Browsing by Author "Quevedo Labbé, Iván Yamil"

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    Digital use of standardised assessment tools for children and adolescents : can available paper-based questionnaires be used free of charge in electronic format?
    (2022) Cottin Arredondo, Marianne; Blum, Kathrin; Konjufca, Jon; Quevedo Labbé, Iván Yamil; Kaaya, Sylvia; Behn Berliner, Alex Joseph; Schmeck, Klaus; Sharp, Carla; Zimmermann, Ronan
    Question: Most adolescents live in low- and middle-income countries (LMIC), and about 10% of them face mental problems. The mental health provision gap in low- and middle-income countries could be addressed by evidence-based practices, however costs are implementational barriers. Digitalization can improve the accessibility of these tools and constitutes a chance for LMIC to use them more easily at a low cost. We reviewed free and brief evidence-based mental health assessment tools available for digital use to assess psychopathology across different domains in youth. Methods: For the current study, instruments from a recent review on paper-based instruments were re-used. Additionally, a systematic search was conducted to add instruments for the personality disorder domain. We searched and classified the copyright and license terms available from the internet in terms of free usage and deliverability in a digital format. In the case that this information was insufficient, we contacted the authors. Results: In total, we evaluated 109 instruments. Of these instruments, 53 were free and digitally usable covering 11 mental health domains. However, retrieving information on copyright and license terms was very difficult. Conclusions: Free and digitally adaptable instruments are available, supporting the strategy of using instruments digitally to increase access. The instrument’s authors support this initiative, however, the lack of copyright information and the difficulties in contacting the authors and licence holders are barriers to using this strategy in LMIC. A comprehensive, online instrument repository for clinical practice would be an appropriate next step to make the instruments more accessible and reduce implementation barriers.
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    Mental Health Information Reporting Assistant (MHIRA)-an open-source software facilitating evidence-based assessment for clinical services
    (2023) Zimmermann, Ronan; Konjufca, Jon; Sakejo, Peter; Kilonzo, Mrema; Quevedo Labbé, Iván Yamil; Blum, Kathrin; Biba, Edison; Mosha, Tumaini; Cottin Arredondo, Marianne; Hernández Contreras, Cristóbal Eduardo; Kaaya, Sylvia; Arenliu, Aliriza; Behn Berliner, Alex Joseph
    Evidence-based assessment (EBA) in mental health is a critical aspect of improving patient outcomes and addressing the gaps in mental health care. EBA involves the use of psychometric instruments to gather data that can inform clinical decision-making, inform policymakers, and serve as a basis for research and quality management. Despite its potential, EBA is often hindered by barriers such as workload and cost, leading to its underutilization. Regarding low- and middle-income countries (LMIC), the implementation of EBA is recognized as a key strategy to address and close the prevalent mental health treatment gap.To simplify the application of EBA including in LMIC, an international team of researchers and practitioners from Tanzania, Kosovo, Chile, and Switzerland developed the Mental Health Information Reporting Assistant (MHIRA). MHIRA is an open-source electronic health record that streamlines EBA by digitising psychometric instruments and organising patient data in a user-friendly manner. It provides immediate and convenient reports to inform clinical decision-making.The current article provides a comprehensive overview of the features and technical details of MHIRA, as well as insights from four implementation scenarios. The experience gained during the implementations as well as the user-feedback suggests that MHIRA has the potential to be successfully implemented in a variety of clinical contexts and simplify the use of EBA. However, further research is necessary to establish its potential to sustainably transform healthcare services and impact patient outcomes.In conclusion, MHIRA represents an important step in promoting the widespread adoption of EBA in mental health. It offers a promising solution to the barriers that have limited the use of EBA in the past and holds the potential to improve patient outcomes and support the ongoing efforts to address gaps in mental health care.
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    Mentalization and epigenetic changes in psycotherapy of adolescents diagnosed with borderline personality disorder
    (2021) Quevedo Labbé, Iván Yamil; Jiménez de la Jara, Juan Pablo; Pontificia Universidad Católica de Chile. Escuela de Psicología
    Genetic and early environmental factors are interwoven in the etiopathogenesis of Borderline Personality Disorder (BPD). Epigenetic mechanisms, allow the molecular machinery to adapt to environmental conditions. There are gaps in the knowledge of how epigenetic mechanisms are involved in the effects of early affective environment, development of BPD and psychotherapy response. This work aims to explore changes in DNA methylation of FKBP5 gene, which encodes for a stress response protein, in relation to psychotherapy, on symptomatology and underlying psychological processes in a sample of 11 female adolescents diagnosed with BPD. For this purpose, measures of early trauma, borderline and depressive symptoms, psychotherapy outcome, mentalization and emotional regulation were studied longitudinally at baseline, 3 and 6 months. Percentage DNA methylation levels of FKBP5 gene intron 7 were measured at the same times. A significant reduction of borderline and depressive symptoms was found. No significant change was observed in emotional regulation and mentalization. A reduction in the average DNA methylation was observed over time. Additionally, it was observed that this decrease in methylation occurred only in those individuals who reported the presence of early trauma and responded to psychotherapy. The results support an effect of psychotherapy on epigenetic mechanisms associated with the stress response, specifically DNA methylation of FKBP5, which is concordant with previous studies in other phenotypes. The fact that the epigenetic change occurred only in the presence of early trauma is suggestive of a specific molecular mechanism of recovery. The results should be taken with caution given the small sample size. Further research is needed to include covariates that modify DNA methylation and incorporate endocrinological markers and therapeutic process variables. Psychotherapy focused on personality pathology could lead to changes in DNA methylation causing permanent reprogramming of phenotypic adaptation to the interpersonal environment.