Yuan Feng

Bio: Yuan Feng is an academic researcher from Capital Medical University. The author has contributed to research in topics: Medicine & Major depressive disorder. The author has an hindex of 8, co-authored 30 publications receiving 318 citations.

Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters

Abstract: Objective:The authors compared measurement-based care with standard treatment in major depression.Methods:Outpatients with moderate to severe major depression were consecutively randomized to 24 weeks of either measurement-based care (guideline- and rating scale-based decisions; N=61), or standard treatment (clinicians’ choice decisions; N=59). Pharmacotherapy was restricted to paroxetine (20–60 mg/day) or mirtazapine (15–45 mg/day) in both groups. Depressive symptoms were measured with the Hamilton Depression Rating Scale (HAM-D) and the Quick Inventory of Depressive Symptomatology–Self-Report (QIDS-SR). Time to response (a decrease of at least 50% in HAM-D score) and remission (a HAM-D score of 7 or less) were the primary endpoints. Outcomes were evaluated by raters blind to study protocol and treatment.Results:Significantly more patients in the measurement-based care group than in the standard treatment group achieved response (86.9% compared with 62.7%) and remission (73.8% compared with 28.8%). Simil...

Depression, anxiety and associated factors among Chinese adolescents during the COVID-19 outbreak: a comparison of two cross-sectional studies.

Abstract: The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. In China, all schools were shut down and students were home quarantined to prevent disease spread; these steps could have potential negative effects on mental health of adolescents. This study aimed to examine changes in depression and anxiety among Chinese adolescents during the COVID-19 epidemic, and explore factors associated with depression and anxiety. Two survey administrations were conducted among Chinese adolescents between February 20 and February 27 and between April 11 and April 19, 2020, respectively. The Center for Epidemiological Studies-Depression Scale (CES-D) and the 7-item Generalized Anxiety Disorder (GAD-7) scale were used to assess depressive symptoms and anxiety symptoms, respectively. A total of 9554 and 3886 adolescents participated in the first and second surveys. During the initial survey, the prevalence of depression was 36.6% (95% CI: 35.6-37.6%) while the prevalence of anxiety was 19% (95% CI: 18.2-19.8%). Rates of depression and anxiety increased to 57.0% (95% CI: 55.4-58.6%) and 36.7% (95% CI: 35.2-38.2%), respectively, in the second survey. Multivariable logistic regression analyses revealed that group membership in the second survey, female gender, senior secondary school enrollment, and concerns about entering a higher grade were positively associated with both depression and anxiety. Conversely, a sleep duration of ≥6 h/day, an exercise duration ≥30 min/day, having the same as typical or higher study efficiency during the COVID-19 outbreak, and living in provinces with 1000-9999 confirmed COVID-19 cases were negatively associated with depression and anxiety. In conclusion, compared to figures reported during the COVID-19 outbreak, the prevalence of depression and anxiety in Chinese adolescents significantly increased after the initial outbreak. Regular screening and appropriate interventions are urgently needed to reduce the risk for emotional disturbances among adolescents during and after the initial COVID-19 outbreaks.

The psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and the Patient Health Questionnaire-9 (PHQ-9) in depressed inpatients in China.

Abstract: This study examined the psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and Patient Health Questionnaire-9 (PHQ-9). The study sample comprised 297 depressed inpatients. The severity of depressive symptoms was assessed with the Hamilton Rating Scale for Depression, the QIDS-SR and the PHQ-9 in all subjects at baseline and a random sample of 50 subjects two weeks later. The internal consistency, convergent validity, factor structure and sensitivity to change of these scales were assessed. Internal consistency (Cronbach's alpha) of the PHQ-9 and QIDS-SR were 0.88 and 0.83, respectively at baseline and 0.91 and 0.87, respectively at exit. Item to total score correlations were higher for the PHQ-9 than those for the QIDS-SR at baseline and exit. Three domains at baseline and two at study exit of the QIDS-SR had a correlation less than 0.65; while only two items at baseline and no item at exit were less than 0.65 for the PHQ-9. Both the PHQ-9 and the QIDS-SR showed uni-dimensional measurement properties at baseline; the two instruments were less sensitive than the HAMD to detect changes of depressive symptoms suggesting low convergent validity. The QIDS-SR and the PHQ-9 have similar and acceptable psychometric properties in most domains as tested in depressed inpatients.

Worldwide prevalence of sexual harassment towards nurses: A comprehensive meta-analysis of observational studies.

Abstract: Aims Sexual harassment towards nurses is a major concern universally, but no meta-analysis on the worldwide prevalence of sexual harassment towards nurses has yet been published. This study examined the worldwide prevalence of sexual harassment against nurses and explored its moderating factors. Design Meta-analysis of observational studies. Data sources The PubMed, PsycINFO, EMBASE, and Web of Science databases from their commencement date to February 2018 were systematically and independently searched by two investigators. Review methods Data on the prevalence of sexual harassment experienced by nurses were extracted and pooled using the random-effects model. Results A total of 43 studies covering 52,345 nurses were included in the analyses. Female nurses accounted for 83.87% of the 32,970 subjects in 25 studies with available data on gender ratio. The prevalence of sexual harassment towards nurses in the past 12 months and during nursing career were 12.6% (95% CI: 10.9-14.4%) and 53.4% (95% CI: 23.1-83.7%), respectively. Gender, use of the WHO questionnaires, lower middle-income and high-income countries, sample size, survey year, and mean age of subjects were significantly associated with the prevalence of sexual harassment. Conclusion The high prevalence of sexual harassment against nurses found in this meta-analysis represents the ongoing sexism and deleterious effects (e.g., poor work quality and efficiency, increased stress and job dissatisfaction) in the profession. Appropriate preventive measures, training, and empowerment of nurses are needed to ensure workplace safety and equality in this profession. Impact The study addressed the worldwide prevalence of sexual harassment against nurses and its moderating factors. Health authorities and hospital administrators should develop organizational policy and preventive strategies to ensure nurses' workplace safety and equality.

A rating scale for drug-induced akathisia

Abstract: A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's kappa) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic in-patients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.

A Tipping Point for Measurement-Based Care

Abstract: Objective:Measurement-based care involves the systematic administration of symptom rating scales and use of the results to drive clinical decision making at the level of the individual patient. Thi...

Implementing Measurement-Based Care in Behavioral Health: A Review

Abstract: Importance Measurement-based care (MBC) is the systematic evaluation of patient symptoms before or during an encounter to inform behavioral health treatment. Despite MBC’s demonstrated ability to enhance usual care by expediting improvements and rapidly detecting patients whose health would otherwise deteriorate, it is underused, with typically less than 20% of behavioral health practitioners integrating it into their practice. This narrative review addresses definitional issues, offers a concrete and evaluable operationalization of MBC fidelity, and summarizes the evidence base and utility of MBC. It also synthesizes the extant literature’s characterization of barriers to and strategies for supporting MBC implementation, sustainment, and scale-up. Observations Barriers to implementing MBC occur at multiple levels: patient (eg, concerns about confidentiality breach), practitioner (eg, beliefs that measures are no better than clinical judgment), organization (eg, no resources for training), and system (eg, competing requirements). Implementation science—the study of methods to integrate evidence-based practices such as MBC into routine care—offers strategies to address barriers. These strategies include using measurement feedback systems, leveraging local champions, forming learning collaboratives, training leadership, improving expert consultation with clinical staff, and generating incentives. Conclusions and Relevance This narrative review, informed by implementation science, offers a 10-point research agenda to improve the integration of MBC into clinical practice: (1) harmonize terminology and specify MBC’s core components; (2) develop criterion standard methods for monitoring fidelity and reporting quality of implementation; (3) develop algorithms for MBC to guide psychotherapy; (4) test putative mechanisms of change, particularly for psychotherapy; (5) develop brief and psychometrically strong measures for use in combination; (6) assess the critical timing of administration needed to optimize patient outcomes; (7) streamline measurement feedback systems to include only key ingredients and enhance electronic health record interoperability; (8) identify discrete strategies to support implementation; (9) make evidence-based policy decisions; and (10) align reimbursement structures.

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 1. Disease Burden and Principles of Care

Abstract: Background:The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines r...