Group schema therapy combined with psychomotor therapy for older adults with a personality disorder: an open-label, multicentre, randomised controlled trial.

Background: Although several types of psychotherapy effectively reduce psychological distress associated with personality disorders, randomised controlled trials (RCT) have systematically excluded older patients. We aimed to examine the effectiveness of group schema therapy combined with psychomotor therapy (GST + PMT) in later life compared with treatment as usual (TAU).

Methods: We did an open-label, multicentre, RCT in eight outpatient clinics for geriatric psychiatry in the Netherlands.

Fear generalization predicts post-traumatic stress symptoms: A two-year follow-up study in Dutch fire fighters.

Introduction: Excessive fear generalization has been associated with pathological anxiety, including posttraumatic stress disorder (PTSD). However, studies investigating the longitudinal relationship between generalization and the development of anxiety symptomatology are scarce. This study aims to test the predictive value of fear generalization for PTSD symptoms in a high-risk profession sample and to explore the relationship between generalization and neuroticism, which are both linked to PTSD.

Association Between Personality Traits and Functional Limitations in Older Adults with Affective Disorders: A Cross Sectional Study.

Objectives: Personality traits and affective disorders are both related to functional limitations. It is unknown whether personality traits have an additional effect on functioning in older adults with affective disorders. We studied the association between personality traits and functioning within this group.

A Systematic Review of the Heterogeneity of Schema Therapy.

We aimed to explore the heterogeneity of schema therapy regarding (a) patient characteristics, (b) content, and (c) way of delivering schema therapy. A search was conducted of the electronic databases EMBASE, PsycINFO, Web of Science, MEDLINE, and COCHRANE up to June 15, 2022. Treatment studies were eligible if they (a) used schema therapy as (component of) the intervention examined, and (b) reported an outcome measure quantitatively.

Frailty and affective disorders throughout adult life: A 5-year follow-up of the Lifelines Cohort Study.

Background: Frailty is an important concept for risk stratification in clinical practice, but it is hardly acknowledged at all in mental healthcare settings. This paper aims to assess the impact of frailty on the course of depression and anxiety, and the impact of these affective disorders on the course of frailty.

Methods: Lifelines, a prospective population-based cohort study, evaluated 167,729 people living in the northern Netherlands.

A Feasibility Study of Group Schema Therapy with Psychomotor Therapy for Older Adults with a Cluster B or C Personality Disorder.

Objectives: Schema group therapy is an effective treatment for personality disorders, but its focus on cognitive techniques may be a limitation for older adults. This article describes the rationale and initial evaluation of a group schema therapy protocol enriched with psychomotor therapy (GST+PMT) for older adults in geriatric mental health care.

Methods: Within an observational feasibility study, we evaluated the effect of a 26-week GST+PMT program in 19 outpatients aged 60-70 years with a cluster B or C personality disorder on the Young Schema Questionnaire, Schema Mode Inventory and Manchester Short Assessment of Quality of Life.

Determinants and consequences of polypharmacy in patients with a depressive disorder in later life.

Objectives: Polypharmacy and late-life depression often congregate in the geriatric population. The primary objective is to identify determinants of polypharmacy in patients with depression, and second to examine polypharmacy in relation to various clinical phenotypes of depression and its course.

Methods: A longitudinal observational study using data of the Netherlands Study of Depression in Older persons (NESDO) including 375 patients with depression 60 years and 132 non-depressed comparisons.

Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders.

Background: Although personality disorders are common and consequential, they are largely ignored in geriatric mental healthcare. We examined the relative contributions of different aspects of personality disorders and comorbid mental disorders to the impairment of mental wellbeing in older adults.

Methods: Baseline data were used of 138 patients who participated in a randomized controlled trial on schema therapy for geriatric mental health outpatients with a full or subthreshold cluster B or C personality disorder.

Determinants of Quality of Life and Treatment Satisfaction During Long-Term Involuntary In-patient Treatment of Dual-Diagnosis Patients.

Introduction: Treatment resistance and disengagement from mental health services are major obstacles in the treatment of dual diagnosis patients with Severe Mental Illness. The patients in this study were admitted to a long-term involuntary treatment facility.

Aim Of The Study: To study which patient experiences and perceptions are related to the outcome measures Subjective Quality of Life (SQOL) and Treatment Satisfaction (TS) during the long-term involuntary treatment.

Frailty measures in immuno-metabolic subtypes of late-life depression; A two-year prospective study.

Background/Objectives - Frailty is highly prevalent with increasing age. Based on the concept of depression as a disorder of accelerated aging and its association with inflammation and metabolic dysregulation, we examined whether frailty measures at baseline and over time differed between immuno-metabolic subtypes of late-life depression. Methods - Clinical cohort study in primary and secondary mental health care with two-year follow-up.

Adverse health outcomes in vitamin D supplementation trials for depression: A systematic review.

Background: Vitamin D deficiency is a universal risk factor for adverse health outcomes. Since depression is consistently associated with low vitamin D levels as well as several adverse health outcomes, vitamin D supplementation may be especially relevant for depressed persons. This review examines the potential benefits of vitamin D for (somatic) health outcomes in randomised controlled supplementation trials for depression.

A prospective study into change of vitamin D levels, depression and frailty among depressed older persons.

Objectives: While vitamin D is involved in frailty as well as depression, hardly any study has examined the course of vitamin D levels prospectively. The objective of this study is to examine whether a change of vitamin D in depressed older adults is associated with either depression course, course of frailty, or both.

Methods: The study population consisted of 232 of 378 older adults (60-93 years) with a DSM-IV defined depressive disorder participating in the Netherlands Study of Depression in Older persons, a prospective clinical cohort study.

Clinical characteristics of late-life depression predicting mortality.

Objective: Depression has been associated with increased mortality rates, and modifying mechanisms have not yet been elucidated. We examined whether specific subtypes or characteristics of late-life depression predict mortality.

Methods: A cohort study including 378 depressed older patients according to DSM-IV criteria and 132 never depressed comparisons.

Measuring social support in psychiatric patients and controls: Validation and reliability of the shortened Close Persons Questionnaire.

Although previous studies have underlined the protective role of social support for physical and psychological health, no self-report questionnaires are validated for measuring social support in large-scale psychiatric epidemiological studies. In the current study, we aim to validate the shortened version of the Close Persons Questionnaire (CPQ), a self-report questionnaire that is administered twice to measure social support received from the partner (CPQ-p) as well as from a close friend/family member (CPQ-f). Data of psychiatric patients (n = 1891) and controls (n = 1872) from three Dutch epidemiological studies that assessed determinants of psychopathology were used to validate the shortened CPQ.

Study design of the Routine Outcome Monitoring for Geriatric Psychiatry & Science (ROM-GPS) project; a cohort study of older patients with affective disorders referred for specialised geriatric mental health care.

Background: Affective disorders, encompassing depressive-, anxiety-, and somatic symptom disorders, are the most prevalent mental disorders in later life. Treatment protocols and guidelines largely rely on evidence from RCTs conducted in younger age samples and ignore comorbidity between these disorders. Moreover, studies in geriatric psychiatry are often limited to the "younger old" and rarely include the most frail.

A Cross-National Analysis of the Psychometric Properties of the Geriatric Anxiety Inventory.

Objectives: Assessing late-life anxiety using an instrument with sound psychometric properties including cross-cultural invariance is essential for cross-national aging research and clinical assessment. To date, no cross-national research studies have examined the psychometric properties of the frequently used Geriatric Anxiety Inventory (GAI) in depth.

Method: Using data from 3,731 older adults from 10 national samples (Australia, Brazil, Canada, The Netherlands, Norway, Portugal, Spain, Singapore, Thailand, and United States), this study used bifactor modeling to analyze the dimensionality of the GAI.

Vitamin D deficiency and course of frailty in a depressed older population.

To study the association between vitamin D levels and frailty, its components and course in a depressed sample. Baseline and two-year follow-up data from the depressed sample of the Netherlands Study of Depression in Older persons (NESDO), a prospective observational cohort study, were analyzed. The 378 participants (aged 60-93) had a diagnosis of depression according to DSM-IV criteria.

Vitamin D deficiency, depression course and mortality: Longitudinal results from the Netherlands Study on Depression in Older persons (NESDO).

Objective: To study the effect of vitamin D levels on depression course and remission status after two years, as well as attrition and mortality, in an older cohort.

Methods: This study was part of the Netherlands Study on Depression in Older persons (NESDO), a prospective cohort study. 367 depressed older persons (≥ 60 years) were included.

Risk assessment by client and case manager for shared decision making in outpatient forensic psychiatry.

Background: In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case managers may be hampered by an incomplete view of client functioning. The client's appreciation of his own problem behaviour is not systematically used for these purposes. The current study tests whether using a new client self-appraisal risk assessment instrument, based on the Short Term Assessment of Risk and Treatability (START), improves the assessment of re-offending risk and can support shared decision making in care planning.

Predictive validity of the Short-Term Assessment of Risk and Treatability for violent behavior in outpatient forensic psychiatric patients.

It remains unclear whether prediction of violence based on historical factors can be improved by adding dynamic risks, protective strengths, selection of person-specific key strengths or critical vulnerabilities, and structured professional judgment (SPJ). We examine this in outpatient forensic psychiatry with the Short-Term Assessment of Risk and Treatability (START) at 3 and 6 months follow-up. An incident occurred during 33 (13%) out of 252 3-month and 44 (21%) out of 211 6-month follow-up periods (n = 188 unique clients).

Association between metabolic syndrome and depressive symptom profiles--sex-specific?

Background: The association between depression and metabolic syndrome is becoming more obvious. Waist circumference (WC) might be the most important metabolic syndrome (MetS) feature in relation to late-life depression, with a possible mediating role for adiponectin.

Methods: Cross-sectional population based survey of 1277 participants (50-70 years).

Role of the police in linking individuals experiencing mental health crises with mental health services.

Background: The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact.

Methods: Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls.

The therapeutic relationship and adherence to antipsychotic medication in schizophrenia.

Objective: Previous research has shown that a better therapeutic relationship (TR) predicts more positive attitudes towards antipsychotic medication, but did not address whether it is also linked with actual adherence. This study investigated whether the TR is associated with adherence to antipsychotics in patients with schizophrenia.

Methods: 134 clinicians and 507 of their patients with schizophrenia or a related psychotic disorder participated in a European multi-centre study.

Non-uniform effectiveness of structured patient-clinician communication in community mental healthcare: an international comparison.

Background: The effectiveness of psychosocial interventions in community mental healthcare has been shown to depend on the setting in which they are implemented. Recently structured patient-clinician communication was found to be effective in a multi-centre trial in six European countries, the DIALOG trial. In the overall study, differences between centres were controlled for, not studied.