Netherlands Institute of Mental Health and Addiction Trimbos Institute

Utrecht, Netherlands

Netherlands Institute of Mental Health and Addiction Trimbos Institute

Utrecht, Netherlands
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Van Dael F.,Maastricht University | Van Os J.,Maastricht University | Van Os J.,King's College London | De Graaf R.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | And 3 more authors.
Acta Psychiatrica Scandinavica | Year: 2011

Objective: Although there is substantial comorbidity between psychotic disorder and obsessive-compulsive disorder (OCD), little is known about how these clinical phenotypes, and their subclinical extended phenotypes, covary and impact on each other over time. This study examined cross-sectional and longitudinal associations between both (extended) phenotypes in the general population.Method: Data were obtained from the three waves of the NEMESIS-study. A representative population sample of 7076 participants were assessed using the composite international diagnostic interview (CIDI) at baseline (T0), 1 year later at T1 and again 2 years later at T2.Results: At T0, a lifetime diagnosis of psychotic disorder was present in 1.5% of the entire sample, in 11.5% of the people with any OC symptom and in 23.0% of individuals diagnosed with OCD. OC symptoms at T0 predicted incident psychotic symptoms at T2. Similarly, T0 psychotic symptoms predicted T2 OC symptoms. The likelihood of persistence of psychotic symptoms or transition to psychotic disorder was higher if early psychosis was accompanied by co-occurring OC symptoms, but not the other way around.Conclusion: OCD and the psychosis phenotype cluster together and predict each other at (sub)clinical level. The co-occurrence of subclinical OC and psychosis may facilitate the formation of a more 'toxic' form of persistent psychosis. © 2010 John Wiley & Sons A/S.


Pot A.M.,Netherlands Institute of Mental Health and Addiction Trimbos institute | Pot A.M.,VU University Amsterdam | Pot A.M.,University of Queensland | Blom M.M.,Alzheimer Nederland Dutch Alzheimers Society | Willemse B.M.,Netherlands Institute of Mental Health and Addiction Trimbos institute
International Psychogeriatrics | Year: 2015

Background: The number of people with dementia is increasing rapidly. Providing care to a relative or friend with dementia may lead to serious mental health problems. Internet interventions may offer opportunities to improve the availability and accessibility of (cost)effective interventions to reduce family caregivers' psychological distress. This study describes the acceptability of a guided self-help Internet intervention "mastery over dementia" (MoD), aimed at reducing caregivers' psychological distress, in terms of reach, adherence and user evaluation. Methods: The sample for this study is the experimental group that participated in the (cost)effectiveness trial of MoD (N = 149). Data on characteristics of family caregivers and people with dementia, completion and user evaluation were used and analyzed with descriptive statistics, χ2and T-tests. Results: MoD reaches a wide variety of caregivers, also those aged 75+, having a relative with a recent diagnosis of dementia or living in a care home. However, the percentage of caregivers who did not complete all eight lessons was rather high (55.7%). Among the completers (N = 66; 44.3%) were significantly more spouses, caregivers living in the same household, older caregivers, and those caring for somebody with another formal diagnosis than Alzheimer's disease. Caregivers' evaluation showed that females rated higher on the comprehensibility of the lessons and feedback and spent less time on the lessons. Conclusion: The guided self-help Internet intervention MoD is acceptable for a broad range of family caregivers of people with dementia. The next step is to substantiate its (cost)effectiveness. Copyright © International Psychogeriatric Association 2015.


Hondebrink L.,University Utrecht | Nugteren-van Lonkhuyzen J.J.,University Utrecht | Van Der Gouwe D.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Brunt T.M.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Brunt T.M.,University of Amsterdam
Drug and Alcohol Dependence | Year: 2015

Background: In recent years, the number of new psychoactive substances (NPS) appearing on the illicit drug market strongly increased. However, little is known about their toxic effects and risks. Therefore, we determined the most frequently occurring NPS in The Netherlands and combined this with data regarding drug-related intoxications. Methods: Data from the Drugs Information and Monitoring System (DIMS) and the Dutch Poisons Information Centre (DPIC) were combined and jointly analyzed. Results: The number of drug samples submitted to DIMS for analysis containing NPS increased from 22 in 2007 to 431 samples in 2013. The most frequently submitted NPS in 2013 included 4-bromo-2,5-dimethoxyphenethylamine (2C-B), 4-fluoroamphetamine (4-FA), methoxetamine (MXE) and 6-(2-aminopropyl)benzofuran (6-APB). From 2012 onwards, the number of NPS bought as drug of choice exceeded those appearing as adulterants in established drugs. The DPIC was consulted about 35 NPS exposures in 2013, most frequently involving 4-FA, mephedrone, MXE, 2C-B and 6-APB. Following NPS exposure, neurological and psychological symptoms were most frequently reported, like agitation and hallucinations. In addition, cardiovascular symptoms like hypertension and tachycardia often occurred. Conclusions: NPS are currently being purchased as drug of choice in The Netherlands and their availability and use is increasing. Although pharmacological and toxicological data are scarce, NPS can induce pronounced clinical effects. Therefore, the monitoring of trends in NPS prevalence needs to be continued, combined with reported clinical effects, and preferably supported by analytical confirmation of exposures in such patients. © 2014 Elsevier Ireland Ltd.


Van Ditzhuijzen J.,University Utrecht | ten Have M.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | de Graaf R.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | van Nijnatten C.H.C.J.,University Utrecht | Vollebergh W.A.M.,University Utrecht
Journal of Psychiatric Research | Year: 2013

Prior research has focused primarily on the mental health consequences of abortion; little is known about mental health before abortion. In this study, the psychiatric history of women who have had an abortion is investigated. 325 Women who recently had an abortion were compared with 1902 women from the population-based Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). Lifetime prevalence estimates of various mental disorders were measured using the Composite International Diagnostic Interview 3.0. Compared to the reference sample, women in the abortion sample were three times more likely to report a history of any mental disorder (OR=3.06, 95% CI=2.36-3.98). The highest odds were found for conduct disorder (OR=6.97, 95% CI=4.41-11.01) and drug dependence (OR=4.96, 95% CI=2.55-9.66). Similar results were found for lifetime-minus-last-year prevalence estimates and for women who had first-time abortions only. The results support the notion that psychiatric history may explain associations that have been found between abortion and mental health. Psychiatric history should therefore be taken into account when investigating the mental health consequences of abortion. © 2013 Elsevier Ltd.


Nugteren-van Lonkhuyzen J.J.,University Utrecht | van Riel A.J.H.P.,University Utrecht | Brunt T.M.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Brunt T.M.,University of Amsterdam | Hondebrink L.,University Utrecht
Drug and Alcohol Dependence | Year: 2015

Background: Recently, the number of new psychoactive substances (NPS) appearing on the illicit drug market has shown a marked increase. Although many users perceive the risk of using NPS as medium or low, these substances can pose a serious health risk and several NPS have been implicated in drug-related deaths. In Europe, frequently detected NPS are 4-bromo-2,5-dimethoxyphenethylamine (2C-B), 4-fluoroamphetamine (4-FA) and benzofurans (5-(2-aminopropyl)benzofuran (5-APB) or 6-(2-aminopropyl)benzofuran (6-APB)). However, little is known about the health risks of these specific NPS. Methods: In this paper, existing literature on the pharmacokinetics and pharmacodynamics of 2C-B, 4-FA and benzofurans (5-APB/6-APB) was reviewed. Results: Our review showed that the clinical effects of 2C-B, 4-FA and benzofurans (5-APB/6-APB) are comparable with common illicit drugs like amphetamine and 3,4-methylenedioxymethamphetamine (MDMA). Therefore, NPS toxicity can be handled by existing treatment guidelines that are based on clinical effects instead of the specific drug involved. Even so, information on the health risks of these substances is limited to a number of case reports that are complicated by confounders such as analytical difficulties, mislabelling of drugs, concomitant exposures and interindividual differences. Conclusion: To aid in early legislation, data on clinical effects from poisons centres and user fora should be combined with (in vitro) screening methods and collaboration on an (inter)national level is essential. As a result, potentially hazardous NPS could be detected more quickly, thereby protecting public health. © 2015 Elsevier Ireland Ltd.


Jochems E.C.,Erasmus Medical Center | Mulder C.L.,Erasmus Medical Center | Duivenvoorden H.J.,Erasmus Medical Center | van der Feltz-Cornelis C.M.,Erasmus Medical Center | And 4 more authors.
Assessment | Year: 2014

Self-determination theory is potentially useful for understanding reasons why individuals with mental illness do or do not engage in psychiatric treatment. The current study examined the psychometric properties of three questionnaires based on self-determination theory—The Treatment Entry Questionnaire (TEQ), Health Care Climate Questionnaire (HCCQ), and the Short Motivation Feedback List (SMFL)—in a sample of 348 Dutch adult outpatients with primary diagnoses of mood, anxiety, psychotic, and personality disorders. Structural equation modeling showed that the empirical factor structures of the TEQ and SMFL were adequately represented by a model with three intercorrelated factors. These were interpreted as identified, introjected, and external motivation. The reliabilities of the Dutch TEQ, HCCQ, and SMFL were found to be acceptable but can be improved on; congeneric estimates ranged from 0.66 to 0.94 depending on the measure and patient subsample. Preliminary support for the construct validities of the questionnaires was found in the form of theoretically expected associations with other scales, including therapist-rated motivation and treatment engagement and with legally mandated treatment. Additionally, the study provides insights into the relations between measures of motivation based on self-determination theory, the transtheoretical model and the integral model of treatment motivation in psychiatric outpatients with severe mental illness. © The Author(s) 2013.


Beekman A.T.F.,University of Amsterdam | Feltz-Cornelis C.V.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Van Marwijk H.W.J.,University of Amsterdam
Current Opinion in Psychiatry | Year: 2013

Purpose of Review: The purpose of this study is to review recent evidence of the effects of enhanced depression care, focusing (1) on symptomatic, functional and economic outcomes and (2) across different countries, (3) ethnic groups and (4) settings. Recent Findings: Collaborative care is currently by far the most influential and best studied method to enhance depression care. Recent trials and reviews provide firm evidence that collaborative care is more effective than care as usual (CAU), though with small effects. These effects generalized across several important health outcomes are probably more pronounced in patients with more complex or severe disorders. Cost-effectiveness and cost utility data demonstrate that collaborative care is of good value for money, and this is probably more pronounced in patients with higher a-priori levels of healthcare utilization. Collaborative care is readily exported to other healthcare systems, other regions of the world and other cultures. Summary: Given parallel development and successful testing of other cheaper and more simple interventions targeting depression (such as guided self-help and e-mental health), it may be that collaborative care will focus on the more severe, complex or recurrent forms of affective disorder in the future. Including effects of collaborative care on other outcomes, especially on work-related functioning and economic productivity, seems fruitful. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Willemse B.M.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Smit D.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | De Lange J.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Pot A.M.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Pot A.M.,VU University Amsterdam
BMC Geriatrics | Year: 2011

Background: There is limited information available on how characteristics of the organization of nursing home care and especially group living home care and staff ratio contribute to care staff well being, quality of care and residents' quality of life. Furthermore, it is unknown what the consequences of the increasingly small scale organization of care are for the amount of care staff required in 2030 when there will be much more older people with dementia. Methods/Design. This manuscript describes the design of the 'Living Arrangements for people with Dementia study' (LAD-study). The aim of this study is to include living arrangements from every part of this spectrum, ranging from large scale nursing homes to small group living homes. The LAD-study exists of quantitative and qualitative research. Primary outcomes of the quantitative study are wellbeing of care staff, quality of care and quality of life of residents. Furthermore, data concerning staff ratio and characteristics of the living arrangements such as group living home care characteristics are assessed. To get more in-depth insight into the barriers and facilitators in living arrangements for people with dementia to provide good care, focus groups and Dementia Care Mapping are carried out. Discussion. Results of this study are important for policymakers, directors and staff of living arrangements providing nursing home care to people with dementia and essential for the development of methods to improve quality of care, residents' and staff well-being. Data collection will be repeated every two years, to generate knowledge on the results of changing policies in this field. © 2011 Willemse et al; licensee BioMed Central Ltd.


Van der Pol P.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Liebregts N.,University of Amsterdam | de Graaf R.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Korf D.J.,University of Amsterdam | And 2 more authors.
International Journal of Methods in Psychiatric Research | Year: 2013

The Severity of Dependence Scale (SDS) measures with five items the degree of psychological dependence on several illicit drugs, including cannabis. Its psychometric properties have not yet been examined in young adult frequent cannabis users, an eminently high-risk group for cannabis dependence. Internal consistency and criterion validity of the SDS were investigated within an enriched community based sample of 577 Dutch frequent (≥ three days per week in the past 12 months) cannabis users between 18-30 years. Criterion validity was tested against the Composite International Diagnostic Interview (CIDI) 3.0 DSM-IV diagnosis cannabis dependence, and psychometric properties were assessed separately for males and females and for ethnic subgroups. Principal component analysis showed that all items of the scale loaded on a single factor and reliability of the SDS total score was good (Cronbach's α=0.70). However, criterion validity against the CIDI diagnosis cannabis dependence was low: area under curve (AUC) was 0.68 (95% confidence interval: 0.64-0.73) and at the optimal differentiating cut-off (SDS≥4), sensitivity was 61.3% and specificity 63.5%. Results were similar for subgroups on gender and ethnicity. While internal consistency of the SDS is good, its use as a screener to differentiate between dependence and non-dependence within populations of young adult frequent cannabis users is not recommended. © 2013 John Wiley & Sons, Ltd.


Hermens M.L.M.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Van Splunteren P.T.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Van Den Bosch A.,Netherlands Institute of Mental Health and Addiction Trimbos Institute | Verheul R.,University of Amsterdam
Psychiatric Services | Year: 2011

Objective: This study determined the gap between actual care and optimal care (recommended in the clinical guideline) for patients with borderline personality disorder in the Netherlands. Factors that affected guideline implementation were identified. Methods: Ten specialized mental health organizations participated in this cross-sectional study. The number and proportion of patients who received optimal diagnosis and treatment were calculated. Focus groups explored implementation barriers. Results: Records of 422 patients with a diagnosis of borderline personality disorder were analyzed, and 315 records from six organizations contained the necessary data. Across the six organizations, most of these patients received this as an initial diagnosis (median 85%). However, only a minority received psychotherapy as a first-step treatment (median 23%). Capacity problems and organizational barriers were the main barriers to providing psychotherapy. Conclusions: Most patients with borderline personality disorder did not receive the recommended first-step treatment (psychotherapy). Care pathways may help improve efficiency and quality of care.

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