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Depression: HELP
Articles by Huibert Burger
Based on 45 articles published since 2010
(Why 45 articles?)
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Between 2010 and 2020, Huibert Burger wrote the following 45 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Psychological interventions for depression in Chinese university students: A systematic review and meta-analysis. 2020

Fu, Zhongfang / Zhou, Sijia / Burger, Huibert / Bockting, Claudi L H / Williams, Alishia D. ·Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, location AMC, the Netherlands. · Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands. · Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, location AMC, the Netherlands; Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, Groningen, the Netherlands. · Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, location AMC, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, the Netherlands. · Department of Psychology, Faculty of Science, The University of New South Wales, Australia. Electronic address: alishia.williams@unsw.edu.au. ·J Affect Disord · Pubmed #31744736.

ABSTRACT: BACKGROUND: University students in China are vulnerable to depression with a high estimated prevalence. It is currently unknown which types of psychological interventions are being delivered to treat depression in this population and whether they are effective. Therefore, a systematic review was conducted to address this issue. METHODS: We searched records in English and Chinese databases up to January 2019. RESULTS: From 2,739 records, we identified 39 randomized controlled trails (RCTs) and 54 non-RCTs. A range of psychological interventions were identified including cognitive behaviour therapy, interpersonal therapy, and local interventions. Hedge's g pooled effect size of 23 comparisons from 21 RCTs (N =858) compared to a control group (N = 802) was 1.08 (95% CI: 0.72 to 1.45). Heterogeneity was moderate with I LIMITATIONS: Publication bias and quality of inclusions. CONCLUSIONS: Collectively, there is evidence that psychological interventions for depression in Chinese university students are effective as compared to control groups, although the effects merit further examination by research of higher quality. Innovations in treatment delivery could facilitate wider dissemination of evidence-based interventions.

2 Review Pharmacological treatment for psychotic depression. 2015

Wijkstra, Jaap / Lijmer, Jeroen / Burger, Huibert / Cipriani, Andrea / Geddes, John / Nolen, Willem A. ·Department of Psychiatry, UMCU, B.01.206, Postbox 85500, 3508 GA, Utrecht, Netherlands. ·Cochrane Database Syst Rev · Pubmed #26225902.

ABSTRACT: BACKGROUND: Evidence is limited regarding the most effective pharmacological treatment for psychotic depression: combination of an antidepressant plus an antipsychotic, monotherapy with an antidepressant or monotherapy with an antipsychotic. This is an update of a review first published in 2005 and last updated in 2009. OBJECTIVES: 1. To compare the clinical efficacy of pharmacological treatments for patients with an acute psychotic depression: antidepressant monotherapy, antipsychotic monotherapy and the combination of an antidepressant plus an antipsychotic, compared with each other and/or with placebo.2. To assess whether differences in response to treatment in the current episode are related to non-response to prior treatment. SEARCH METHODS: A search of the Cochrane Central Register of Controlled Trials and the Cochrane Depression, Anxiety and Neurosis Group Register (CCDANCTR) was carried out (to 12 April 2013). These registers include reports of randomised controlled trials from the following bibliographic databases: EMBASE (1970-), MEDLINE (1950-) and PsycINFO (1960-). Reference lists of all studies and related reviews were screened and key authors contacted. SELECTION CRITERIA: All randomised controlled trials (RCTs) that included participants with acute major depression with psychotic features, as well as RCTs consisting of participants with acute major depression with or without psychotic features, that reported separately on the subgroup of participants with psychotic features. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias in the included studies, according to the criteria of the Cochrane Handbook for Systematic Reviews of Interventions. Data were entered into RevMan 5.1. We used intention-to-treat data. For dichotomous efficacy outcomes, the risk ratio (RR) with 95% confidence intervals (CIs) was calculated. For continuously distributed outcomes, it was not possible to extract data from the RCTs. Regarding the primary outcome of harm, only overall dropout rates were available for all studies. MAIN RESULTS: The search identified 3659 abstracts, but only 12 RCTs with a total of 929 participants could be included in the review. Because of clinical heterogeneity, few meta-analyses were possible. The main outcome was reduction of severity (response) of depression, not of psychosis.We found no evidence for the efficacy of monotherapy with an antidepressant or an antipsychotic.However, evidence suggests that the combination of an antidepressant plus an antipsychotic is more effective than antidepressant monotherapy (three RCTs; RR 1.49, 95% CI 1.12 to 1.98, P = 0.006), more effective than antipsychotic monotherapy (four RCTs; RR 1.83, 95% CI 1.40 to 2.38, P = 0.00001) and more effective than placebo (two identical RCTs; RR 1.86, 95% CI 1.23 to 2.82, P = 0.003).Risk of bias is considerable: there were differences between studies with regard to diagnosis, uncertainties around randomisation and allocation concealment, differences in treatment interventions (pharmacological differences between the various antidepressants and antipsychotics) and different outcome criteria. AUTHORS' CONCLUSIONS: Psychotic depression is heavily understudied, limiting confidence in the conclusions drawn. Some evidence indicates that combination therapy with an antidepressant plus an antipsychotic is more effective than either treatment alone or placebo. Evidence is limited for treatment with an antidepressant alone or with an antipsychotic alone.

3 Review Pharmacological treatment for psychotic depression. 2013

Wijkstra, Jaap / Lijmer, Jeroen / Burger, Huibert / Geddes, John / Nolen, Willem A. ·Department of Psychiatry, UMCU, B.01.206, Postbox 85500, 3508 GA, Utrecht, Netherlands. ·Cochrane Database Syst Rev · Pubmed #24282034.

ABSTRACT: BACKGROUND: Evidence is limited regarding the most effective pharmacological treatment for psychotic depression: combination of an antidepressant plus an antipsychotic, monotherapy with an antidepressant or monotherapy with an antipsychotic. This is an update of a review first published in 2005 and last updated in 2009. OBJECTIVES: 1. To compare the clinical efficacy of pharmacological treatments for patients with an acute psychotic depression: antidepressant monotherapy, antipsychotic monotherapy and the combination of an antidepressant plus an antipsychotic, compared with each other and/or with placebo.2. To assess whether differences in response to treatment in the current episode are related to non-response to prior treatment. SEARCH METHODS: A search of the Cochrane Central Register of Controlled Trials and the Cochrane Depression, Anxiety and Neurosis Group Register (CCDANCTR) was carried out (to 12 April 2013). These registers include reports of randomised controlled trials from the following bibliographic databases: EMBASE (1970-), MEDLINE (1950-) and PsycINFO (1960-). Reference lists of all studies and related reviews were screened and key authors contacted. SELECTION CRITERIA: All randomised controlled trials (RCTs) that included participants with acute major depression with psychotic features, as well as RCTs consisting of participants with acute major depression with or without psychotic features, that reported separately on the subgroup of participants with psychotic features. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias in the included studies, according to the criteria of the Cochrane Handbook for Systematic Reviews of Interventions. Data were entered into RevMan 5.1. We used intention-to-treat data. For dichotomous efficacy outcomes, the risk ratio (RR) with 95% confidence intervals (CIs) was calculated. For continuously distributed outcomes, it was not possible to extract data from the RCTs. Regarding the primary outcome of harm, only overall dropout rates were available for all studies. MAIN RESULTS: The search identified 3659 abstracts, but only 12 RCTs with a total of 929 participants could be included in the review. Because of clinical heterogeneity, few meta-analyses were possible. The main outcome was reduction of severity (response) of depression, not of psychosis.We found no evidence for the efficacy of monotherapy with an antidepressant or an antipsychotic.However, evidence suggests that the combination of an antidepressant plus an antipsychotic is more effective than antidepressant monotherapy (three RCTs; RR 1.49, 95% CI 1.12 to 1.98, P = 0.006), more effective than antipsychotic monotherapy (four RCTs; RR 1.83, 95% CI 1.40 to 2.38, P = 0.00001) and more effective than placebo (two identical RCTs; RR 1.86, 95% CI 1.23 to 2.82, P = 0.003).Risk of bias is considerable: there were differences between studies with regard to diagnosis, uncertainties around randomisation and allocation concealment, differences in treatment interventions (pharmacological differences between the various antidepressants and antipsychotics) and different outcome criteria. AUTHORS' CONCLUSIONS: Psychotic depression is heavily understudied, limiting confidence in the conclusions drawn. Some evidence indicates that combination therapy with an antidepressant plus an antipsychotic is more effective than either treatment alone or placebo. Evidence is limited for treatment with an antidepressant alone or with an antipsychotic alone.

4 Review Double trouble: does co-morbid chronic somatic illness increase risk for recurrence in depression? A systematic review. 2013

Kok, Gemma D / Bockting, Claudi L H / Burger, Huibert / Hannig, Wiebke / Pijnenborg, Gerdina H M / Cuijpers, Pim / Hollon, Steven D. ·Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands. ·PLoS One · Pubmed #23472087.

ABSTRACT: OBJECTIVE: To perform a systematic review, and if possible a meta-analysis, to establish whether depressed patients with co-morbid chronic somatic illnesses are a high risk "double trouble" group for depressive recurrence. METHOD: The databases PubMed, EMbase and PsycINFO were systematically searched until the 4(th) of December 2012 by using MeSH and free text terms. Additionally, reference lists of retrieved publications and treatment guidelines were reviewed, and experts were consulted. Inclusion criteria were: depression had to be measured at least twice during the study with qualified instruments and the chronic somatic illness had to be assessed by self-report or by a medical professional. Information on depressive recurrence was extracted and additionally risk ratios of recurrence were calculated. RESULTS: The search generated four articles that fulfilled our inclusion criteria. These studies showed no differences in recurrence over one- two- three- and 6.5 years of follow-up for a total of 2010 depressed patients of which 694 patients with a co-morbid chronic somatic illness versus 1316 patients without (Study 1: RR = 0.49, 95% CI, 0.17-1.41 at one year follow-up and RR = 1.37, 95% CI, 0.78-2.41 at two year follow-up; Study 2: RR = 0.94, 95% CI, 0.65-1.36 at two year follow-up; Study 3: RR = 1.15, 95% CI, 0.40-3.27 at one year follow-up; RR = 1.07, 95% CI, 0.48-2.42 at two year follow-up and RR = 0.99, 95% CI,0.55-1.77 at 6.5 years follow-up; Study 4: RR = 1.16, 95% CI, 0.86-1.57 at three year follow-up). CONCLUSION: We found no association between a heightened risk for depressive recurrence and co-morbid chronic somatic illnesses. There is a need for more longitudinal studies to justify the current specific treatment advice such as long-term pharmacological maintenance treatment for this presumed "double trouble" group.

5 Article Gender Differences in Developing Biomarker-Based Major Depressive Disorder Diagnostics. 2020

Jentsch, Mike C / Burger, Huibert / Meddens, Marjolein B M / Beijers, Lian / van den Heuvel, Edwin R / Meddens, Marcus J M / Schoevers, Robert A. ·Brainscan BV, 7418 AH Deventer, The Netherlands. · Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands. · Department of General Practice, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands. · Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands. · Department of Mathematics and Computer Science, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands. · Research School of Behavioral and Cognitive Neurosciences, University of Groningen, 9713 AV Groningen, The Netherlands. ·Int J Mol Sci · Pubmed #32344909.

ABSTRACT: The identification of biomarkers associated with major depressive disorder (MDD) holds great promise to develop an objective laboratory test. However, current biomarkers lack discriminative power due to the complex biological background, and not much is known about the influence of potential modifiers such as gender. We first performed a cross-sectional study on the discriminative power of biomarkers for MDD by investigating gender differences in biomarker levels. Out of 28 biomarkers, 21 biomarkers were significantly different between genders. Second, a novel statistical approach was applied to investigate the effect of gender on MDD disease classification using a panel of biomarkers. Eleven biomarkers were identified in men and eight in women, three of which were active in both genders. Gender stratification caused a (non-significant) increase of Area Under Curve (AUC) for men (AUC = 0.806) and women (AUC = 0.807) compared to non-stratification (AUC = 0.739). In conclusion, we have shown that there are differences in biomarker levels between men and women which may impact accurate disease classification of MDD when gender is not taken into account.

6 Article Guided internet interventions for depression: impact of sociodemographic factors on treatment outcome in Indonesia. 2020

van der Wal, Junus M / Arjadi, Retha / Nauta, Maaike H / Burger, Huibert / Bockting, Claudi L H. ·Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands. Electronic address: j.m.vanderwal@amsterdamumc.nl. · Atma Jaya Catholic University of Indonesia, Faculty of Psychology, Jl. Jenderal Sudirman No. 51, Jakarta, 12930, Indonesia. · University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands. · Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Department of General Practice, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands. · Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands. ·Behav Res Ther · Pubmed #32220473.

ABSTRACT: Depression is the leading cause of disability worldwide, but an alarming treatment gap exists, especially in lower- and middle income countries (LMIC), where people are exposed to many societal and sociodemographic risk factors. As internet access increases in LMIC, online interventions could decrease this gap, especially when shown suitable for all demographics, including vulnerable groups with low socioeconomic status (SES). We used mixed-model analysis to explore moderating effects of sociodemographic factors (age, sex, education level, SES and urbanicity) on treatment effect in a recent trial in Indonesia, comparing guided online behavioral activation versus online psychoeducation only for depression, in 313 participants from (sub)urban areas. Outcome measures were self-reported Patient Health Questionnaire 9 (PHQ-9) and Inventory of Depressive Symptomatology (IDS-SR). Without correction for multiple testing, we found urbanicity to moderate treatment effect, with stronger treatment effect in suburban relative to urban participants (IDS-SR 24 weeks past baseline, p = 0.04) and a trend towards moderation by SES, with stronger treatment effect in low SES groups (PHQ-9 10 weeks past baseline, p = 0.07). These exploratory results suggest online treatments are a promising mental health intervention for all demographics in a (sub)urban LMIC setting, but hypothesis-testing studies including rural participants are warranted.

7 Article Cognitive Behavioral Therapy for Antenatal Depression in a Pilot Randomized Controlled Trial and Effects on Neurobiological, Behavioral and Cognitive Outcomes in Offspring 3-7 Years Postpartum: A Perspective Article on Study Findings, Limitations and Future Aims. 2020

Bleker, Laura S / Milgrom, Jeannette / Sexton-Oates, Alexandra / Parker, Donna / Roseboom, Tessa J / Gemmill, Alan W / Holt, Christopher J / Saffery, Richard / Connelly, Alan / Burger, Huibert / de Rooij, Susanne R. ·Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands. · Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands. · Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia. · Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia. · Murdoch Children's Research Institute-Cancer and Disease Epigenetics, Royal Children's Hospital, Melbourne, VIC, Australia. · Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia. · University Medical Center Groningen, Department of General Practice, University of Groningen, Groningen, Netherlands. · Academic Medical Centre, Department of Psychiatry, Amsterdam UMC, Amsterdam, Netherlands. ·Front Psychiatry · Pubmed #32116849.

ABSTRACT: Purpose of Article: In a previous pilot randomized controlled trial including 54 pregnant women with depression, maternal mood improved after Cognitive Behavioural Therapy (CBT) compared to treatment as usual (TAU), showing medium to large effect sizes. The effect persisted up to 9 months postpartum, with infant outcomes also showing medium to large effects favoring CBT in various child domains. This perspective article summarizes the results of a follow-up that was performed approximately 5 years later in the same cohort, assessing the effects of antenatal Cognitive Behavioural Therapy for depression and anxiety on child buccal cell DNA-methylation, brain morphology, behavior and cognition. Findings: Children from the CBT group had overall lower DNA-methylation compared to children from the TAU group. Mean DNA-methylation of all Summary: Our explorative findings suggest that antenatal depression treatment decreases overall child DNA-methylation, increases cortical thickness, and decreases white matter fiber-bundle cross-section in regions involved in cognitive function and the stress response. Nevertheless, larger studies are warranted to confirm our preliminary conclusion that CBT in pregnancy alters neurobiological outcomes in children. Clinical relevance remains unclear as we found no effects of antenatal CBT on child behavior or cognition (yet).

8 Article Dose-effect of maternal serotonin reuptake inhibitor use during pregnancy on birth outcomes: A prospective cohort study. 2020

Molenaar, Nina M / Houtman, Diewertje / Bijma, Hilmar H / Brouwer, Marlies E / Burger, Huibert / Hoogendijk, Witte J G / Bockting, Claudi L H / Kamperman, Astrid M / Lambregtse-van den Berg, Mijke P. ·Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, United States. Electronic address: nina.molenaar@mssm.edu. · Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands. · Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands. · Department of Psychiatry, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, the Netherlands. · Department of Psychiatry, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. · Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; Epidemiological and Social Psychiatric Research Institute, Erasmus Medical Center, Rotterdam, the Netherlands. · Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia's Children Hospital, Rotterdam, the Netherlands. ·J Affect Disord · Pubmed #32063573.

ABSTRACT: BACKGROUND: While antidepressant use during pregnancy is increasingly common, there is concern about the possible effects of in-utero antidepressant exposure on the child. Our objective was to examine whether there is a dose-effect of maternal serotonin reuptake inhibitors (SRI) during pregnancy on birth outcomes. METHODS: Women between 12 and 16 weeks of gestation, who were using an SRI, were eligible for participation in this nation-wide prospective observational cohort study. Recruitment took place between April 2015 and February 2018 (n = 145). SRI exposure and psychopathology symptoms were assessed throughout pregnancy. Exposure was defined as SRI standardized dose at 36 weeks of gestation and mean SRI standardized dose over total pregnancy. Multivariable linear and logistic regression were used to examine the associations with birth weight, gestational age at birth, and being small for gestational age. RESULTS: Maternal SRI dose at 36 weeks of gestation was significantly associated with birth weight (adjusted ß = -180.7, 95%CI -301.1;-60.2, p-value < 0.01) as was mean SRI standardized dose during total pregnancy (adjusted ß = -187.3, 95%CI -322.0;-52.6, p-value < 0.01). No significant associations between maternal SRI dose and gestational age or being small for gestational age were observed. LIMITATIONS: Although prospective, we cannot make full causal inferences given that we did not randomize women to different dosages. CONCLUSION: These findings suggest that careful dosing of SRI use during pregnancy may prevent a negative impact on birth weight and indicate the need for further investigation of causality.

9 Article Effects of psychological treatment of mental health problems in pregnant women to protect their offspring: randomised controlled trial. 2020

Burger, Huibert / Verbeek, Tjitte / Aris-Meijer, Judith L / Beijers, Chantal / Mol, Ben W / Hollon, Steven D / Ormel, Johan / van Pampus, Mariëlle G / Bockting, Claudi L H. ·Associate Professor of Clinical Epidemiology, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. · Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia. · Professor of Psychology, Department of Psychology, Vanderbilt University, Tennessee, USA. · Professor of Social Psychiatry and Psychiatric Epidemiology, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. · Gynaecologist, Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, The Netherlands. · Professor of Clinical Psychology, Department of Psychiatry, Amsterdam University Medical Centre; and Institute for Advanced Study, University of Amsterdam, The Netherlands. ·Br J Psychiatry · Pubmed #31806071.

ABSTRACT: BACKGROUND: Perinatal depression and anxiety are associated with unfavourable child outcomes. AIMS: To assess among women with antenatal depression or anxiety the effectiveness of prenatally initiated cognitive-behavioural therapy (CBT) on mother and child compared with care as usual (CAU). Trial registration: Netherlands Trial Register number NTR2242. METHOD: Pregnant women (n = 282) who screened positive for symptoms of depression and/or anxiety were randomised to either CBT (n = 140) or CAU (n = 142). The primary outcome was child behavioural and emotional problems at age 18 months, assessed using the Child Behavior Checklist (CBCL). Secondary outcomes were maternal symptoms during and up to 18 months after pregnancy, neonatal outcomes, mother-infant bonding and child cognitive and motor development at age 18 months. RESULTS: In total, 94 (67%) women in the CBT group and 98 (69%) in the CAU group completed the study. The mean CBCL Total Problems score was non-significantly higher in the CBT group than in the CAU group (mean difference: 1.38 (95% CI -1.82 to 4.57); t = 0.85, P = 0.399). No effects on secondary outcomes were observed except for depression and anxiety, which were higher in the CBT group than in the CAU group at mid-pregnancy. A post hoc analysis of the 98 women with anxiety disorders showed lower infant gestational age at delivery in the CBT than in the CAU group. CONCLUSIONS: Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety. Our findings are not in line with present recommendations for universal screening and treatment for antenatal depression or anxiety, and future work may include the relevance of baseline help-seeking.

10 Article I am a total failure: associations between beliefs and anxiety and depression in patients with inflammatory bowel disease with poor mental quality of life. 2020

Bennebroek Evertsz', Floor / Sprangers, Mirjam A G / de Vries, Laura M / Sanderman, Robbert / Stokkers, Pieter C F / Verdam, Mathilde G E / Burger, Huibert / Bockting, Claudi L H. ·Department of Medical Psychology, Amsterdam University of Medical Centres, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands. · Department of Medical Psychology, Amsterdam University of Medical Centres, Vrije University of Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. · Department of Health Psychology, University Medical Centre Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. · Department of Gastroenterology, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands. · Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands. · Department of General Practice, University Medical Centre, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. · Department of Psychiatry, Amsterdam University of Medical Centres, University of Amsterdam, Meibergdreef 15,1105 AZ Amsterdam, The Netherlands. ·Behav Cogn Psychother · Pubmed #31423955.

ABSTRACT: BACKGROUND: According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy. AIMS: The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL). METHOD: This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I). RESULTS: Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS). CONCLUSIONS: Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.

11 Article Correlates of prenatal and postnatal mother-to-infant bonding quality: A systematic review. 2019

Tichelman, Elke / Westerneng, Myrte / Witteveen, Anke B / van Baar, Anneloes L / van der Horst, Henriëtte E / de Jonge, Ank / Berger, Marjolein Y / Schellevis, François G / Burger, Huibert / Peters, Lilian L. ·Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. · University of Groningen, University Medical Centre Groningen, Department of General Practice & Elderly Care Medicine, Groningen, the Netherlands. · Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands. · Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. · NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands. ·PLoS One · Pubmed #31550274.

ABSTRACT: BACKGROUND: Mother-to-infant bonding is defined as the emotional tie experienced by a mother towards her child, which is considered to be important for the socio-emotional development of the child. Numerous studies on the correlates of both prenatal and postnatal mother-to-infant bonding quality have been published over the last decades. An up-to-date systematic review of these correlates is lacking, however. OBJECTIVE: To systematically review correlates of prenatal and postnatal mother-to-infant bonding quality in the general population, in order to enable targeted interventions. METHODS: MEDLINE, Embase, CINAHL, and PsychINFO were searched through May 2018. Reference checks were performed. Case-control, cross-sectional or longitudinal cohort studies written in English, German, Swedish, Spanish, Norwegian, French or Dutch defining mother-to-infant bonding quality as stipulated in the protocol (PROSPERO CRD42016040183) were included. Two investigators independently reviewed abstracts, full-text articles and extracted data. Methodological quality was assessed using the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional studies and was rated accordingly as poor, fair or good. Clinical and methodological heterogeneity were examined. MAIN RESULTS: 131 studies were included. Quality was fair for 20 studies, and poor for 111 studies. Among 123 correlates identified, 3 were consistently associated with mother-to-infant bonding quality: 1) duration of gestation at assessment was positively associated with prenatal bonding quality, 2) depressive symptoms were negatively associated with postnatal mother-to-infant bonding quality, and 3) mother-to-infant bonding quality earlier in pregnancy or postpartum was positively associated with mother-to-infant bonding quality later in time. CONCLUSION: Our review suggests that professionals involved in maternal health care should consider monitoring mother-to-infant bonding already during pregnancy. Future research should evaluate whether interventions aimed at depressive symptoms help to promote mother-to-infant bonding quality. More high-quality research on correlates for which inconsistent results were found is needed.

12 Article What If Pregnancy Is Not Seventh Heaven? The Influence of Specific Life Events during Pregnancy and Delivery on the Transition of Antenatal into Postpartum Anxiety and Depression. 2019

Aris-Meijer, Judith / Bockting, Claudi / Stolk, Ronald / Verbeek, Tjitte / Beijers, Chantal / van Pampus, Mariëlle / Burger, Huibert. ·Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. j.l.aris@umcg.nl. · Department of Clinical Psychology, University of Groningen, 3584 CS Groningen, The Netherlands. · Department of Clinical and Health Psychology, Utrecht University, 3512 JE Utrecht, The Netherlands. · Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. · Department of General Practice, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. · Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. · Department of Obstetrics and Gynecology, OLVG, 1011 BM Amsterdam, The Netherlands. · Department of General Practice, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. h.burger@umcg.nl. · Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. h.burger@umcg.nl. ·Int J Environ Res Public Health · Pubmed #31405014.

ABSTRACT: INTRODUCTION: Postpartum symptoms of anxiety and depression are known to have a negative impact on mother and child, and major life events constitute a major risk factor for these symptoms. We aimed to investigate to what extent specific life events during pregnancy, delivery complications, unfavorable obstetric outcomes, and antenatal levels of anxiety or depression symptoms were independently associated with postpartum levels of anxiety and depression symptoms. METHODS: Within a prospective population-based cohort study ( RESULTS: Antenatal levels of both anxiety and depression symptoms were associated with postpartum levels of anxiety and depression symptoms. Life events related to health and sickness of self or loved ones, to the relation with the partner or conflicts with loved ones, or to work, finance, or housing problems were significantly associated with higher postpartum levels of anxiety symptoms ( CONCLUSIONS: Women with increased antenatal levels of anxiety or depression symptoms are at increased risk of elevated levels of both postpartum depression and anxiety symptoms. Experiencing life events during pregnancy that were not related to the pregnancy was associated with higher levels of anxiety and depression in the postpartum period, as opposed to pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. These results suggest that events during pregnancy but not related to the pregnancy and birth are a highly important predictor for postpartum mental health.

13 Article Brain Magnetic Resonance Imaging Findings in Children after Antenatal Maternal Depression Treatment, a Longitudinal Study Built on a Pilot Randomized Controlled Trial. 2019

Bleker, Laura S / Milgrom, Jeannette / Parker, Donna / Gemmill, Alan W / Holt, Christopher J / Connelly, Alan / Burger, Huibert / Roseboom, Tessa J / de Rooij, Susanne R. ·Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. l.s.bleker@amc.uva.nl. · Amsterdam UMC, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. l.s.bleker@amc.uva.nl. · Parent-Infant Research Institute, Heidelberg, VIC 3084, Australia. jeannette.milgrom@austin.org.au. · Melbourne School of Psychological Sciences, University of Melbourne, VIC 3010, Australia. jeannette.milgrom@austin.org.au. · Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC 3084, Australia. donna.parker@florey.edu.au. · Parent-Infant Research Institute, Heidelberg, VIC 3084, Australia. alan.gemmill@austin.org.au. · Parent-Infant Research Institute, Heidelberg, VIC 3084, Australia. christopher.holt@acap.edu.au. · Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC 3084, Australia. a.connelly@brain.org.au. · Department of General Practice, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, 9712 CP Groningen, The Netherlands. h.burger@umcg.nl. · Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. t.j.roseboom@amc.uva.nl. · Amsterdam UMC, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. t.j.roseboom@amc.uva.nl. · Amsterdam UMC, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. s.r.derooij@amc.uva.nl. ·Int J Environ Res Public Health · Pubmed #31121887.

ABSTRACT: Antenatal depression is associated with an increased risk of offspring neuro-developmental disorders, potentially as a consequence of an altered brain development

14 Article Recurrence of depression in the perinatal period: Clinical features and associated vulnerability markers in an observational cohort. 2019

Molenaar, Nina M / Brouwer, Marlies E / Kamperman, Astrid M / Burger, Huibert / Williams, Alishia D / Hoogendijk, Witte J G / Bockting, Claudi L H / Lambregtse-van den Berg, Mijke P. ·The Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands. · The Department of Psychiatry, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands. · The Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands. · The Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. · Faculty of Science, School of Psychology, The University of New South Wales, Sydney, Australia. · The Department of Child and Adolescent Psychiatry, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands. ·PLoS One · Pubmed #30794709.

ABSTRACT: OBJECTIVE: Antidepressant medication is commonly used for the prevention of depression recurrence in the perinatal period, yet it is unknown what vulnerability markers may play a role in recurrence. The objective of the current study was to provide a descriptive overview of the associated characteristics of women who experienced a perinatal recurrence of depression despite ongoing antidepressant use, and further, to identify clinically measurable vulnerability markers associated with recurrence. METHODS: Eighty-five pregnant women with a history of depression who used antidepressants (e.g. Selective Serotonin Reuptake Inhibitors or Serotonin and Noradrenaline Reuptake Inhibitors) at the start of the study were included. Clinical features, including information on psychiatric history and antidepressant use, were collected throughout the perinatal period (in this study defined as the period between 12 weeks of pregnancy untill three months postpartum). The clinical features of women experiencing recurrence of depression were described in detail. To identify vulnerability markers associated with recurrence of depression, we performed exploratory univariable logistic regression analyses. RESULTS: Eight women (9.4%) experienced a recurrence of depression; two during pregnancy and six in the first 12 weeks postpartum. All women with recurrence of depression had first onset of depression during childhood or adolescence and had at least 2 psychiatric co-morbidities. Identification of vulnerability markers associated with recurrence of depression yielded associations with depressive symptoms around 16 weeks of pregnancy (OR 1.28, 95%CI 1.08-1.52), number of psychiatric co-morbidities (OR 1.89, 95%CI 1.16-3.09) and duration of antidepressant use (OR 1.01, 95%CI 1.00-1.02). CONCLUSION: Implementing adequate risk assessment in pregnant women who use antidepressants can help identify predictors for recurrence of depression in future studies and thus ultimately lead to improved care.

15 Article Exploring the effect of antenatal depression treatment on children's epigenetic profiles: findings from a pilot randomized controlled trial. 2019

Bleker, Laura S / Milgrom, Jeannette / Sexton-Oates, Alexandra / Roseboom, Tessa J / Gemmill, Alan W / Holt, Christopher J / Saffery, Richard / Burger, Huibert / de Rooij, Susanne R. ·Department of Obstetrics and Gynecology, Amsterdam UMC, location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. l.s.bleker@amc.uva.nl. · Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. l.s.bleker@amc.uva.nl. · Austin Health, Parent-Infant Research Institute, 300 Waterdale Road, Heidelberg West, VIC, 3081, Australia. · Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia. · Murdoch Children's Research Institute-Cancer and Disease Epigenetics, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, VIC, 3052, Australia. · Department of Obstetrics and Gynecology, Amsterdam UMC, location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. · Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. · Department of General Practice, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. ·Clin Epigenetics · Pubmed #30717815.

ABSTRACT: BACKGROUND: Children prenatally exposed to maternal depression more often show behavioral and emotional problems compared to unexposed children, possibly through epigenetic alterations. Current evidence is largely based on animal and observational human studies. Therefore, evidence from experimental human studies is needed. In this follow-up of a small randomized controlled trial (RCT), DNA-methylation was compared between children of women who had received cognitive behavioral therapy (CBT) for antenatal depression and children of women who had received treatment as usual (TAU). Originally, 54 women were allocated to CBT or TAU. A beneficial treatment effect was found on women's mood symptoms. FINDINGS: We describe DNA methylation findings in buccal swab DNA of the 3-7-year-old children (CBT(N) = 12, TAU(N) = 11), at a genome-wide level at 770,668 CpG sites and at 729 CpG sites spanning 16 a priori selected candidate genes, including the glucocorticoid receptor (NR3C1). We additionally explored associations with women's baseline depression and anxiety symptoms and offspring DNA methylation, regardless of treatment. Children from the CBT group had overall lower DNA methylation compared to children from the TAU group (mean ∆β = - 0.028, 95% CI - 0.035 to - 0.022). Although 68% of the promoter-associated NR3C1 probes were less methylated in the CBT group, with cg26464411 as top most differentially methylated CpG site (p = 0.038), mean DNA methylation of all NR3C1 promoter-associated probes did not differ significantly between the CBT and TAU groups (mean ∆β = 0.002, 95%CI - 0.010 to 0.011). None of the effects survived correction for multiple testing. There were no differences in mean DNA methylation between the children born to women with more severe depression or anxiety compared to children born to women with mild symptoms of depression or anxiety at baseline (mean ∆β (depression) = 0.0008, 95% CI - 0.007 to 0.008; mean ∆β (anxiety) = 0.0002, 95% CI - 0.004 to 0.005). CONCLUSION: We found preliminary evidence of a possible effect of CBT during pregnancy on widespread methylation in children's genomes and a trend toward lower methylation of a CpG site previously shown by others to be linked to depression and child maltreatment. However, none of the effects survived correction for multiple testing and larger studies are warranted. TRIAL REGISTRATION: Trial registration of the original RCT: ACTRN12607000397415 . Registered on 2 August 2007.

16 Article The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: A systematic review and meta-analysis. 2019

Massoudi, Btissame / Holvast, Floor / Bockting, Claudi L H / Burger, Huibert / Blanker, Marco H. ·University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands. Electronic address: b.massoudi@umcg.nl. · University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands. Electronic address: f.holvast@umcg.nl. · University of Utrecht, Department of Clinical Psychology, Utrecht, the Netherlands; University of Groningen, Department of Clinical Psychology, Groningen, the Netherlands. Electronic address: c.l.h.bockting@uu.nl. · University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands. Electronic address: h.burger@umcg.nl. · University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands. Electronic address: m.h.blanker@umcg.nl. ·J Affect Disord · Pubmed #30447572.

ABSTRACT: PURPOSE: Psychological interventions are labor-intensive and expensive, but e-health interventions may support them in primary care. In this study, we systematically reviewed the effectiveness and cost-effectiveness of e-health interventions for depressive and anxiety symptoms and disorders in primary care. METHODS: We searched MEDLINE, Cochrane library, Embase, and PsychINFO until January 2018, for randomized controlled trials of e-health interventions for depression or anxiety in primary care. Two reviewers independently screened the identified publications, extracted data, and assessed risk of bias using the Cochrane Collaboration's tool. RESULTS: Out of 3617 publications, we included 14 that compared 33 treatments in 4183 participants. Overall, the methodological quality was poor to fair. The pooled effect size of e-health interventions was small (standardized mean difference = -0.19, 95%CI -0.31 to -0.06) for depression compared to control groups in the short-term, but this was maintained in the long-term (standardized mean difference = -0.22, 95%CI -0.35 to -0.09). Further analysis showed that e-health for depression had a small effect compared to care as usual and a moderate effect compared to waiting lists. One trial on anxiety showed no significant results. Four trials reported on cost-effectiveness. LIMITATIONS: The trials studied different types of e-health interventions and had several risks of bias. Moreover, only one study was included for anxiety. CONCLUSIONS: E-health interventions for depression have a small effect in primary care, with a moderate effect compared to waiting lists. The approach also appeared to be cost-effective for depression. However, we found no evidence for its effectiveness for anxiety.

17 Article Non-adherence to antidepressants among older patients with depression: a longitudinal cohort study in primary care. 2019

Holvast, Floor / Oude Voshaar, Richard C / Wouters, Hans / Hek, Karin / Schellevis, Francois / Burger, Huibert / Verhaak, Peter F M. ·Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen. · University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen. · NIVEL, Netherlands Institute for Health Services Research, Utrecht. · Department of General Practice and Elderly Care Medicine/Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. ·Fam Pract · Pubmed #30395196.

ABSTRACT: Background: Depression is common among older adults and is typically treated with antidepressants. Objective: To determine the non-adherence rates to antidepressants among older adults in primary care, based on non-initiation, suboptimal implementation or non-persistence. Methods: We selected all patients aged ≥60 years and diagnosed with depression in 2012, from the Netherlands Institute for Health Services Research (NIVEL) Primary Care Database. Non-initiation was defined as no dispensing within 14 days of the first prescription; suboptimal implementation, as fewer than 80% of the days covered by dispensed dosages; and non-persistence, as discontinuation within 294 days after first dispense. First, we determined the antidepressant non-initiation, suboptimal implementation and non-persistence rates. Second, we examined whether comorbidity and chronic drug use were associated with non-adherence by mixed-effects logistic regression (non-initiation or suboptimal implementation as dependent variables) and a clustered Cox regression (time to non-persistence). Results: Non-initiation, suboptimal implementation and non-persistence rates were 13.5%, 15.2% and 37.1%, respectively. As the number of chronically used drugs increased, the odds of suboptimal implementation (odds ratio, 0.89; 95% confidence interval, 0.83-0.95) and of non-persistence (hazard ratio, 0.87; 95% confidence interval, 0.82-0.92) reduced. Conclusions: Non-adherence to antidepressants is high among older patients with depression in primary care settings. Adherence is better when patients are accustomed to taking larger numbers of prescribed drugs, but this only provides partial explanation of the variance. GPs should be aware of the high rates of non-adherence. Emphasizing the importance of adhering to the optimal length of antidepressant therapy might be prudent first steps to improving adherence.

18 Article Personality Traits Predict Meeting the WHO Recommendation of 6 Months' Breastfeeding: A Prospective General Population Cohort Study. 2019

Verbeek, Tjitte / Quittner, Loes / de Cock, Paul / de Groot, Nynke / Bockting, Claudi L H / Burger, Huibert. ·Departments of General Practice (Drs Verbeek and Burger), Epidemiology (Ms de Groot), and Clinical Psychology (Dr Bockting), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands · Department of Midwifery Science, AVAG and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands (Ms Quittner) · Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland (Dr de Cock) · Department of Obstetrics & Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Ms de Groot) · and Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (Dr Bockting). ·Adv Neonatal Care · Pubmed #30325749.

ABSTRACT: BACKGROUND: Although personality as well as anxiety and depression are recognized as predictors for breastfeeding initiation, evidence of an association of these factors with 6 months' exclusive breastfeeding as recommended by the World Health Organization (WHO) is sparse. PURPOSE: The purpose of this study was to investigate the associations of personality and symptoms of anxiety and depression during and after pregnancy with meeting the WHO recommendation of 6 months' exclusive breastfeeding. METHODS: In their first trimester of pregnancy, 5784 pregnant women were enrolled in Dutch primary obstetric care centers and hospitals, of which 2927 completed the breastfeeding assessments 6 months postpartum. We performed logistic regression analyses to test the associations of "big five" personality traits (NEO Five Factor Inventory), anxiety (State-Trait Anxiety Inventory), and depression (Edinburgh Postnatal Depression Scale) symptom levels during pregnancy and postpartum with meeting the WHO recommendation of 6 months' exclusive breastfeeding. RESULTS: Agreeableness (odds ratio [OR] = 1.18, P = .006) and openness (OR = 1.31, P < .001) were positively associated with meeting the WHO recommendation, whereas extraversion (OR = 0.83, P = .005) and neuroticism (OR = 1.18, P = .006) were negatively associated. After adjustment for both antenatal and postpartum symptom levels of anxiety and depression, the associations of the agreeableness, extraversion, and openness personality traits remained strong and statistically significant (P < .05). IMPLICATIONS FOR PRACTICE: Patient-centered care should take personality into account in an effort to tailor interventions to optimize breastfeeding behavior. IMPLICATIONS FOR RESEARCH: In contrast to earlier findings, personality traits may be of greater importance than symptoms of anxiety and depression for meeting the WHO recommendation of 6 months' exclusive breastfeeding.

19 Article Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study. 2019

Holvast, Floor / Wouters, Hans / Hek, Karin / Schellevis, François / Oude Voshaar, Richard / van Dijk, Liset / Burger, Huibert / Verhaak, Peter. ·University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands. Electronic address: f.holvast@umcg.nl. · University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands. · NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands. · NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; Department of General Practice and Elderly care medicine/Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands. · University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, the Netherlands. · University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, the Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands. ·Int J Cardiol · Pubmed #30249352.

ABSTRACT: BACKGROUND: Depression is common among patients with cardiovascular disease and has been associated with both drug non-adherence and increased mortality. Non-adherence can occur because of non-initiation, suboptimal implementation, or non-persistence. We aimed to determine if depression increased the risk of any of these components of non-adherence among older patients prescribed cardiovascular drugs in primary care. METHODS: A longitudinal analysis of routine primary care data from the Nivel Primary Care Database was performed using data for 2011-2013. A total of 1512 patients aged ≥60 years diagnosed with depression in 2012 were compared with age- and sex-matched groups with either other psychological diagnoses (N = 1457) or mentally healthy controls (N = 1508), resulting in the inclusion of 4477 patients. Non-adherence was classified as non-initiation, suboptimal implementation, or non-persistence. Regression analyses were performed to determine the association between mental health status and non-initiation, suboptimal implementation, and non-persistence. RESULTS: Mixed-effects logistic regression analyses showed increased odds for suboptimal implementation of beta-blockers among depressed patients (2.18; 95% CI 1.29-3.69). For non-persistence, a clustered Cox regression analysis demonstrated that, compared with controls, there was an increased hazard ratio for depressed patients to discontinue beta-blockers (2.31; 95% CI 1.58-3.37) and calcium antagonists (1.74; 95% CI 1.23-2.46). CONCLUSIONS: It is likely that older patients in primary care diagnosed with depression are at increased risk of non-persistence with cardiovascular drug therapy. Because non-adherence is associated with increased cardiovascular mortality, it is important that physicians ensure that older depressed patients persevere with therapy.

20 Article Low socioeconomic status increases effects of negative life events on antenatal anxiety and depression. 2019

Verbeek, Tjitte / Bockting, Claudi L H / Beijers, Chantal / Meijer, Judith L / van Pampus, Mariëlle G / Burger, Huibert. ·Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: t.verbeek@umcg.nl. · Department of Psychiatry, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands; Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands. · Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. · Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. ·Women Birth · Pubmed #29887508.

ABSTRACT: PROBLEM: Low socioeconomic status and prior negative life events are documented risk factors for antenatal anxiety and depression, preterm birth and birth weight. We aimed to asses whether the adverse effects of prior negative life events increase with lower socioeconomic status and which aspects of socioeconomic status are most relevant. METHODS: We performed a population-based cohort study in the Netherlands including 5398 women in their first trimester of pregnancy. We assessed the number of negative life events prior to pregnancy, aspects of paternal and maternal socio-economic position and symptoms of anxiety and depression. Associations of the number of prior negative life events with anxiety, depression, low birth weight and gestational age were quantified. FINDINGS: The number of prior negative life events, particularly when they had occurred in the two years before pregnancy and maternal aspects of low socioeconomic status (educational level, unemployment and income) were associated with antenatal anxiety and depression. Furthermore, low socioeconomic status increased the adverse effects of prior negative life events. Obstetric outcomes showed similar trends, although mostly not statistically significant. DISCUSSION: Low socioeconomic status and prior negative life events both have an adverse effect on antenatal anxiety and depression. Furthermore, low socioeconomic status increases the adverse impact of prior negative life events on anxiety and depressive symptoms in pregnancy. CONCLUSION: Interventions for anxiety and depression during pregnancy should be targeted particularly to unemployed, less-educated or low-income women who recently experienced negative life events.

21 Article Economic Evaluation of an Internet-Based Preventive Cognitive Therapy With Minimal Therapist Support for Recurrent Depression: Randomized Controlled Trial. 2018

Klein, Nicola S / Bockting, Claudi Lh / Wijnen, Ben / Kok, Gemma D / van Valen, Evelien / Riper, Heleen / Cuijpers, Pim / Dekker, Jack / van der Heiden, Colin / Burger, Huibert / Smit, Filip. ·Department of Psychology, University of Groningen, Groningen, Netherlands. · Top Referent Traumacentrum, GGZ Drenthe, Beilen, Netherlands. · Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands. · Department of Public Mental Health, Trimbos Institute, Utrecht, Netherlands. · Care and Public Health Research Institute School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, Netherlands. · Ambulante Forensische Psychiatrie Noord, GGZ Drenthe, Emmen, Netherlands. · Department of Geriatrics, University Medical Center Utrecht, Utrecht, Netherlands. · Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands. · Amsterdam Public Health, VU University Medical Center, Amsterdam, Netherlands. · GGZ inGeest, Amsterdam, Netherlands. · Research Department, Arkin Mental Health Institute, Amsterdam, Netherlands. · Department of Psychology, Erasmus University Rotterdam, Rotterdam, Netherlands. · PsyQ Mental Health Care Center, Rotterdam, Netherlands. · Department of General Practice, University Medical Center Groningen, Groningen, Netherlands. ·J Med Internet Res · Pubmed #30478021.

ABSTRACT: BACKGROUND: Major depressive disorder (MDD) is highly recurrent and has a significant disease burden. Although the effectiveness of internet-based interventions has been established for the treatment of acute MDD, little is known about their cost effectiveness, especially in recurrent MDD. OBJECTIVES: Our aim was to evaluate the cost effectiveness and cost utility of an internet-based relapse prevention program (mobile cognitive therapy, M-CT). METHODS: The economic evaluation was performed alongside a single-blind parallel group randomized controlled trial. Participants were recruited via media, general practitioners, and mental health care institutions. In total, 288 remitted individuals with a history of recurrent depression were eligible, of whom 264 were randomly allocated to M-CT with minimal therapist support added to treatment as usual (TAU) or TAU alone. M-CT comprised 8 online lessons, and participants were advised to complete 1 lesson per week. The economic evaluation was performed from a societal perspective with a 24-month time horizon. The health outcomes were number of depression-free days according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) criteria assessed with the Structured Clinical Interview for DSM-IV axis I disorders by blinded interviewers after 3, 12, and 24 months. Quality-adjusted life years (QALYs) were self-assessed with the three level version of the EuroQol Five Dimensional Questionnaire (EQ-5D-3L). Costs were assessed with the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness (TiC-P). Incremental cost-effectiveness ratios were calculated and cost-effectiveness planes and cost-effectiveness acceptability curves were displayed to assess the probability that M-CT is cost effective compared to TAU. RESULTS: Mean total costs over 24 months were €8298 (US $9415) for M-CT and €7296 (US $8278) for TAU. No statistically significant differences were found between M-CT and TAU regarding depression-free days and QALYs (P=.37 and P=.92, respectively). The incremental costs were €179 (US $203) per depression-free day and €230,816 (US $261,875) per QALY. The cost-effectiveness acceptability curves suggested that for depression-free days, high investments have to be made to reach an acceptable probability that M-CT is cost effective compared to TAU. Regarding QALYs, considerable investments have to be made but the probability that M-CT is cost effective compared to TAU does not rise above 40%. CONCLUSIONS: The results suggest that adding M-CT to TAU is not effective and cost effective compared to TAU alone. Adherence rates were similar to other studies and therefore do not explain this finding. The participants scarcely booked additional therapist support, resulting in 17.3 minutes of mean total therapist support. More studies are needed to examine the cost effectiveness of internet-based interventions with respect to long-term outcomes and the role and optimal dosage of therapist support. Overall, more research is needed on scalable and cost-effective interventions that can reduce the burden of recurrent MDD. TRIAL REGISTRATION: Netherlands Trial Register NTR2503; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2503 (Archived by WebCite at http://www.webcitation.org/73aBn41r3).

22 Article Offspring outcomes after prenatal interventions for common mental disorders: a meta-analysis. 2018

Brouwer, Marlies E / Williams, Alishia D / van Grinsven, Sam E / Cuijpers, Pim / Lambregtse-van den Berg, Mijke P / Burger, Huibert / Bockting, Claudi L H. ·Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands. · Department of Psychiatry, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. · Faculty of Science, School of Psychology, The University of New South Wales, Sydney, NSW, 2052, Australia. · Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands. · Department of Psychiatry and Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre Rotterdam, P.O. Box 2060, 3000 CB, Rotterdam, the Netherlands. · Department of General Practice, University Medical Centre Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands. · Department of Psychiatry, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. c.l.bockting@amc.uva.nl. ·BMC Med · Pubmed #30428883.

ABSTRACT: BACKGROUND: It is presumed that pharmacological and non-pharmacological treatment of prenatal common mental disorders can mitigate associated adverse effects in offspring, yet strong evidence for the prophylactic benefits of treatment is lacking. We therefore examined the effect of prenatal treatments for common mental disorders on offspring outcomes. METHODS: For this meta-analysis, articles published up to August 31, 2017, were obtained from PubMed, PsycInfo, Embase, and Cochrane databases. Included studies needed to be randomized controlled trials (RCTs) on the effect of treatment of prenatal common mental disorders comparing an intervention to a control condition, including offspring outcome(s). Random effects models were used to calculate Hedges' g in the program Comprehensive Meta-Analysis RESULTS: Sixteen randomized controlled trials among 2778 pregnant women compared offspring outcomes between prenatal interventions and control groups. There were zero pharmacological, 13 psychological, and three other interventions (homeopathy, relaxation interventions, and short psycho-education). Birth weight (mean difference 42.88 g, g = 0.08, 95% CI -0.06 to 0.22, p = 0.27, n = 11), Apgar scores (g = 0.13, 95% CI -0.28 to 0.54, p = 0.53, n = 4), and gestational age (g = 0.03, 95% CI -0.06 to 0.54, p = 0.49, n = 10) were not significantly affected. Other offspring outcomes could not be meta-analyzed due to the inconsistent reporting of offspring outcomes and an insufficient number of studies. CONCLUSIONS: Non-pharmacological interventions had no significant effect on birth outcomes, although this outcome should be considered with caution due to the risk of biases. No randomized controlled trial examined the effects of prenatal pharmacological treatments as compared to treatment as usual for common mental disorders on offspring outcomes. Present clinical guidelines may require more research evidence on offspring outcomes, including child development, in order to warrant the current recommendation to routinely screen and subsequently treat prenatal common mental disorders. TRIAL REGISTRATION: PROSPERO CRD42016047190.

23 Article Development and validation of a clinical prediction tool to estimate the individual risk of depressive relapse or recurrence in individuals with recurrent depression. 2018

Klein, Nicola S / Holtman, Gea A / Bockting, Claudi L H / Heymans, Martijn W / Burger, Huibert. ·Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands; Top Referent Traumacentrum, GGZ Drenthe, Altingerweg 1, 9411 PA Beilen, The Netherlands. · Department of General Practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. · Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands; Department of Psychiatry, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: c.l.bockting@amc.uva.nl. · Department of Epidemiology and Biostatistics, VU University Medical Center, De Boelelaan 1117, PO Box 7057, Amsterdam, The Netherlands. ·J Psychiatr Res · Pubmed #29908389.

ABSTRACT: OBJECTIVES: Many studies examined predictors of depressive relapse/recurrence but no simple tool based on well-established risk factors is available that estimates the risk within an individual. We developed and validated such a prediction tool in remitted recurrently depressed individuals. METHODS: The tool was developed using data (n = 235) from a pragmatic randomised controlled trial in remitted recurrently depressed participants and externally validated using data (n = 209) from a similar randomised controlled trial of remitted recurrently depressed participants using maintenance antidepressants. Cox regression was used with time to relapse/recurrence within 2 years as outcome and well-established risk factors as predictors. Performance measures and absolute risk scores were calculated, a practically applicable risk score was created, and the tool was externally validated. RESULTS: The 2-year cumulative proportion relapse/recurrence was 46.2% in the validation dataset. The tool included number of previous depressive episodes, residual depressive symptoms, severity of the last depressive episode, and treatment. The C-statistic and calibration slope were 0.56 and 0.81 respectively. The tool stratified participants into relapse/recurrence risk classes of 37%, 55%, and 72%. The C-statistic and calibration slope in the external validation were 0.59 and 0.56 respectively, and Kaplan Meier curves showed that the tool could differentiate between risk classes. CONCLUSIONS: This is the first study that developed a simple prediction tool based on well-established risk factors of depressive relapse/recurrence, estimating the individual risk. Since the overall performance of the model was poor, more studies are needed to enhance the performance before recommending implementation into clinical practice.

24 Article Effectiveness of preventive cognitive therapy while tapering antidepressants versus maintenance antidepressant treatment versus their combination in prevention of depressive relapse or recurrence (DRD study): a three-group, multicentre, randomised controlled trial. 2018

Bockting, Claudi L H / Klein, Nicola S / Elgersma, Hermien J / van Rijsbergen, Gerard D / Slofstra, Christien / Ormel, Johan / Buskens, Erik / Dekker, Jack / de Jong, Peter J / Nolen, Willem A / Schene, Aart H / Hollon, Steven D / Burger, Huibert. ·Academic Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands. Electronic address: c.l.bockting@amc.uva.nl. · Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands. · Department of Early Detection and Intervention in Psychosis, GGZ Drenthe, Assen, Netherlands. · Lentis Psychiatric Institute, Lentis Research, Groningen, Netherlands. · University Medical Centre Groningen, Department of Psychiatry, University of Groningen, Groningen, Netherlands. · Health Technology Assessment, University of Groningen, Groningen, Netherlands. · Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, Amsterdam, Netherlands; Arkin Institute for Mental Health, Amsterdam, Netherlands. · Department of Psychiatry, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of General Practice, University of Groningen, Groningen, Netherlands. ·Lancet Psychiatry · Pubmed #29625762.

ABSTRACT: BACKGROUND: Keeping individuals on antidepressants after remission or recovery of major depressive disorder is a common strategy to prevent relapse or recurrence. Preventive cognitive therapy (PCT) has been proposed as an alternative to maintenance antidepressant treatment, but whether its addition would allow tapering of antidepressants or enhance the efficacy of maintenance antidepressant treatment is unclear. We aimed to compare the effectiveness of antidepressants alone, with PCT while tapering off antidepressants, or PCT added to antidepressants in the prevention of relapse and recurrence. METHODS: In this single-blind, multicentre, parallel, three-group, randomised controlled trial, individuals recruited by general practitioners, pharmacists, secondary mental health care, or media were randomly assigned (10:10:8) to PCT and antidepressants, antidepressants alone, or PCT with tapering of antidepressants, using computer-generated randomised allocation stratified for number of previous depressive episodes and type of care. Eligible participants had previously experienced at least two depressive episodes and were in remission or recovery on antidepressants, which they had been receiving for at least the past 6 months. Exclusion criteria were current mania or hypomania, a history of bipolar disorder, any history of psychosis, current alcohol or drug abuse, an anxiety disorder that requires treatment, psychological treatment more than twice a month, and a diagnosis of organic brain damage. The primary outcome was time-related proportion of individuals with depressive relapse or recurrence in the intention-to-treat population, assessed four times in 24 months. Assessors were masked to treatment allocation, whereas physicians and participants could not be masked. This trial is registered with the Netherlands Trial Register, number NTR1907. FINDINGS: Between July 14, 2009, and April 30, 2015, 2486 participants were assessed for eligibility and 289 were randomly assigned to PCT and antidepressant (n=104), antidepressant alone (n=100), or PCT with tapering of antidepressant (n=85). The overall log-rank test was significant (p=0·014). Antidepressants alone were not superior to PCT while tapering off antidepressants in terms of the risk of relapse or recurrence (hazard ratio [HR] 0·86, 95% CI 0·56-1·32; p=0·502). Adding PCT to antidepressant treatment resulted in a 41% relative risk reduction compared with antidepressants alone (0·59, 0·38-0·94; p=0·026). There were two suicide attempts (one in the antidepressants alone group and one in the PCT with tapering of antidepressants group) and one death (in the PCT and antidepressants group) not related to the interventions during the 24 months' follow-up. INTERPRETATION: Maintenance antidepressant treatment is not superior to PCT after recovery, whereas adding PCT to antidepressant treatment after recovery is superior to antidepressants alone. PCT should be offered to recurrently depressed individuals on antidepressants and to individuals who wish to stop antidepressants after recovery. FUNDING: The Netherlands Organisation for Health Research and Development.

25 Article Antidepressants during pregnancy: Guideline adherence and current practice amongst Dutch gynaecologists and midwives. 2018

Molenaar, Nina M / Brouwer, Marlies E / Duvekot, Johannes J / Burger, Huibert / Knijff, Esther M / Hoogendijk, Witte J / Bockting, Claudi L H / de Wolf, G S / Lambregtse-van den Berg, Mijke P. ·Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: n.m.molenaar@erasmusmc.nl. · Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands. Electronic address: m.e.brouwer@uu.nl. · Department of Obstetrics and Gynaecology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: j.j.duvekot@erasmusmc.nl. · Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: h.burger@umcg.nl. · Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: e.knijff@erasmusmc.nl. · Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: w.hoogendijk@erasmusmc.nl. · Department of Psychiatry, Academic Medical Center Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands. Electronic address: c.l.h.bockting@uu.nl. · Department of Clinical Methods and Public Health, Amsterdam Medical Center, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands. Electronic address: g.s.dewolf@amc.uva.nl. · Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: mijke.vandenberg@erasmusmc.nl. ·Midwifery · Pubmed #29524773.

ABSTRACT: BACKGROUND AND OBJECTIVES: prescription rates of antidepressants during pregnancy range from 2-3% in The Netherlands to 6.2% in the USA. Inconclusive evidence about harms and benefits of antidepressants during pregnancy leads to variation in advice given by gynaecologists and midwives. The objective was to investigate familiarity with, and adherence to the Dutch multidisciplinary guideline on Selective Serotonin Reuptake Inhibitor (SSRI) use during pregnancy by gynaecologists and midwives in the Netherlands. METHODS: an online survey was developed and send to Dutch gynaecologists and midwives. The survey consisted mainly of multiple-choice questions addressing guideline familiarity and current practice of the respondent. Also, caregiver characteristics associated with guideline adherence were investigated. FINDINGS: a total of 178 gynaecologists and 139 midwives responded. Overall familiarity with the Dutch guideline was 92.7%. However, current practice and advice given to patients by caregivers differed substantially, both between gynaecologists and midwives as well as within both professions. Overall guideline adherence was 13.9%. Multivariable logistic regression showed that solely caregiver profession was associated with guideline adherence, with gynaecologists having a higher adherence rate (OR 2.10, 95%CI 1.02-4.33) than midwives. KEY CONCLUSION: although reported familiarity with the guideline is high, adherence to the guideline is low, possibly resulting in advice to patients that is inconsistent with guidelines and unwanted variation in current practice. IMPLICATIONS FOR PRACTICE: further implementation of the recommendations as given in the guideline should be stimulated. Additional research is needed to examine how gynaecologists and midwives can be facilitated to follow the recommendations of the clinical guideline on SSRI use during pregnancy.

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