Effectiveness of Inpatient Psychotherapy for Patients With and Without Migratory Background: Do They Benefit Equally?

Kobel, Friederike; Morawa, Eva; Erim, Yeşim

doi:10.3389/fpsyt.2020.00542

Cited by 12 publications

(12 citation statements)

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“…This relation could be explained because parents' PTSD can impact the functioning of parenting (lower parenting satisfaction, less optimal parent-child relationships, and more frequent use of negative parenting practices, such as overt hostility and controlling behaviors [54]). In this context, it is necessary to develop interventions which help migrant women with PTSD, especially since some studies showed that patients with a migratory background did not benefit from psychotherapy as much as patients without a migratory background [55].…”

Section: Discussionmentioning

confidence: 99%

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters

Roze

Melchior

Vuillermoz

et al. 2020

IJERPH

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Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in adulthood (sexual abuse, street victimization). This study’s objective was to describe the factors associated with the likelihood of post-traumatic stress disorder (PTSD) among homeless migrant mothers in the Paris region. Face-to-face interviews were conducted by bilingual psychologists and interviewers in a representative sample of homeless families in the Paris region. PTSD was ascertained using the Mini International Neuropsychiatric Interview (MINI) (n = 691 mothers). We studied PTSD in mothers using weighted Poisson regression. Homeless migrant mothers had high levels of PTSD (18.9%) in the 12 months preceding the study. In multivariate analysis, PTSD was associated with departure from the country of origin because of violence (PR = 1.45 95% CI 1.03; 2.04), depression in the preceding 12 months (PR = 1.82 95% CI 1.20; 2.76), and residential instability (PR = 1.93 95% CI 1.27; 2.93). Homeless migrant mothers have high levels of traumatic events and PTSD. Improvements in screening for depression and PTSD and access to appropriate medical care are essential for this vulnerable group.

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Section: Discussionmentioning

confidence: 99%

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters

Roze

Melchior

Vuillermoz

et al. 2020

IJERPH

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“…At discharge 229 patients were counted as completers and therefore were included at remission analysis. For more information see: Kobel et al [ 60 ]. Among these we included 55 first- or second-generation immigrants at admission, and at discharge 48 were included in the analysis of PHQ-9 and 47 of PHQ-15.…”

Section: Resultsmentioning

confidence: 99%

“…The most frequent countries of origin were Poland (n = 10, 18.2%) and Turkey (n = 7, 12.7%). For more information see: Kobel et al [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…Remission after treatment was defined as response to treatment plus a post value of less than 10 points in the respective questionnaire. More information can be found in the first article of this study [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, they are trained to include the patients’ history of migration in their anamnesis and address migratory issues during therapy. The effectiveness of inpatient psychotherapy was dealt with in detail in the first article of this study [ 60 ].…”

Section: Methodsmentioning

confidence: 99%

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Predictors for successful psychotherapy: Does migration status matter?

2021

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Background We investigated, if migration status, and additional sociodemographic and clinical factors, are associated with somatization and depressiveness at admission and with remission after inpatient psychotherapy. Methods Multiple linear and binary logistic regression analyses were used to identify predictors for severity of somatoform and depressive symptoms at admission of inpatient psychotherapy (T0), and for remission after inpatient psychotherapy (T1). We tested the association between symptoms concerning somatization (PHQ-15: Patient-Health-Questionnaire Somatization Module) and depression (PHQ-9: Patient-Health-Questionnaire Depression Module) and several sociodemographic and clinical factors in 263 patients at admission. For remission after treatment, we additionally included severity of symptoms at admission, number of diagnoses and duration of treatment in the regression models. Remission after treatment was defined as response plus a post value of less than 10 points in the respective questionnaire. Clinical relevance was interpreted using effect sizes (regression coefficients, Odds Ratio (OR)) and Confidence Intervals (CI). Findings Significant and clinically relevant predictors for high symptom severity at T0 were lower education (β = -0.13, p = 0.04), pretreatment(s) (β = 0.205, p = 0.002) and migration status (β = 0.139, p = 0.023) for somatization, and potential clinically relevant predictors (|β|>0.1) for depression were living alone (β = -0.116, p = 0.083), pretreatment(s) (β = 0.118, p = 0.071) and migration status (β = 0.113, p = 0.069). At T1 patients with pretreatment(s) (OR = 0.284 [95% CI: 0.144, 0.560], p<0.001) and multiple diagnoses (OR = 0.678 [95% CI: 0.472, 0.973], p = 0.035) were significantly and clinically relevant less likely to show a remission of depressive symptoms. In addition, a potentially clinically meaningful effect of migration status on remission of depressive symptoms (OR = 0.562 [95% CI: 0.264, 1.198], p = 0.136) cannot be ruled out. For somatoform symptoms pretreatment(s) (OR = 0.403, [95% CI: 0.156, 1.041], p = 0.061) and education (OR = 1.603, [95% CI: 0.670, 3.839], p = 0.289) may be regarded as clinically relevant predictors for remission. Conclusion The results of our study suggest that migration status has a clinically relevant influence on severity of somatoform and depressive symptoms at admission. Clinical relevance of migration status can also be assumed regarding the remission of depression. Migration status and further factors affecting the effectiveness of the treatment should be analyzed in future research among larger samples with sufficient power to replicate these findings.

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Measurement Properties of the Patient Health Questionnaire–15 and Somatic Symptom Scale–8

Hybelius,

Kosic,

Salomonsson

et al. 2024

JAMA Netw Open

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ImportanceThe subjective experience of somatic symptoms is a key concern throughout the health care system. Valid and clinically useful instruments are needed.ObjectiveTo evaluate the measurement properties of 2 widespread patient-reported outcomes: the Patient Health Questionnaire–15 (PHQ-15) and Somatic Symptom Scale–8 (SSS-8).Data SourcesMedline, PsycINFO, and Web of Science were last searched February 1, 2024.Study SelectionEnglish-language studies reporting estimates pertaining to factor analysis, taxometric analysis, internal consistency, construct validity, mean scores in relevant groups, cutoffs, areas under the receiver operating characteristic curves (AUROCs), minimal clinically important difference, test-retest reliability, or sensitivity to change.Data Extraction and SynthesisSearch hits were reviewed by independent raters. Cronbach α, Pearson r, means, and between-group effect sizes indicative of sensitivity to change were pooled in random-effects meta-analysis. Study quality was assessed using 3 instruments. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 reporting guideline.Main Outcomes and MeasuresComprehensive overview of evidence pertaining to the measurement properties of the PHQ-15 and SSS-8.ResultsA total of 305 studies with 361 243 participants were included. Most concerned routine care (178 studies) and the general population (27 studies). In factor analyses, both scales reflected a combination of domain-specific factors (cardiopulmonary, fatigue, gastrointestinal, pain) and a general symptom burden factor. The pooled PHQ-15 α was 0.81 (95% CI, 0.80-0.82), but with low item-total correlations for items concerning menstrual problems, fainting spells, and sexual problems (item-total correlations &lt;0.40), and the SSS-8 α was 0.80 (0.77-0.83). Pooled correlations with other measures of somatic symptom burden were 0.71 (95% CI, 0.64-0.78) for the PHQ-15 and 0.82 (95% CI, 0.72-0.92) for the SSS-8. Reported AUROCs for identification of somatoform disorders ranged from 0.63 (95% CI, 0.50-0.76) to 0.79 (95% CI, 0.73-0.85) for the PHQ-15 and from 0.71 (95% CI, 0.66-0.77) to 0.73 (95% CI, 0.69-0.76) for the SSS-8. The minimal clinically important difference on both scales was 3 points. Test-retest reliability could not be pooled and was inconsistent for the PHQ-15 (PHQ-15: r = 0.65-0.93; ICC, 0.87; SSS-8: r = 0.996, ICC = 0.89). The PHQ-15 showed tentative sensitivity to change (g = 0.32; 95% CI, 0.08-0.56), but data for the SSS-8 were lacking.Conclusions and RelevanceIn this systematic review and meta-analysis, findings supported use of the PHQ-15 and SSS-8 for the assessment of symptom burden, but users should be aware of the complex, multifactorial structures of these scales. More evidence is needed concerning longitudinal measurement properties.

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Effectiveness of Inpatient Psychotherapy for Patients With and Without Migratory Background: Do They Benefit Equally?

Cited by 12 publications

References 59 publications

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters

Predictors for successful psychotherapy: Does migration status matter?

Measurement Properties of the Patient Health Questionnaire–15 and Somatic Symptom Scale–8

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