in MS. Participants in this prospective cohort study (n=188) were followed for six months, starting with two baseline risk factor assessments then completing a depression screening instrument, the PHQ-9, every 2 weeks. At monthly intervals, information was collected on potential risk factors, using standard items from existing validated scales and instruments. Associations were estimated using prevalence ratios (PR) and hazard ratios (HR). A response feature analysis used standard deviation of total depression scores to categorize participants in an alternative way to the typical depression high/low cut-point measures. Baseline cross-sectional analyses found a depression prevalence estimate of 22% using the traditional PHQ-9 cut-point of 10. Predictors of incidence included low self-esteem (HR=4.9), perceived inability to cope with demands of daily life (HR=5.4) low self-efficacy (HR=5.0) and task oriented coping (HR=0.2). The response feature analysis found there is a group of non-depressed participants with high PHQ-9 score variability that shares some risk factors with the depressed patients. These results indicate depression in MS exhibits a risk factor profile similar to that of depression in the general population, with the additional impact of MS illness-related factors. Depression in MS is often regarded as being neurologically induced due to brain lesions, inflammation or axonal loss. While these results do not obviate this possibility, they provide a clear indication that depression in MS exhibits a risk factor profile characterized prominently by psychological and social factors. Future research should adopt a greater focus on such determinants, particularly coping with stress style, which may provide unrecognized opportunities for prevention and/or treatment of depression in this population.
- ItemOpen AccessThe development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: The opening minds scale for Health Care Providers (OMS-HC)(BioMed Central, 2012-06-13) Kassam, Aliya; Papish, Andriyka; Modgill, Geeta; Patten, Scott
- ItemOpen AccessThe effect of neighborhood deprivation on mental health in low- and middle-income countries: A scoping review protocol(2022-11-08) Sharifi, Vandad; Patten, Scott; Amini, Homayoun; McClurg, CaitlinBackground: Most environmental research on mental health originates from high-income countries, and information about the rest of the world is very limited. The impact of the environment on mental health can vary depending on socio-cultural contexts. Still, very few studies have explored the association between neighborhood deprivation and mental health in Low and Middle-Income Countries (LMICs). We intend to conduct our exploration of such an association by using a scoping review approach. Objectives: We will address the following broad questions: 1) what does published research in LMIC countries tell us about the evidence regarding the association between neighborhood-level deprivation and indicators of mental health and illness? 2) What are the proposed mechanisms explaining any observed association in LMICs? 3) What are the gaps in research in the LMIC settings that should be approached in future research? Methods: The following stages will be completed: First, we will systematically search for relevant primary studies in electronic databases (Ovid Medline, Scopus, Socindex, Policy Commons, and PsycINFO), citations in the reference lists, and by contacting existing networks and researchers. Then, a two-stage screening procedure will be employed to select the relevant studies. First, we will screen the titles and abstracts and then review the selected full text by two independent researchers. After charting the data from the selected study reports, we will collate, summarize, report, and discuss the results.
- ItemOpen AccessEffects of Repetitive Transcranial Magnetic Stimulation and Possible Predictors of Response in Youth with Treatment Resistant Depression(2016) Jasaui, Yamile; MacMaster, Frank; Hill, Matthew; Patten, ScottAdolescents with treatment-resistant depression (TRD) do not respond to conventional antidepressant interventions. Repetitive transcranial magnetic stimulation (rTMS) is a novel therapeutic technique to treat TRD. The left dorsolateral prefrontal cortex (DLPFC), important in emotion regulation and the excitatory neurotransmitter glutamate, are altered in TRD. rTMS applied to the left DLPFC can increase glutamate concentrations in this area. Adolescents (aged 12-21) underwent 3 weeks of rTMS, pre and post magnetic resonance spectroscopy (MRS) to measure glutamate concentrations and weekly Ham-D depression rating scale applications. A 50% reduction in depression scores indicated response to treatment. Depression scores decreased in all participants but declined significantly in responders whose glutamate concentrations pre-treatment were considerably lower. Thus, low glutamate concentrations pre-treatment might be a biomarker of response to rTMS. One explanation for this result is that rTMS stimulates glutamate release, which activates the left DLPFC’s emotional regulation function, which in turn reduces depressive symptomatology.
- ItemOpen AccessEpidemiological Assessment of Bipolar Disorder in Canada(2015-05-04) McDonald, Keltie; Patten, ScottObjective: The original aim of this thesis was to estimate the prevalence of bipolar disorder (BD) including bipolar I (BDI) and bipolar II (BDII) disorder subtypes, in Canada in 2012 and to characterize persons with BD in terms of demographic features, health status, and mental health service utilization. During the course of this thesis, a third objective emerged which was to examine some indicators of validity of the World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) classifications of BD. Methods: Data were from the Canadian Community Health Survey-Mental Health (CCHS-MH; n=25,113) Interviews were based on the WMH-CIDI. The WMH-CIDI uses algorithms to determine the presence or absence of BD. Alternative classification methods were also considered. Using proportions and generalized linear modeling, I estimated prevalence of BD, examined agreement among different methods for classifying BD and described the epidemiology of BD according to the different classifications in terms of demographic features, health status and impact, and mental health service utilization. Results: According the WMH-CIDI algorithm, the prevalence of BDI and BDII in Canada in 2012 was 0.87% (95% CI 0.67% to 1.07%) and 0.57% (95% CI 0.44% to 0.71%), respectively. I observed a lack of congruence between WMH-CIDI defined and self-reported BD, and few people taking lithium were positive for BD on the WMH-CIDI, which raises concern about the validity of the WMH-CIDI’s assessment of BD. Conclusion: Prevalence estimates using the WMH-CIDI align with those reported in prior literature. However, existing algorithms used to diagnose BD in the WMH-CIDI appear to result in a large proportion of misclassification. Fully structured interviews may be inaccurate for assessing BD. Future research should aim to develop and evaluate new methods of identifying BD in the general population.
- ItemOpen AccessEvaluating the Impact of Community-Driven Grassroots Vaping Interventions on Changing the Attitudes, Perceptions, and Knowledge of Adolescents in Grade 7 and 8 Classrooms(None, 2023-11-14) Beg, Mirza; Dawood, Yahya; Patten, ScottThis is a protocol for a randomized control study design evaluating the effectiveness of a video designed to increase knowledge and improve attitudes towards vaping in a student population attending a middle school.
- ItemOpen AccessExamining the impact of missing data in an undergraduate mental health survey(2023-08-04) Hews-Girard, Julia; Patten, Scott; Dimitropoulos, Gina; Szeto, Andrew; Thannhauser, Jennifer; Duffy, Anne; Rivera, Daniel; King, Nathan
- ItemOpen AccessExploring Perceptions, Experiences, Acceptability and Validity of Mental Health Screening and Diagnosis among Undergraduate Students: A mixed methods study(2023-08-04) Hews-Girard, Julia; Patten, Scott; Dimitropoulos, Gina; Szeto, Andrew; Thannhauser, Jennifer
- ItemOpen AccessFrailty, Cognition, and Depression in Older Subjects with Coronary Artery Disease(2015-09-28) Freiheit, Elizabeth Ann; Patten, Scott; Maxwell, ColleenFrailty is an area of increasing interest for researchers in cardiovascular health, as health providers look for ways to improve patient resiliency and outcomes. However, little is known about the behavior of frailty or frailty components, particularly cognitive and emotional vulnerability, over time and which groups are more at risk of decline in resiliency after a coronary intervention. The Calgary Cardiac and Cognition (3C) study is a prospective, longitudinal cohort study of patients undergoing coronary angiography who subsequently received a revascularization procedure or only medical treatment. Using the 3C data, three separate but related studies were completed. First, the independent associations of baseline potential frailty criteria with 12-month decline in activities of daily living (ADL) were compared. Those categorized as frail in the best multivariable model had 9.0 times the risk of ADL decline and 3.8 times the risk of health-related quality of life (HQRL) decline compared to those categorized as robust. In the second study, the association over time between two frailty criteria, depression and cognition, was further investigated. Persistent depressive symptoms were more strongly associated with cognitive decline after coronary intervention than depressive symptoms measured only at baseline. Executive function scores for those with persistent depression in the first year, declined by 0.3 to 0.5 standard deviations in the subsequent 18 months. In the third study, frailty scores on average formed a U-shaped curve with frailty declining from baseline (pre-procedure) to 6 and 12 months, and increasing again by 30 months. Women had higher scores than men, but not significantly so. Frailty trajectory by initial treatment plan differed by age group as those aged 75 and older did not decline (improve) in frailty after the intervention for some treatment types. A better understanding of the nature of frailty and frailty components, provided by this research, may help researchers plan and interpret future intervention studies aimed at preventing worsened frailty or better supporting frail persons in follow up to coronary intervention. It lays the groundwork for more studies designed to better anticipate and address the loss of resilience, functional decline, and quality of life in patients after coronary intervention.
- ItemOpen AccessImmigration and Depression in Canada: Is there really a Healthy Immigrant Effect? What is the Pattern of Depression by Time since Immigration?(2017) Diaz, Ruth; Patten, Scott; Bulloch, Andrew; Thomas, Bejoy; Sajobi, TolulopeObjective: This study aimed to contribute to the understanding on inequalities in mental health in Canada by exploring whether or not immigrants have lower prevalence of past-year major depressive episode (MDE) than non-immigrants (i.e., the healthy immigrant effect HIE). Methods: Data were from ten cross-sectional Canadian population health surveys. Survey-specific log odd ratios were calculated, and then pooled using random effects meta-analytic techniques. Results: Evidence of the HIE on MDE was found; however, the HIE disappears with age. The pattern of the HIE by age was observed overall, and when the analysis was conducted by sex, country of birth, and time since immigration. Elder immigrants seem to be at similar or higher risk of MDE than elder Canadian-born. Conclusion: More research is needed to replicate this findings, and to understand why elder immigrants may be at higher risk of MDE than elder non-immigrants.
- ItemOpen AccessIs the Prevalence of Major Depression Increasing in Canadian Adolescents? Assessing Trends from 2000 to 2014.(2016) Wiens, Kathryn; Patten, Scott; Duffy, Anne; Pringsheim, Tamara; Sajobi, TolulopeObjective: The aim of this thesis was to determine whether there is evidence of an epidemic of major depression in Canadian adolescents. Methods: Prevalence estimates for major depressive episodes (MDE) were derived from a series of Canadian Community Health Surveys. Meta regression and graphical analyses were used to evaluate trends over time. Results: The findings do not support an increase in MDE prevalence in Canadian adolescents from 2000 to 2014 (=0.0006; p=0.532). Age and sex groups did not modify the observance of trends. A post hoc analysis observed mood disorder diagnosis to increase from 2003 to 2014 (=0.0012; p=0.024). Conclusion: MDE prevalence in adolescents has remained relatively stable over the past 15 years. These results suggest mood disorder diagnosis is increasing, which may contribute to the popular belief of an epidemic in adolescents. Policy makers may need to incorporate increasing need of services into future planning.
- ItemOpen AccessNeuropsychiatric Symptoms and Incident Cognitive Decline and Dementia in Cognitively Normal Older Adults: A Systematic Review and Meta-Analysis(2022-06) Elbayoumi, Heba; Ismail, Zahinoor; Patten, Scott; Goodarzi, Zahra; Bulloch, Andrew; Pringsheim, Tamara MilkaObjective: To determine risks of cognitive decline or dementia in cognitively normal cohorts with neuropsychiatric symptoms (NPS), stratified by mild behavioral impairment (MBI) domains. Methods: A systematic search (MEDLINE, EMBASE, and PSYCINFO) was completed up to January 2022. Pooled hazard ratios (HR) with Standard Error (SE), I2, and tau2 were determined utilizing DerSimonian-Laird random-effects models. Heterogeneity and publication bias were investigated. PRISMA and MOOSE checklists were followed. Results: Of 12,674 screened abstracts, 36 prospective studies representing 326,739 participants were included. Risks (HR) for incident cognitive decline or dementia by MBI domain were: 1) apathy 2.00 (95%CI:1.57-2.57); 2) affect 1.61 (95%CI:1.45-1.80; adjusted 1.44, 95%CI:1.30-1.61); 3) agitation 3.07 (95%CI: 2.15-4.38); 4) social inappropriateness 3.84 (95%CI:1.54-9.55); and 5) psychosis 3.99 (95%CI:3.05-5.23). Heterogeneity was most evident in affect (I2=86.56%, tau2=0.04), with time and NPS ascertainment as the main contributors. Conclusion: Cognitively normal older adults with NPS are at greater risk for mild cognitive impairment and dementia than those without NPS. Risks differ between the 5 MBI domains.
- ItemOpen AccessOutdoor Air Pollution in Canada: Associations with Major Depressive Episodes and Depressive Symptoms(2021-07-08) Dores, Ashley Katherine; Patten, Scott; Fick, Gordon; MacMaster, FrankObjective: The objective of this thesis was to assess whether exposure to increased levels of outdoor air pollution is associated with an increased prevalence of major depression. Methods: The prevalence of major depressive episode (MDE) from 2011 to 2014 and moderate-severe depressive symptoms of major depression from 2015-2016 were derived from six consecutive survey years of the annual Canadian Community Health Survey (CCHS). The Canadian Urban Environmental Research Consortium provided estimates of the annual average concentration of fine particulate matter ≤2.5 micrometers (µm) in diameter (PM2.5) (2012-2015), ozone (O3) (2013-2015), sulfur dioxide (SO2) (2011-2015), and nitrogen dioxide (NO2) (2012). Outdoor air pollution data was linked with the annual CCHS survey data via 6-digit residential postal codes. Long-term exposure to increased levels of residential outdoor air pollution was defined by the upper quartile of the annual average concentration of PM2.5, O3, SO2, and NO2. Log-binomial models were used to estimate prevalence ratios with corresponding 95% confidence intervals. Single outdoor air pollutant models included adjustment for age, sex, marital status, income, education, employment status, urban versus rural households, cigarette smoking, and chronic illness. Results: Overall, these findings did not suggest that exposure to increased levels of outdoor air pollution is associated with an elevated prevalence of MDE or moderate-severe symptoms of major depression. No evidence of modification or confounding was observed. Conclusions: The analysis did not find evidence that outdoor air pollution is associated with major depression in Canada. Although outdoor air pollution was not identified as a neighbourhood-level determinant of major depression, these results should be generalized to other countries with caution. The null results that we observed may be due to the relatively low levels of outdoor air pollution in Canada. Air pollution at these levels may not be sufficient to activate the relevant mechanisms of major depression (e.g., inflammation, aggravation of chronic conditions, production of depressive symptoms). Future research should examine whether outdoor air pollution is linked to major depression in regions with higher levels of outdoor air pollution or during intervals of elevated exposure such as those that may occur during natural disasters.
- ItemOpen AccessPhysical Activity, Smoking, and Other Health-Related Behaviours in Canadians with Epilepsy: Are Behaviours Changing Over Time?(2014-07-21) Roberts, Jodie; Jetté, Nathalie; Patten, ScottPrevious studies have indicated that people with epilepsy (PWE) are more likely to smoke cigarettes and less likely to engage in physical activity or consume fruits and vegetables. It is unknown whether improvements have occurred following updated guidelines and public health interventions. This project aimed to explore patterns of health related behaviors (HRBs) such as smoking and physical activity in Canadians with epilepsy and examine whether behaviors have changed over time using data from a series of five national population-based surveys spanning from 2001 to 2011. In total, 522,722 Canadians were included in the dataset, including 3,220 PWE. The proportion of PWE who did not participate in any physical activity decreased over time (2001=17.2%, 2010/2011=8.5%), as did the proportion of PWE who currently smoked (2001=32.3%, 2010/2011=18.0%). However, fruit and vegetable consumption was consistently inadequate among PWE. Physicians should continue to counsel epilepsy patients on the importance of healthy lifestyle choices.
- ItemOpen AccessPreterm Birth: Understanding Temporal Changes in Anxiety and Depression Measures(2017) Doktorchik, Chelsea; Premji, Shahirose; Patten, Scott; Slater, Donna; Williamson, TylerBackground: This study aimed to understand whether there is a pattern of change in levels of anxiety and depression between the second and third trimesters of pregnancy that are associated with a risk of PTB. Chronic stress was assessed as a potential modifier of the relationship. Methods: This study conducted a secondary data analysis on the All Our Babies prospective cohort. Logistic regression modeling was used to analyze the data. Results: A worsening of anxiety during pregnancy increased the odds of preterm delivery (OR 2.70, 95% CI 1.28, 5.69; p=0.009). An improvement in anxiety reduced the odds of PTB (OR 0.96, 95% CI 0.94, 0.98; p=<0.001). Consistently low depression decreased the odds of PTB (OR 0.65, 95% CI 0.45, 0.96; p=0.029). Chronic stress did not modify any of these relationships. Conclusions: Efforts should be made to replicate these results in a cohort with a larger sample size.