Anne Chatton

Cognitive behavioural therapy for weight gain associated with antipsychotic drugs

BACKGROUND Overweight and obesity are common concerns in individuals with severe mental disorders. In particular, antipsychotic drugs (AP) frequently induce weight gain. This phenomenon lacks current management and no previous controlled studies seem to use cognitive therapy to modify eating and weight-related cognitions. Moreover, none of these studies considered binge eating or eating and weight-related cognitions as possible outcomes. AIM The main aim of this study is to assess the effectivity of cognitive and behavioural treatment (CBT) on eating and weight-related cognitions, binge eating symptomatology and weight loss in patients who reported weight gain during AP treatment. METHOD A randomized controlled study (12-week CBT vs. Brief Nutritional Education) was carried out on 61 patients treated with an antipsychotic drug who reported weight gain following treatment. Binge eating symptomatology, eating and weight-related cognitions, as well as weight and body mass index were assessed before treatment, at 12 weeks and at 24 weeks. RESULTS The CBT group showed some improvement with respect to binge eating symptomatology and weight-related cognitions, whereas the control group did not. Weight loss occurred more progressively and was greater in the CBT group at 24 weeks. CONCLUSION The proposed CBT treatment is particularly interesting for patients suffering from weight gain associated with antipsychotic treatment.

Internet use by patients with psychiatric disorders in search for general and medical informations.

Background Internet is commonly used by the general population, notably for health information-seeking. There has been little research into its use by patients treated for a psychiatric disorder. Aim To evaluate the use of internet by patients with psychiatric disorders in searching for general and medical information. Methods In 2007, 319 patients followed in a university hospital psychiatric out-patient clinic, completed a 28-items self-administered questionnaire. Results Two hundred patients surveyed were internet users. Most of them (68.5%) used internet in order to find health-related information. Only a small part of the patients knew and used criteria reflecting the quality of contents of the websites consulted. Knowledge of English and private Internet access were the factors significantly associated with the search of information on health on Internet. Conclusions Internet is currently used by patients treated for psychiatric disorders, especially for medical seeking information.

Does Self-Selection Affect Samples’ Representativeness in Online Surveys? An Investigation in Online Video Game Research

Background The number of medical studies performed through online surveys has increased dramatically in recent years. Despite their numerous advantages (eg, sample size, facilitated access to individuals presenting stigmatizing issues), selection bias may exist in online surveys. However, evidence on the representativeness of self-selected samples in online studies is patchy. Objective Our objective was to explore the representativeness of a self-selected sample of online gamers using online players’ virtual characters (avatars). Methods All avatars belonged to individuals playing World of Warcraft (WoW), currently the most widely used online game. Avatars’ characteristics were defined using various games’ scores, reported on the WoW’s official website, and two self-selected samples from previous studies were compared with a randomly selected sample of avatars. Results We used scores linked to 1240 avatars (762 from the self-selected samples and 478 from the random sample). The two self-selected samples of avatars had higher scores on most of the assessed variables (except for guild membership and exploration). Furthermore, some guilds were overrepresented in the self-selected samples. Conclusions Our results suggest that more proficient players or players more involved in the game may be more likely to participate in online surveys. Caution is needed in the interpretation of studies based on online surveys that used a self-selection recruitment procedure. Epidemiological evidence on the reduced representativeness of sample of online surveys is warranted.

Brief DISCERN, six questions for the evaluation of evidence-based content of health-related websites.

OBJECTIVE To extract and to validate a brief version of the DISCERN which could identify mental health-related websites with good content quality. METHOD The present study is based on the analysis of data issued from six previous studies which used DISCERN and a standardized tool for the evaluation of content quality (evidence-based health information) of 388 mental health-related websites. After extracting the Brief DISCERN, several psychometric properties (content validity through a Factor analysis, internal consistency by the Cronbachs alpha index, predictive validity through the diagnostic tests, concurrent validity by the strength of association between the Brief DISCERN and the original DISCERN scores) were investigated to ascertain its general applicability. RESULTS A Brief DISCERN composed of two factors and six items was extracted from the original 16 items version of the DISCERN. Cronbachs alpha coefficients were more than acceptable for the complete questionnaire (alpha=0.74) and for the two distinct domains: treatments information (alpha=0.87) and reliability (alpha=0.83). Sensibility and specificity of the Brief DISCERN cut-off score > or =16 in the detection of good content quality websites were 0.357 and 0.945, respectively. Its predictive positive and negative values were 0.98 and 0.83, respectively. A statistically significant linear correlation was found between the total scores of the Brief DISCERN and those of the original DISCERN (r=0.84 and p<0.0005). CONCLUSION The Brief DISCERN seems to be a reliable and valid instrument able to discriminate between websites with good and poor content quality. PRACTICE IMPLICATIONS The Brief DISCERN is a simple tool which could facilitate the identification of good information on the web by patients and general consumers.

HON Label and DISCERN as Content Quality Indicators of Health-Related Websites

Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). “Health on the Net” (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patients.

Arabic validation of the Compulsive Internet Use Scale (CIUS)

BackgroundThe popularity of using the Internet and related applications has grown in Arabic countries in recent years. Despite numerous advantages in terms of optimizing communications among individuals and social systems, the use of the Internet may in certain cases become problematic and engender negative consequences in daily life. As no instrument in the Arabic language is available, however, to measure excessive Internet use, the goal of the current study was to validate an Arabic version of the Compulsive Internet Use Scale (CIUS).MethodsThe Arabic version of the CIUS was administered to a sample of 185 Internet users and exploratory and confirmatory analyses performed.ResultsAs found previously for the original version, a one-factor model of the CIUS had good psychometric properties and fit the data well. The total score on the CIUS was positively associated with time spent online.ConclusionThe Arabic version of the CIUS seems to be a valid self-report to measure problematic Internet use.

Quality of Web-based Information on Pathological Gambling

The present study aims to evaluate the quality of web-based information on gambling and to investigate potential content quality indicators. The following key words: gambling, pathological gambling, excessive gambling, gambling problem and gambling addiction were entered into two popular search engines: Google and Yahoo. Websites were assessed with a standardized proforma designed to rate sites on the basis of “accountability”, “presentation”, “interactivity”, “readability” and “content quality”. “Health on the Net” (HON) quality label, and DISCERN scale scores aiding people without content expertise to assess quality of written health publication were used to verify their efficiency as quality indicators. Of the 200 links identified, 75 websites were included. The results of the study indicate low scores on each of the measures. A composite global score appeared as a good content quality indicator. While gambling-related education websites for patients are common, their global quality is poor. There is a need for useful evidence-based information about gambling on the web. As the phenomenon has greatly increased, it could be relevant for Internet sites to improve their content by using global score as a quality indicator.

French validation of the compulsive internet use scale (CIUS).

The popularity of using the Internet and related applications has grown in European countries in the last two decades. Despite numerous advantages in terms of optimizing communications among individuals and social systems, the use of the Internet may be associated with excessive use and possible Internet addiction. The goals of the current study were to validate a French version of the Compulsive Internet Use Scale (CIUS) and to assess its links with common psychiatric symptoms such as depression (assessed with the Beck Depression Inventory: BDI), anxiety (assessed with the Trait Anxiety Inventory: STAI) and alcohol misuse (assessed with the Alcohol Use Disorder Identification Test: AUDIT). The French versions of the CIUS, BDI, STAI and AUDIT were administered to a sample of Internet users. Exploratory and confirmatory analyses, correlation analysis and logistic regression were performed. As previously found with the original version, a one-factor model of the CIUS had good psychometric properties and fit the data well. Excessive use of the Internet was associated with depressive symptoms.

Quality of Web-based information on depression

Background: Although some studies have already been done on the quality of websites on depression, they have mainly focused on content quality, and were mostly carried out about a decade ago. The main aim of this work was thus to examine the quality of current websites on depression through the use of several indicators. Methods: Three keywords on depression were entered into a popular search engine. Websites were evaluated on accountability, interactivity, esthetics, readability, and content quality. Moreover, the presence of the “Health on the Net” (HON) quality label and the websites affiliation were checked, and the Brief DISCERN was used as a potential content quality indicator for general consumers. Results: A total of 45 websites were analyzed. The content quality of the depression‐related websites was good. Websites with the HON label had significantly higher accountability, content quality, and Brief DISCERN scores. Moreover, websites with a high score on the Brief DISCERN scored significantly higher for accountability and content quality. Finally, the content quality of websites was significantly and positively correlated with the Brief DISCERN score, the presence of the HON label, and affiliation of the websites. Conclusion: The overall quality of websites on depression seems to be rather good. Depression and Anxiety, 2010.

Internet Poker Websites and Pathological Gambling Prevention Policy

Despite the widespread increase in online poker playing and the risk related to excessive poker playing, research on online poker websites is still lacking with regard to pathological gambling prevention strategies offered by the websites. The aim of the present study was to assess the pathological gambling-related prevention strategies of online poker websites. Two keywords (“poker” and “poker help”) were entered into two popular World Wide Web search engines. The first 20 links related to French and English online poker websites were assessed. Seventy-four websites were assessed with a standardized tool designed to rate sites on the basis of accountability, interactivity, prevention strategies, marketing, and messages related to poker strategies. Prevention strategies appeared to be lacking. Whereas a substantial proportion of the websites offered incitation to gambling such as betting “tips,” few sites offered strategies to prevent or address problem gambling. Furthermore, strategies related to poker, such as probability estimation, were mostly reported without acknowledging their limitations. Results of this study suggest that more adequate prevention strategies for risky gambling should be developed for online poker.