3 results
Understanding the potential of digital therapies in implementing the standard of care for depression in Europe
- Philippe Courtet, Odile Amiot, Enrique Baca-Garcia, Lara Bellardita, Giancarlo Cerveri, Anne-Hélène Clair, Diego De Leo, Dominique Drapier, Eric Fakra, Francis Gheysen, Lucas Giner, Ana Gonzalez-Pinto, Gualberto Gussoni, Emmanuel Haffen, Laurent Lecardeur, Fermin Mayoral-Cleries, Francesco Saverio Mennini, Pilar A Sáiz, Eduard Vieta, Diego Alberto Hidalgo, Umberto Volpe
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- Journal:
- European Psychiatry / Volume 66 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 24 October 2023, e82
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Depressive disorders represent the largest proportion of mental illnesses, and by 2030, they are expected to be the first cause of disability-adjusted life years [1]. The COVID-19 pandemic exacerbated prevalence and burden of depression and increased the occurrence of depressive symptoms in general population [2]. The urgency of implementing mental health services to address new barriers to care persuaded clinicians to use telemedicine to follow patients and stay in touch with them, and to explore digital therapeutics (DTx) as potential tools for clinical intervention [2]. The combination of antidepressants and psychotherapy is widely recommended for depression by international guidelines [3] but is less frequently applied in real-world practice. Commonly used treatments are pharmacological, but while being effective, some aspects such as adherence to the drug regimen, residual symptoms, resistance, lack of information, and stigma may hinder successful treatment. In case of less severe depression, standalone psychological therapies should be the first-line treatment option [3], but access to trained psychotherapists remains inequitable. DTx are evidence-based therapies driven by software programs to treat or complement treatment of a specific disease. DTx are classified as Medical Devices, and given their therapeutic purpose, they need to be validated through randomized controlled clinical trials, as for drug-based therapies. In the last 10 years, studies of digital interventions have proliferated; these studies demonstrate that digital interventions increase remission rates and lower the severity of depressive symptoms compared with waitlist, treatment as usual, and attention control conditions [4]. Despite the efficacy demonstrated in clinical trials, many of these tools never reach real-life patients; thus, it might be necessary to implement DTx in the public health system to expand access to valid treatment options. In this framework, DTx represent a good opportunity to help people with depression receive optimal psychotherapeutic care [5].
Deprexis® Acceptability study in REal life (DARE): study design
- O. Amiot, A. H. Clair, P. Courtet, E. Fakra, V. Narboni, F. Gheysen, E. Haffen, D. Drapier, L. Lecardeur
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S859
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Introduction
Depression is a leading cause of disability, worldwide. Recently, WHO highlighted the negative impact of recent crises (COVID-19 pandemic, war in Ukraine, economic crisis).
Although most international guidelines recommend psychotherapies as first-line treatment of depression, access remains scarce in France due to limited availability of trained clinicians (notably those with CBT certification), high cost for patient in a context of non-reimbursement and fear of stigmatization (Coldefy M. HCAA, 2022/04,19). Therefore, online blended psychological treatment such as deprexis® could increase access to care for people with depression. It presents several advantages such as easy access, scalability, and a proven efficacy (Twomey et al. PLoS One. 2020;15(1):e022810).
ObjectivesThis study aims to test real-life acceptability of deprexis® for people with depression in France outside a reimbursement pathway.
Primary objective of this cross-sectional study is to measure acceptability of deprexis® a new digital therapy in France.
Questionnaire includes acceptability of deprexis® assessed with patient willingness to complete deprexis® course, reasons of refusal, when needed, demographics and depression characteristics.
The secondary objectives are to study 1/ acceptability according to type of center (Hospital based, Community Based or private practice) and type of practitioners (psychiatrists or psychologists), 2/ differences in acceptability according to severity’s level (evaluated with PHQ 9), 3/ differences in acceptability according to administration or not of a treatment (including psychotherapy), 4/ differences in acceptability according to prescriber’s profile (age, sex, place and type of practice), 5/ identification of reasons for refusal , and 6/ analyze refusal rate over time.
MethodsDARE is as a cross-sectional study in which deprexis® is suggested to any patient meeting the inclusion criteria over the fixed inclusion period June-December 2022
Inclusion criteria are: 1/ depression, 2/ age between 18 and 65 years, 3/ speak French sufficiently, 4/ access to Internet with a device to connect to deprexis® platform.
Exclusion criteria are diagnosis of bipolar disorder, psychotic symptoms and/or suicidal thoughts during the current episode.
All investigators received a video-based training on deprexis® before inclusion to make sure they all have same level of information and understanding on the program.
ResultsThe study is currently recruiting. Data will be available for EPA congress.
ConclusionsIt is a first time a digital therapy is completing the current therapeutic options for the treatment of depression in France. Acceptability of this innovation by both patients and Healthcare providers is a first step.
DARE may allow to have a better understanding of the acceptability of a digital therapy in the treatment of depression in France and identify the different factors influencing it in a natural setting.
Disclosure of InterestO. Amiot Consultant of: Ethypharm Digital Therapy, A. H. Clair Consultant of: Ethypharm Digital Therapy, P. Courtet Consultant of: Ethypharm Digital Therapy, E. Fakra Consultant of: Ethypharm Digital Therapy, V. Narboni Employee of: Ethypharm Digital Therapy, F. Gheysen Consultant of: Ethypharm Digital Therapy, E. Haffen Consultant of: Ethypharm Digital Therapy, D. Drapier Consultant of: Ethypharm Digital Therapy, L. Lecardeur Consultant of: Ethypharm Digital Therapy
Algebras of acyclic cluster type: Tree type and type Ã
- Claire Amiot, Steffen Oppermann
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- Journal:
- Nagoya Mathematical Journal / Volume 211 / September 2013
- Published online by Cambridge University Press:
- 11 January 2016, pp. 1-50
- Print publication:
- September 2013
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In this paper, we study algebras of global dimension at most 2 whose generalized cluster category is equivalent to the cluster category of an acyclic quiver which is either a tree or of type Ã. We are particularly interested in their derived equivalence classification. We prove that each algebra which is cluster equivalent to a tree quiver is derived equivalent to the path algebra of this tree. Then we describe explicitly the algebras of cluster type Ãn for each possible orientation of Ãn. We give an explicit way to read off the derived equivalence class in which such an algebra lies, and we describe the Auslander-Reiten quiver of its derived category. Together, these results in particular provide a complete classification of algebras which are cluster equivalent to tame acyclic quivers.
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