Publications by authors named "Lars de Winter"

In this meta-analysis, we evaluated changes in cognition for patients with schizophrenia spectrum disorders (SSD) with different durations of illness (DOIs). Records were identified through searches in PubMed, PsycINFO, CINAHL, and Cochrane until December 2021. We used terms related to SSDs, chronicity, course, and recovery.

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Background: Mental health in the workplace is a growing concern for enterprises and policy makers. MENTUPP is a multi-level mental health intervention implemented in small and medium size enterprises from three work sectors in nine countries. This pilot study aimed to evaluate the feasibility, delivery, and instruments for the MENTUPP intervention to inform the planning of a clustered randomized controlled trial.

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Background And Hypothesis: In schizophrenia spectrum disorders (SSD) personal recovery and subjective quality of life (S-QOL) are crucial and show conceptual overlap. There is limited knowledge about how these outcomes change over time. Therefore, we investigated changes in personal recovery or S-QOL for patients with SSD.

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Among the many social determinants of health and mental health, employment and work are getting momentum in the European political agenda. On 30-31 January 2024, a 'High-level Conference on Mental Health and Work' was held in Brussels on the initiative of the rotating Belgian Presidency of the European Union. It addressed the issue developing two different perspectives: (1) preventing the onset of poor mental health conditions or of physical and mental disorders linked to working conditions (primary prevention); (2) create an inclusive labour market that welcomes and supports all disadvantaged categories who are at high risk of exclusion (secondary and tertiary prevention).

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Background: According to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices.

Objectives: This article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study.

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Background: Small and medium-sized enterprises (SMEs) face major financial losses due to mental health issues affecting employees at all levels but seldom apply programs to promote wellbeing and prevent mental health issues among employees. To support the development of a multi-country workplace-based mental health intervention for SMEs (MENTUPP), a multinational consultation study was conducted. The study aimed to examine the experiences and needs of SMEs concerning the promotion of employee wellbeing, and the prevention and management of non-clinical mental health problems in workplaces.

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Background: Due to increased cardiometabolic risks and premature mortality in people with severe mental illness (SMI), monitoring cardiometabolic health is considered essential. We aimed to analyse screening rates and prevalences of cardiometabolic risks in routine mental healthcare and its associations with patient and disease characteristics.

Methods: We collected screening data in SMI from three mental healthcare institutions in the Netherlands, using most complete data on the five main metabolic syndrome (MetS) criteria (waist circumference, blood pressure, HDL-cholesterol, triglycerides, fasting blood glucose) within a 30-day timeframe in 2019/2020.

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In schizophrenia spectrum disorders, improvement in symptoms varies between patients with short and long durations of illness. In this meta-analysis we provided an overview of both short- and long-term symptomatic improvement for patients with schizophrenia spectrum disorders with distinct durations of illness. We included 82 longitudinal studies assessing the course of positive, negative, depressive and disorganization symptoms.

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Background: There is a gap between the necessity of effective mental health interventions in the workplace and the availability of evidence-based information on how to evaluate them. The available evidence outlines that mental health interventions should follow integrated approaches combining multiple components related to different levels of change. However, there is a lack of robust studies on how to evaluate multicomponent workplace interventions which target a variety of outcomes at different levels taking into account the influence of different implementation contexts.

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Most cognitive remediation (CR) programs are based on multiple scientific learning principles. The role of those learning principles in the beneficial effects of CR is poorly understood. A better understanding of such underlying mechanisms is important to further tailor the intervention and to learn about optimal contexts.

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Objectives: This systematic review assesses the scientific evidence regarding the effectiveness of organisational-level workplace mental health interventions on stress, burnout, non-clinical depressive and anxiety symptoms, and wellbeing in construction workers.

Methods: Eligibility criteria were randomized controlled trials (RCTs), cluster randomized controlled trials (cRCTs), controlled or uncontrolled before- and after studies published in peer-reviewed journals between 2010 and May 2022 in five databases (Academic Search Complete, PsycInfo, PubMed, Scopus and Web of Science). Outcomes were stress, burnout and non-clinical depression and anxiety symptoms, and wellbeing (primary) and workplace changes and sickness absenteeism (secondary).

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Objective: The narrative enhancement and cognitive therapy (NECT) intervention aims to reduce self-stigma among people with severe mental illness. Based on previous studies that showed the intervention's beneficial outcomes, we conducted an uncontrolled pilot study of NECT in the Netherlands to assess both feasibility in delivering NECT and outcomes of the intervention for self-stigma, hope, recovery, and self-concept clarity.

Methods: Feasibility was assessed through uptake and implementation data that included an assessment of enhancing and impeding factors according to surveys with NECT facilitators, and interviews with participants.

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Aims: Individual placement and support (IPS) is an evidence-based service model to support people with mental disorders in obtaining and sustaining competitive employment. IPS is increasingly offered to a broad variety of service users. In this meta-analysis we analysed the relative effectiveness of IPS for different subgroups of service users both based on the diagnosis and defined by a range of clinical, functional and personal characteristics.

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Depression and anxiety are the most prevalent mental health difficulties in the EU, causing immense suffering and costing the global economy EUR 1 trillion each year in lost productivity. Employees in construction, health and information and communications technology have an elevated risk of mental health difficulties. Most mental health interventions for the workplace have been targeted at larger companies and small and medium-sized enterprises (SMEs) are often overlooked despite most people being employed in SMEs.

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In this meta-analysis we investigated changes in social functioning and its moderators in patients with a psychotic disorder but different durations of illness at baseline. We included longitudinal studies assessing the course of five domains of social functioning in patients with a psychotic disorder. Effect sizes of change between baseline and follow-up within these domains were analyzed in four subgroups based on durations of psychotic disorder at baseline: less than 2 years, between 2 and 5 years, between 5 and 10 years, and more than 10 years.

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Background: After a first episode of psychosis, cognitive impairments present an important barrier to successful (re-)entry into work and education. We assessed whether cognitive remediation (CR) as an add-on to Individual Placement and Support (IPS) can improve participation in regular employment and education.

Method: Participants with early psychosis (N = 73) were randomly assigned to receive IPS supplemented with computerized CR, or IPS plus an active control intervention (computer games).

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Objective: After young adults experience a first episode of psychosis, many express a need for help with education and employment. A quality improvement collaborative (QIC) launched in the Netherlands aimed to reinforce vocational recovery by improving participation in education and employment and by enhancing cognitive skills and self-management. This study examined methods used to implement interventions, barriers and facilitators, and implementation outcomes (fidelity, uptake, and availability).

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People with severe mental illness have difficulties finding and maintaining competitive employment. This is particularly so for those living in supported housing who, by definition, have significant day-to-day support needs: in the Netherlands only 3 to 5% of people with serious mental health problems who live in supported housing are competitively employed. To support these people in finding and maintaining competitive employment, Individual Placement, and Support (IPS) was introduced within supported housing services in the Netherlands in 2015.

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Purpose: Individual placement and support (IPS) is an evidence-based supported employment intervention. Quality of IPS implementation is assessed using a validated fidelity scale. Previous studies found a positive association between fidelity and employment outcomes at a single time-point.

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Objective: This article addresses the rise of individual placement and support (IPS) within vocational services for people with severe mental illness (SMI), the current state of affairs, and future directions of IPS in the Netherlands.

Method: Review of the literature on IPS in the Netherlands, analysis of registration data, and exploration of future avenues for IPS in Dutch mental health care.

Findings: In the first decade of this century, an implementation study showed that IPS was feasible in the Netherlands, and a multisite randomized controlled trial (RCT) indicated that IPS was also effective in the Dutch context.

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Background: Psychiatric rehabilitation (PR) can improve functioning in people with severe mental illness (SMI), but outcomes are still suboptimal. Cognitive impairments have severe implications for functioning and might reduce the effects of PR. It has been demonstrated that performance in cognitive tests can be improved by cognitive remediation (CR).

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Background: Cognitive-behavioral therapy (CBT) is first choice of treatment for depressive symptoms and disorders in adolescents, however improvements are necessary because overall efficacy is low. Insights on CBT components and contextual and structural characteristics might increase the efficacy. The aim of our approach is to evaluate the efficacy of CBT for youth with depression and investigate the influence of specific components, contextual and structural factors that could improve effects.

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