School for Mental Health and Neuroscience

Maastricht, Netherlands

School for Mental Health and Neuroscience

Maastricht, Netherlands
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Verbunt J.A.,Care and Public Health | Derick T W.,Care and Public Health | Derick T W.,Maastricht University | Van Heugten C.M.,Oxford Center for Enablement | And 2 more authors.
Journal of Rehabilitation Medicine | Year: 2010

Objective: To study factors related to quality of life after a hypoxic period due to cardiac arrest. Design: Retrospective cohort study. Subjects: Eighty-eight survivors of out-of-hospital cardiac arrest, admitted to a Dutch academic hospital between 2001 and 2006. Methods: Patients received a set of questionnaires at home. The main outcome measures were physical and mental quality of life (Medical Outcomes Study 36-item Short Form Health Survey; SF-36). Potential determinants were cognitive complaints, emotional problems (depression/anxiety), post-traumatic stress, fatigue, daily functioning and participation in society. Multiple linear regression analyses were performed with physical and mental quality of life as dependent variables. Results: Sixty-three (72%) patients responded. Mean time since cardiac arrest was 36 months (standard deviation (SD) 19) . Backward regression analyses showed that physical quality of life was significantly (p<0.001, adjusted R 2=0.531) related to cognitive complaints (β=-0.318), instrumental daily life activities (β=0.262), post-traumatic stress (β=-0.246) and fatigue (β=-0.226). Mental quality of life was significantly (p<0.001, adjusted R2=0.664) explained by anxiety/depression (β=-0.609), fatigue (β=-0.177) and cognitive complaints (β=-0.175). Conclusion: Quality of life is related to cognitive complaints, fatigue, anxiety/depression, post-traumatic stress and difficulties in daily activities in survivors of out-of-hospital cardiac arrest. Rehabilitation programmes for this group should specifically address these topics. © 2010 Foundation of Rehabilitation Information.


Janssens M.,School for Mental Health and Neuroscience | Van Haren N.E.M.,University Utrecht
Australian and New Zealand Journal of Psychiatry | Year: 2015

Background: The Remission in Schizophrenia Working Group (RSWG) has proposed remission criteria for schizophrenia, which were shown to be valid in terms of functional and clinical outcomes. However, studies investigating the association between dynamics in remission status in relation to longitudinal functional and clinical outcome are scarce. Methods: A total of 648 patients were allocated to four change-in-remission groups, i.e. remission/remission, remission/no-remission, no-remission/remission, and no-remission/no-remission. Remission status was based on PANSS ratings. Multilevel linear modelling techniques were used to investigate whether enduring remission was associated with more improvement in functional outcome at follow-up. Further, change in functional and clinical outcome at follow-up measurement was assessed for each remission category separately. Results: Both at baseline and at follow-up, remission status was associated with better functioning. At baseline, patients who subsequently moved out of remission status could be characterized by more severe psychopathology, disabilities, unmet needs and worse quality of life (QoL) compared with patients who continued to be in remission. The stable inremission group was characterized by significantly better functioning and QoL, both at baseline and follow-up compared with all other remission groups. Nevertheless, QoL increased in all four patient categories. Conclusions: In a large sample of patients with a non-affective psychotic disorder, stable remission or moving into remission over time, based on the RSWG criteria, was associated with a favourable functional outcome and QoL, providing further support for the clinical validity of the RSWG remission criteria. The findings also suggest growing adaptation and self-management over time, despite ongoing difficulties. © 2014 The Royal Australian and New Zealand College of Psychiatrists.


PubMed | University Utrecht and School for Mental Health and Neuroscience
Type: Journal Article | Journal: The Australian and New Zealand journal of psychiatry | Year: 2015

The Remission in Schizophrenia Working Group (RSWG) has proposed remission criteria for schizophrenia, which were shown to be valid in terms of functional and clinical outcomes. However, studies investigating the association between dynamics in remission status in relation to longitudinal functional and clinical outcome are scarce.A total of 648 patients were allocated to four change-in-remission groups, i.e. remission/remission, remission/no-remission, no-remission/remission, and no-remission/no-remission. Remission status was based on PANSS ratings. Multilevel linear modelling techniques were used to investigate whether enduring remission was associated with more improvement in functional outcome at follow-up. Further, change in functional and clinical outcome at follow-up measurement was assessed for each remission category separately.Both at baseline and at follow-up, remission status was associated with better functioning. At baseline, patients who subsequently moved out of remission status could be characterized by more severe psychopathology, disabilities, unmet needs and worse quality of life (QoL) compared with patients who continued to be in remission. The stable in-remission group was characterized by significantly better functioning and QoL, both at baseline and follow-up compared with all other remission groups. Nevertheless, QoL increased in all four patient categories.In a large sample of patients with a non-affective psychotic disorder, stable remission or moving into remission over time, based on the RSWG criteria, was associated with a favourable functional outcome and QoL, providing further support for the clinical validity of the RSWG remission criteria. The findings also suggest growing adaptation and self-management over time, despite ongoing difficulties.


Janssens M.,School for Mental Health and Neuroscience | Lataster T.,School for Mental Health and Neuroscience | Simons C.J.P.,School for Mental Health and Neuroscience | Simons C.J.P.,Institute For Mental Health Care Eindhoven En Of Kempen | And 6 more authors.
Schizophrenia Research | Year: 2012

Background: Patients with psychotic disorders show impairments in the recognition of emotions in other people. These impairments have been associated with poor social functioning as measured by self-report questionnaires, clinical interviews and laboratory-based tests of social skills. The ecological validity of these tests, however, is low. Associations were examined between emotion recognition and daily life social interactions in 50 patients diagnosed with a non-affective psychotic disorder and 67 healthy controls. Methods: All participants were assessed with the Degraded Facial Affect Recognition Task (DFAR), a computer test measuring the recognition of emotional facial expressions. Social functioning in daily life was assessed using the Experience Sampling Method (a random time sampling technique) with focus on measures of social context and appraisal of the social situation. Results: Groups differed significantly in the recognition of angry faces, whereas no differences existed for other emotions. There were no associations between emotion recognition and social functioning in daily life and there was no evidence for differential associations in patients as compared to controls. Discussion: Social functioning, when assessed in an ecologically valid fashion, is not sensitive to variation in the traditional experimental assessment of emotion recognition. Real life measures of functioning should guide research linking the handicaps associated with psychosis to underlying cognitive and emotional dysregulation. © 2012 Elsevier B.V.


Klinkenberg S.,Maastricht University | Aalbers M.W.,Maastricht University | Aalbers M.W.,School for Mental Health and Neuroscience | Vles J.S.H.,Maastricht University | And 9 more authors.
Developmental Medicine and Child Neurology | Year: 2012

Aim The aim of this study was to evaluate the effects of vagus nerve stimulation (VNS) in children with intractable epilepsy on seizure frequency and severity and in terms of tolerability and safety. Method In this study, the first randomized active controlled trial of its kind in children, 41 children (23 males; 18 females; mean age at implantation 11y 2mo, SD 4y 2mo, range 3y 10mo-17y 8mo) were included. Thirty-five participants had localization-related epilepsy (25 symptomatic; 10 cryptogenic), while six participants had generalized epilepsy (four symptomatic; two idiopathic). During a baseline period of 12weeks, seizure frequency and severity were recorded using seizure diaries and the adapted Chalfont Seizure Severity Scale (NHS3), after which the participants entered a blinded active controlled phase of 20weeks. During this phase, half of the participants received high-output VNS (maximally 1.75mA) and the other half received low-output stimulation (0.25mA). Finally, all participants received high-output stimulation for 19weeks. For both phases, seizure frequency and severity were assessed as during the baseline period. Overall satisfaction and adverse events were assessed by semi-structured interviews. Results At the end of the randomized controlled blinded phase, seizure frequency reduction of 50% or more occurred in 16% of the high-output stimulation group and in 21% of the low-output stimulation group (p=1.00). There was no significant difference in the decrease in seizure severity between participants in the stimulation groups. Overall, VNS reduced seizure frequency by 50% or more in 26% of participants at the end of the add-on phase The overall seizure severity also improved (p<0.001). Interpretation VNS is a safe and well-tolerated adjunctive treatment of epilepsy in children. Our results suggest that the effect of VNS on seizure frequency in children is limited. However, the possible reduction in seizure severity and improvement in well-being makes this treatment worth considering in individual children with intractable epilepsy. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.


Kootker J.A.,Radboud University Nijmegen | Fasotti L.,Radboud University Nijmegen | Fasotti L.,Rehabilitation Medical Center Groot Klimmendaal | Rasquin S.M.C.,Adelante Rehabilitation Foundation Limburg | And 4 more authors.
BMC Neurology | Year: 2012

Background: Post-Stroke Depression with or without Anxiety (PSDA) is a common disorder in the chronic phase of stroke. Neuropsychiatric problems, such as PSDA, have a negative impact on social reintegration and quality of life. Currently, there is no evidence-based treatment available for reducing PSDA symptoms. In the recent literature on depression in the general population it has been shown that depression complaints can diminish by cognitive behavioural therapy (CBT). In the current study, the effectiveness of augmented, activation-based and individually tailored CBT on the reduction of depression and anxiety will be investigated in patients with PSDA. Additionally, the effects on various secondary outcome measures, such as quality of life, goal attainment and societal participation will be evaluated. This study is embedded in a consortium of 4 interrelated studies on quality of life after stroke (Restore4Stroke).Methods/design: A multi-centre, assessor-blind, randomized controlled trial is conducted. A sample of 106 PSDA patients, as assessed with the Hospital Anxiety and Depression Scale (HADS depression subscale >7), will be recruited and randomly allocated to either an experimental or a control group. The experimental intervention consists of an augmented CBT intervention. The intervention is based on CBT principles of recognizing, registering, and altering negative thoughts and cognitions so that mood, and emotional symptoms are improved. CBT is augmented with direct in-vivo activation offered by occupational or movement therapists. Patients in the control group will receive a computerized cognitive training intervention. Outcomes will be assessed at baseline, immediately post intervention, and at 6 and 12 months follow up.Discussion: This study is the first randomized clinical trial that evaluates the (maintenance of) effects of augmented CBT on post-stroke depression with or without anxiety symptoms. Together with three other projects, the Restore4Stroke PSDA trial will provide novel information about the (treatment of) emotional problems and quality of life after stroke.Trial registration: Trial registration number: Dutch Trial Register NTR2999. © 2012 Kootker et al.; licensee BioMed Central Ltd.


Geurtsen G.J.,Rehabilitation Medical Center Groot Klimmendaal | Van Heugten C.M.,School for Mental Health and Neuroscience | Van Heugten C.M.,Maastricht University | Meijer R.,Rehabilitation Medical Center Groot Klimmendaal | And 3 more authors.
Brain Injury | Year: 2011

Objective: To examine the effects of a residential community reintegration programme for patients with psychosocial problems due to acquired chronic brain injury on caregivers' emotional burden and family functioning. Design: A prospective cohort study with waiting list control and 1-year follow-up. Subjects: Forty-one caregivers of which 28 female. Mean age was 48±8.3 years and 33 caregivers were parents. Intervention: A structured residential treatment programme was offered to the patients directed at domestic life, work, leisure time and social interactions. Measures: The Involvement Evaluation Questionnaire for Brain Injury (IEQ-BI) for emotional burden, the General Health Questionnaire (GHQ) for psychological health and the Family Assessment Device (FAD) for family functioning were used. Results: There was an overall significant effect of Time for all outcome measures (MANOVA T2=9.1, F15,317=64.1, p=0.000). The effect sizes were moderate for three IEQ-BI sub-scales (partial η2=0.12-0.17) and small for two sub-scales (partial η2=0.05-0.09). The effect size for GHQ was moderate (partial η2=0.11). As for FAD no significant time effects were present (partial η2=0.00-0.04). Conclusions: Emotional burden and psychological health of the caregivers improved significantly when patients with acquired brain injury and psychosocial problems followed a residential community reintegration programme. Family dynamics remained stable. © 2011 Informa UK Ltd All rights reserved.


Stauder J.E.A.,Maastricht University | Cornet L.J.M.,Maastricht University | Ponds R.W.H.M.,School for Mental Health and Neuroscience
Research in Autism Spectrum Disorders | Year: 2011

According to the Extreme Male Brain theory persons with autism possess masculinised cognitive traits. In this study masculinisation of gender role behaviour is evaluated in 25 persons with an autism spectrum condition (ASC) and matched controls with gender role behaviour as part of a shortened version of the Minnesota Multiphasic Personality Inventory-2 and the Empathizing Quotient and Systemizing Quotient. Both males and females with an ASC showed minimum male role behaviour. It is suggested that the minimum male gender role could be related to an underdeveloped Theory of Mind, a well-known feature of autism. © 2011 Elsevier Ltd. All rights reserved.


Kohler S.,School for Mental Health and Neuroscience | Kohler S.,Northumbria University | Van Boxtel M.P.J.,School for Mental Health and Neuroscience | Van Os J.,School for Mental Health and Neuroscience | And 6 more authors.
Journal of the American Geriatrics Society | Year: 2010

OBJECTIVES: To examine the temporal association between depressive symptoms and cognitive functioning and estimate the effect measure modification of the apolipoprotein E (APOE) ε4 allele on this relationship. DESIGN: Prospective cohort study. SETTING: General community. PARTICIPANTS: Population-based sample of 598 cognitively intact older adults aged 60 and older, with re-assessments after 3 (N=479) and 6 years (N=412). MEASUREMENTS: Depressive symptoms (Symptom Checklist) and neurocognitive functioning (memory, Visual Verbal Learning Test; attention, Stroop Color-Word Test; processing speed, Letter Digit Substitution Test; general cognition, Mini-Mental State Examination). Longitudinal associations were assessed using linear mixed models. The risk for cognitive impairment, no dementia (CIND) was examined using logistic regression. RESULTS: Adjusting for age, sex, education, and baseline cognition, the rate of change in memory z-scores was 0.00, -0.11, -0.20, and -0.37 for those in the lowest (reference group), second, third, and highest depressive symptom quartiles at baseline, respectively (P<.001 for highest vs lowest quartile). The odds ratios for developing CIND with amnestic features were 1.00, 0.87, 0.69, and 2.98 for the four severity groups (P=.05 for highest vs lowest quartile). Associations were strongest for those with persistent depressive symptoms, defined as high depressive symptoms at baseline and at least one follow-up visit. Results were similar for processing speed and global cognitive function but were not as strong for attention. No APOE interaction was observed. CONCLUSION: Depression and APOE act independently to increase the risk for cognitive decline and may provide targets for prevention and early treatment. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.


PubMed | School for Mental Health and Neuroscience
Type: Journal Article | Journal: Hypertension (Dallas, Tex. : 1979) | Year: 2014

Midlife hypertension is a risk factor for dementia, but little is known about the cognitive trajectories of individuals with incident hypertension. This study follows the cognitive functioning in prevalent and incident hypertension for 12 years and in relation to age and treatment status. Cognitively intact adults aged 25 to 84 years (n=1805) were serially assessed at baseline, 6 years, and 12 years. Hypertension was defined by sphygmomanometry or antihypertensive medication use, and its association with cognitive decline was tested in random-effects models. At baseline, 638 (35.3%) participants had hypertension. They showed faster decline in memory ((2) test for homogeneity=35.75; df=2; P<0.001), executive functions ((2)=21.68; df=2; P<0.001), and information processing speed ((2)=81.96; df= 2; P<0.001) than baseline normotensive participants. At follow-up, 352 individuals (30.2%) developed incident hypertension. They showed faster decline in memory ((2)=7.88; df=2; P=0.019) and information processing speed ((2)= 18.06; df=2; P<0.001), especially from 6- to 12-year follow-up. Effects were most pronounced and widespread in midlife for both prevalent and incident hypertension and in those with untreated and uncontrolled hypertension. This study shows that incident hypertension predicts cognitive decline in middle-aged individuals, and those with poorly controlled blood pressure are most at risk. In newly diagnosed individuals, decline evolves gradually, possibly opening a window for early intervention.

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