Publications by authors named "Kaloyan Kamenov"

20 Publications

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Disability and COVID-19: ensuring no one is left behind.

Arch Public Health 2021 Aug 20;79(1):148. Epub 2021 Aug 20.

International Telecommunication Union, Geneva, Switzerland.

The United Nations' Sustainable Development Agenda calls for targeted attention to the needs and rights of the most vulnerable populations to ensure a life of dignity and human security for all. In this paper, we argue that persons with disabilities are in a disproportionately vulnerable situation in public health emergencies. By using the example of Coronavirus disease 2019 (Covid-19), we explain why that is and call for the systematic consideration of the needs and rights of persons with disabilities during the response to the outbreak and during the recovery phase. Otherwise, equity will continue to be merely an aspiration during this COVID-19 emergency - as it will in future health emergencies.
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http://dx.doi.org/10.1186/s13690-021-00656-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377454PMC
August 2021

Measuring functioning and disability using household surveys: metric properties of the brief version of the WHO and World Bank model disability survey.

Arch Public Health 2021 Jul 12;79(1):128. Epub 2021 Jul 12.

Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.

Background: The Model Disability Survey (MDS) is the current standard recommended by WHO to collect functioning and disability data. Answering calls from countries requesting a version to be implemented as a module that could be integrated into existing surveys and be used for monitoring disability trends and for data disaggregation, WHO developed the brief MDS. The objectives of this paper are to evaluate the metric properties of the disability metrics generated with the Brief MDS and the precision of the Brief MDS in comparison with the full MDS.

Results: The partial credit model, a unidimensional model for polytomous data from the Rasch family, was applied to evaluate psychometric properties using data from national MDS implementations in Chile (N = 12,265) and in Sri Lanka (N = 3000). The Brief MDS generates valid metrics for measuring disability, from the perspectives of capacity and performance, thereby achieving good levels of measurement precision in comparison with its full counterpart.

Conclusion: Given the scarcity of valid functioning and disability modules for household surveys, the Brief MDS represents a milestone in disability measurement. The Brief MDS is currently used by countries to monitor disability trends over time, which is especially important to evaluate the impact of health policies and public health interventions, to disaggregate indicators of the Sustainable Development Goals, and to monitor the implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD).
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http://dx.doi.org/10.1186/s13690-021-00654-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273944PMC
July 2021

The world report on hearing, 2021.

Bull World Health Organ 2021 Apr;99(4):242-242A

Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.

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http://dx.doi.org/10.2471/BLT.21.285643DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085630PMC
April 2021

Ear and Hearing Care Workforce: Current Status and its Implications.

Ear Hear 2021 01 21;42(2):249-257. Epub 2021 Jan 21.

Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland.

Objective: This study aimed to provide comprehensive global evidence on the availability of ear and hearing care (EHC) professionals and real-life examples that showcase the impact of workforce shortages on the workload faced by existing professionals.

Methods: Six sources of data were used to estimate availability of EHC workforce: a scoping literature review, World Health Organization (WHO) National Health Workforce Accounts platform, WHO Member States survey and regional consultations, hearing care organizations survey, and official government statistics. EHC professionals' workload undertaking common interventions was estimated through the WHO workload indicators of staffing need human resource management tool.

Results: With data on otolaryngologists from 138, audiologists from 102, speech and language therapists from 124, and teachers of the deaf from 86 countries, this study revealed large gaps in availability of EHC cadres. The majority of countries in the African region had less than one professional in each cadre per million in comparison with most European countries having up to 50 times higher densities. Workload indicators of staffing need calculations revealed the challenging workload faced by existing EHC professionals, with ratios between existing and required staff of 0.01-0.86.

Conclusion: There is an enormous shortage of EHC professionals and urgent actions are needed to ensure sufficient and equitable access to services. Task sharing, a novel approach for improving access to hearing care alongside the development of new cadres, can be a vital strategy in overcoming the shortage of highly qualified providers in many settings, even in well-resourced health systems, to facilitate equitable access to required EHC services.
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http://dx.doi.org/10.1097/AUD.0000000000001007DOI Listing
January 2021

The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability.

J Phys Act Health 2021 01 3;18(1):86-93. Epub 2021 Jan 3.

Background: The World Health Organization has released the first global public health guidelines on physical activity and sedentary behavior for people living with disability. This paper presents the guidelines, related processes, and evidence, and elaborates upon how the guidelines can support inclusive policy, practice, and research.

Methods: Methods were consistent with the World Health Organization protocols for developing guidelines. Systematic reviews of the evidence on physical activity for health for people living with disability were appraised, along with a consideration of the evidence used to inform the general 2020 World Health Organization guidelines.

Results: Evidence supported the development of recommendations for people living with disability, stressing that there are no major risks to engaging in physical activity appropriate to an individual's current activity level, health status, and physical function, and that the health benefits accrued generally outweigh the risks. They also emphasize the benefits of limiting sedentary behavior.

Conclusions: The guidelines mark a positive step forward for disability inclusion, but considerable effort is needed to advance the agenda. This paper highlights key considerations for the implementation of the new recommendations for people living with disability, in line with the human rights agenda underpinning the Global Action Plan on Physical Activity 2018-2030 and allied policies.
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http://dx.doi.org/10.1123/jpah.2020-0629DOI Listing
January 2021

Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019.

Lancet 2021 12 1;396(10267):2006-2017. Epub 2020 Dec 1.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Background: Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.

Methods: To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability (YLDs) of 25 diseases, impairments, or bespoke aggregations of sequelae that were selected as amenable to rehabilitation. All analyses were done at the country level and then aggregated to seven regions: World Bank high-income countries and the six WHO regions (ie, Africa, the Americas, Southeast Asia, Europe, Eastern Mediterranean, and Western Pacific).

Findings: Globally, in 2019, 2·41 billion (95% uncertainty interval 2·34-2·50) individuals had conditions that would benefit from rehabilitation, contributing to 310 million [235-392] YLDs. This number had increased by 63% from 1990 to 2019. Regionally, the Western Pacific had the highest need of rehabilitation services (610 million people [588-636] and 83 million YLDs [62-106]). The disease area that contributed most to prevalence was musculoskeletal disorders (1·71 billion people [1·68-1·80]), with low back pain being the most prevalent condition in 134 of the 204 countries analysed.

Interpretation: To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.

Funding: Bill & Melinda Gates Foundation.
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http://dx.doi.org/10.1016/S0140-6736(20)32340-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7811204PMC
December 2021

Methodological quality of clinical guidelines for universal newborn hearing screening.

Dev Med Child Neurol 2021 01 27;63(1):16-21. Epub 2020 Sep 27.

Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland.

Aim: To review existing guidelines for universal newborn hearing screening (UNHS), identify those that provide comprehensive and clear recommendations on the subject, and provide a brief overview.

Method: A scoping literature review was performed in PubMed, the Guidelines International Network library, and national guideline databases to identify guidelines on newborn hearing screening developed or updated between 2004 and 2019. The quality of the guidelines was checked with the Checklist for the Quality Assessment of Guidelines (AGREE II).

Results: Six guidelines met all the inclusion criteria. All six were based on the 1-3-6 benchmark (screening completed by 1mo, audiological diagnosis by 3mo, enrolment in early intervention by 6mo). However, the guidelines varied in terms of their recommendations for the application of screening methods, role of health professionals in the screening process, and quality. Based on the AGREE II score, flexibility, adaptability, and foundation role for all other guidelines, the 2019 guidelines of the Joint Committee on Infant Hearing position statement were identified as the most appropriate to be recommended for adaptation by countries or programmes.

Interpretation: The diversity in the existing guidance can be confusing for countries and institutions that are planning to develop universal hearing screening programmes. As more countries and organizations develop their newborn hearing screening programmes, they will need examples to emulate. This review provides an evaluation of the quality, comprehensiveness, and applicability of existing clinical guidelines that can serve as a facilitator for countries, institutions, or organizations in their planning and implementation of a UNHS programme.
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http://dx.doi.org/10.1111/dmcn.14694DOI Listing
January 2021

Psychosocial interventions for violence exposed youth - A systematic review.

Child Abuse Negl 2020 10 14;108:104530. Epub 2020 Aug 14.

Countway Library, Harvard School of Public Health, Boston, United States.

Background: Violence exposure (direct, indirect, individual, structural) affects youth mental health.

Objective: We aimed to evaluate the effectiveness of psychosocial interventions in addressing the sequelae of violence exposure on youth (15-24 years old) and evaluate whether moderating factors impact intervention effectiveness.

Methods: We systematically searched eight databases and reference lists to retrieve any studies of psychosocial interventions addressing mental health among youth aged 15-25 exposed to violence. We assessed study risk of bias using an adapted version of the Downs and Black's Risk of Bias Scale.

Results: We identified n = 3077 studies. Sixteen articles representing 14 studies met were included. The studies assessed direct and indirect individual violence exposure at least once. We pooled the data from the 14 studies and evaluated the effects. We estimated an average effect of r+ = 0.57 (RCTs: 95 % CI 0.02-1.13; observational studies: 95 % CI 0.27-86) with some heterogeneity (RCTs: I = 78.03, longitudinal studies: I = 82.93). The most effective interventions are Cognitive Behavioral Therapy, and Exposure Therapy with an exposure focus. However, due to the small number of studies we are uncertain about benefits of interventions.

Conclusions: No study assessed structural violence. Therefore, studies are needed to evaluate the effects of psychosocial interventions for youth exposed to direct, indirect, individual and structural violence.
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http://dx.doi.org/10.1016/j.chiabu.2020.104530DOI Listing
October 2020

Global and regional needs, unmet needs and access to hearing aids.

Int J Audiol 2020 03 3;59(3):166-172. Epub 2020 Feb 3.

Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

This article aims to estimate the global and regional needs, unmet needs and access to hearing aids, as well as the morbidity that can be averted by their use. The study was based on Global Burden of Disease data. Study sample: Hearing impaired individuals "in need" of a hearing aid were defined as those in the moderate, moderately severe, and severe categories. Globally, 401.4 million people are 'in need' of hearing aids. The large majority (83%) of them do not use hearing aids, with higher levels being in some regions such as the African region (90%). Accounting for hearing aid coverage reduced morbidity by 14.6% (95% UI 13.1- 16) - from 25 million YLDs to 21.3 million YLDs. It was estimated that if every single prevalent case in need would use a hearing aid, the burden of disease in this population would be reduced from the untreated 25 million YLDs to 10.3 million YLDs - a reduction of 59%. Development of innovative low-cost technologies with effective service delivery models, policy and regulatory changes to improve access, and combatting the stigma and lack of awareness are some of the potential solutions to improve access to hearing aids.
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http://dx.doi.org/10.1080/14992027.2020.1721577DOI Listing
March 2020

Health system requirements for hearing care services.

Bull World Health Organ 2019 Oct;97(10):647-647A

Department of noncommunicable diseases, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.

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http://dx.doi.org/10.2471/BLT.19.243683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796674PMC
October 2019

Needs and unmet needs for rehabilitation services: a scoping review.

Disabil Rehabil 2019 05 5;41(10):1227-1237. Epub 2018 Jan 5.

a Department for the Management of Noncommunicable Disease, Disability, Injury and Violence Prevention , World Health Organization , Geneva , Switzerland.

Background: There is a global demand for rehabilitation services but to date little attention has been paid to rehabilitation as part of the health agenda, especially in low- and middle-income countries. The objective of the scoping review was to get an overview of the needs and unmet needs for rehabilitation services described in the literature.

Materials And Methods: Electronic search was performed in PubMed and REHABDATA for studies published between 2000 and 2017.

Results: Eighty-six articles met the inclusion criteria. Results revealed a profound need for rehabilitation among different user groups with non-communicable diseases and injuries across countries. However, this need considerably outstripped the provision of services, which left many people with substantial unmet needs for rehabilitation. The main reasons for the unmet needs for rehabilitation were the absence of or unequal geographical distribution of services within a country, lack of transportation, and unaffordability of the services.

Conclusions: There are substantial unmet needs for rehabilitation and numerous barriers to accessing services. Efforts need to focus on building the capacity for rehabilitation research predominantly in low- and middle-income countries. The comprehensive data that this review provides is useful for raising awareness for the need of rehabilitation at policy level. Implications for rehabilitation There is a profound need for rehabilitation services due to the ageing population and growing prevalence of non-communicable diseases. This scoping review shows that the need for rehabilitation considerably outstrips the provision of services. There are substantial unmet needs for rehabilitation and numerous barriers to accessing services. Concerted global action to scale up quality rehabilitation services is needed, especially in low- and middle-income countries.
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http://dx.doi.org/10.1080/09638288.2017.1422036DOI Listing
May 2019

What makes the difference in people's lives when they have a mental disorder?

Int J Public Health 2018 Jan 25;63(1):57-67. Epub 2017 Nov 25.

Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität München, Munich, Germany.

Objectives: The objective of this study was to identify which environmental factors are the most responsible for the disability experienced by persons with mental disorders and whether they differ (1) from those in cardiovascular diseases, chronic respiratory conditions, diabetes, and cancer, and (2) depending on the capacity level-a proxy for the impact of health conditions on the health state of individuals.

Methods: Nationally representative data from 12,265 adults in Chile collected in 2015 with the WHO Model Disability Survey was analyzed.

Results: The availability of personal assistance, frequency of receiving personal assistance, and assistive devices for mobility were the most important environmental factors across mental and other non-communicable diseases. Perception of discrimination and use of health services were also prominent factors. There was a huge overlap between the factors found relevant for mental and other non-communicable diseases, but a substantial variability depending on the intensity of difficulties in capacity.

Conclusions: This study challenges the appropriateness of disease-specific approaches and suggests that considering intrinsic capacity levels is more informative than focusing on diagnosis alone when comparing needs and barriers that affect the performance in daily life of specific groups of individuals.
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http://dx.doi.org/10.1007/s00038-017-1047-5DOI Listing
January 2018

Determinants of Work Performance in Workers with Depression and Anxiety: A Cross-Sectional Study.

Int J Environ Res Public Health 2017 04 26;14(5). Epub 2017 Apr 26.

Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377 Munich, Germany.

Depression and anxiety are highly prevalent disorders with an impact on existential aspects of person's life, including employment i.e., work performance (WP). In order to develop appropriate strategies, it is essential to identify determinants of WP. The objective of this study was to identify the built, social, attitudinal and health system-related environmental determinants of WP in workers with anxiety or depression in total ( = 1211) and regarding the level of disability. Hierarchical binary logistic regression was performed on data obtained from implementation of the WHO Model Disability Survey (MDS) in Chile in 2015. Hindering aspects of means of transportation and workplace, and the use of personal assistance were determinants of WP for all workers with anxiety or depression. Results differed with level of disability. Hindering aspects of means of transportation and workplace, and discrimination were determinants of WP for persons with mild to moderate disability, while hindering aspects of the workplace and dwelling, and the use of personal assistance were determinants of WP for persons with severe disability. Our results emphasize the need for a broader understanding of determinants of WP and the requirement for an integrative approach in developing both universal and specific strategies that go beyond workplace settings.
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http://dx.doi.org/10.3390/ijerph14050466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5451917PMC
April 2017

Research Recommendations for Improving Measurement of Treatment Effectiveness in Depression.

Front Psychol 2017 9;8:356. Epub 2017 Mar 9.

Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red, CIBERMadrid, Spain; Department of Psychiatry, Universidad Autónoma de MadridMadrid, Spain; Instituto de Investigación de La Princesa (IIS-IP), Hospital Universitario de La PrincesaMadrid, Spain.

Despite the steadily escalating psychological and economic burden of depression, there is a lack of evidence for the effectiveness of available interventions on functioning areas beyond symptomatology. Therefore, the main objective of this study was to give an insight into the current measurement of treatment effectiveness in depression and to provide recommendations for its improvement. The study was based on a multi-informant approach, comparing data from a systematic literature review, an expert survey with representatives from clinical practice (130), and qualitative interviews with patients (11) experiencing depression. Current literature places emphasis on symptomatic outcomes and neglects other domains of functioning, whereas clinicians and depressed patients highlight the importance of both. Interpersonal relationships, recreation and daily activities, communication, social participation, work difficulties were identified as being crucial for recovery. Personal factors, neglected by the literature, such as self-efficacy were introduced by experts and patients. Furthermore, clinicians and patients identified a number of differences regarding the areas improved by psychotherapeutic or pharmacological interventions that were not addressed by the pertinent literature. Creation of a new cross-nationally applicable measure of psychosocial functioning, broader remission criteria, report of domain-specific information, and a personalized approach in treatment decision-making are the first crucial steps needed for the improvement of the measurement of treatment effectiveness in depression. A better measurement will facilitate the clinical decision making and answer the escalating burden of depression.
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http://dx.doi.org/10.3389/fpsyg.2017.00356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343004PMC
March 2017

Which Are the Most Burdensome Functioning Areas in Depression? A Cross-National Study.

Front Psychol 2016 31;7:1342. Epub 2016 Aug 31.

Centro Investigación Biomédica en Red, Instituto de Salud Carlos IIIMadrid, Spain; Department of Psychiatry, Universidad Autónoma de MadridMadrid, Spain; Instituto de Investigación Sanitaria del Hospital de La Princesa, Hospital Universitario de la PrincesaMadrid, Spain.

Background: The study aimed to identify the most burdensome functioning domains in depression and their differential impact on the quality of life (QoL) of individuals from nine countries in Asia, Africa, Europe, and Latin America.

Materials And Methods: Data from two multi-country projects-the World Health Organization's Study on Global Ageing and Adult Health (SAGE) and the Collaborative Research on Ageing in Europe (COURAGE)-were analyzed. Eight functioning domains (pain, mobility, self-care, cognition, interpersonal activities, domestic life, and work, sleep and energy, and affect) and QoL were assessed in 4051 individuals with depression.

Results: The analyses of the pooled sample showed that affect (ß = -0.21, p < 0.001), domestic life and work (ß = -0.16, p < 0.001) and interpersonal activities (ß = -0.15, p < 0.001) were the most affected functioning domains. When the analysis was stratified by gender, women showed similar patterns to the total sample, whereas mobility, self-care, cognition and pain were not significant amongst men. The cross-national analysis revealed that difficulties in affect and interpersonal activities were common across countries, whereas the rest of the domains showed country variability. In addition, being a woman (ß = -0.05), being older (ß = 0.07), being married (ß = 0.05), not having a comorbid condition (ß = -0.03) and having a higher education (ß = 0.04) were all factors associated with higher levels of QoL.

Conclusion: There was a variation in the level of decrements in different functioning domains across countries. This is in line with the growing evidence that reporting functioning sum-scores obscures potential differences among people. Functioning tools should capture the distinctiveness among individuals in order to provide tailored responses.
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http://dx.doi.org/10.3389/fpsyg.2016.01342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005959PMC
September 2016

Factors Related to Social Support in Neurological and Mental Disorders.

PLoS One 2016 22;11(2):e0149356. Epub 2016 Feb 22.

Instituto de Salud Carlos III, Centro Investigación Biomédica en Red, CIBER, Madrid, Spain.

Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149356PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764676PMC
July 2016

How much do we know about the functional effectiveness of interventions for depression? A systematic review.

J Affect Disord 2015 Dec 2;188:89-96. Epub 2015 Sep 2.

Instituto de Salud Carlos III, Centro Investigación Biomédica en Red, CIBER, C/ Diego de León 62, 28006 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 4, 28029 Madrid, Spain; Instituto de investigación de la Princesa, (IIS-IP), Hospital Universitario de la Princesa, C/ Diego de León 62, 28006 Madrid, Spain. Electronic address:

Background: Functional difficulties are determined as one of the reasons for the public health priority given to depression. However, previous literature shows that the evidence on treatment effectiveness in depression does not reflect all relevant functional areas affected. This paper aimed to review recent literature and identify which areas are addressed and what are the gaps in the measurement of treatment effectiveness in depression.

Methods: Electronic search was performed in PsycINFO, PubMed, Web of science, and the Cochrane Central Register of Controlled Trials. A content item analysis of outcome measures was performed.

Results: Two hundred and fourty-seven studies were included. The functional areas addressed in the measurement process did not vary across studies assessing psychotherapeutic, pharmacological or alternative interventions. The content analysis revealed that 80% of the areas covered by instruments represented symptomatology. Many functional areas were insufficiently covered, whereas others like handling stress, solving problems, maintaining daily routine, problems in education, or participation in community, political or religious life were not addressed at all.

Limitations: Only articles in English were included and the time frame was limited.

Conclusions: More than 10 years after the first global burden of disease studies have been published evidence on the treatment effectiveness in depression is still based primarily on symptoms. Many important functional areas remain unexplored. Consequently the effectiveness of well recognized interventions might be overestimated. Future steps should include use of comprehensive tools, provision of detailed information on functional areas instead of global scores of instruments, and design of functional impairment oriented therapies.
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http://dx.doi.org/10.1016/j.jad.2015.08.035DOI Listing
December 2015

Analysing psychosocial difficulties in depression: a content comparison between systematic literature review and patient perspective.

Biomed Res Int 2014 9;2014:319634. Epub 2014 Jun 9.

Instituto de Salud Carlos III, Centro Investigación Biométrica en Red (CIBER), C/Diego de León 62, 28006 Madrid, Spain ; Departamento de Psiquiatría, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 4, 28029 Madrid, Spain ; Instituto de Investigación de la Princesa (IIS-IP), Hospital Universitario de la Princesa, C/Diego de León 62, 28006 Madrid, Spain.

Despite all the knowledge on depression, it is still unclear whether current literature covers all the psychosocial difficulties (PSDs) important for depressed patients. The aim of the present study was to identify the gaps in the recent literature concerning PSDs and their related variables. Psychosocial difficulties were defined according to the World Health Organization International Classification of Functioning, Disability and Health (ICF). A comparative approach between a systematic literature review, a focus group, and individual interviews with depressed patients was used. Literature reported the main psychosocial difficulties almost fully, but not in the same degree of importance as patients' reports. Furthermore, the covered areas were very general and related to symptomatology. Regarding the related variables, literature focused on clinical variables and treatments above all but did not report that many psychosocial difficulties influence other PSDs. This study identified many existing research gaps in recent literature mainly in the area of related variables of PSDs. Future steps in this direction are needed. Moreover, we suggest that clinicians select interventions covering not only symptoms, but also PSDs and their modifiable related variables. Furthermore, identification of interventions for particular psychosocial difficulties and personalisation of therapies according to individuals' PSDs are necessary.
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http://dx.doi.org/10.1155/2014/319634DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070279PMC
February 2015
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