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17 results

  • Cost-effectiveness of twice-weekly versus once-weekly sessions of cognitive–behavioural therapy and interpersonal psychotherapy for depression at 12 months after start of treatment: randomised controlled trial

  • Judith E. Bosmans, Sanne J. E. Bruijniks, Mohamed El Alili, Steven D. Hollon, Frenk P. M. L. Peeters, Arnoud Arntz, Pim Cuijpers, Lotte H. J. M. Lemmens, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Michael van den Boogaard, Jan Spijker, Jos W. R. Twisk, Marcus J. H. Huibers
  • Journal:
    BJPsych Open / Volume 9 / Issue 6 / November 2023
    Published online by Cambridge University Press:
    13 October 2023, e186
    • Article
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      • Open access
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  • Background

    Cost-effective treatments are needed to reduce the burden of depression. One way to improve the cost-effectiveness of psychotherapy might be to increase session frequency, but keep the total number of sessions constant.

    Aim

    To evaluate the cost-effectiveness of twice-weekly compared with once-weekly psychotherapy sessions after 12 months, from a societal perspective.

    Method

    An economic evaluation was conducted alongside a randomised controlled trial comparing twice-weekly versus once-weekly sessions of psychotherapy (cognitive–behavioural therapy or interpersonal psychotherapy) for depression. Missing data were handled by multiple imputation. Statistical uncertainty was estimated with bootstrapping and presented with cost-effectiveness acceptability curves.

    Results

    Differences between the two groups in depressive symptoms, physical and social functioning, and quality-adjusted life-years (QALY) at 12-month follow-up were small and not statistically significant. Total societal costs in the twice-weekly session group were higher, albeit not statistically significantly so, than in the once-weekly session group (mean difference €2065, 95% CI −686 to 5146). The probability that twice-weekly sessions are cost-effective compared with once-weekly sessions was 0.40 at a ceiling ratio of €1000 per point improvement in Beck Depression Inventory-II score, 0.32 at a ceiling ratio of €50 000 per QALY gained, 0.23 at a ceiling ratio of €1000 per point improvement in physical functioning score and 0.62 at a ceiling ratio of €1000 per point improvement in social functioning score.

    Conclusions

    Based on the current results, twice-weekly sessions of psychotherapy for depression are not cost-effective over the long term compared with once-weekly sessions.

  • Long-term outcomes of once weekly v. twice weekly sessions of cognitive behavioral therapy and interpersonal psychotherapy for depression

  • Sanne J. E. Bruijniks, Steven D. Hollon, Lotte H. J. M. Lemmens, Frenk P. M. L. Peeters, Arnoud Arntz, Pim Cuijpers, Jos Twisk, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Michael van den Boogaard, Jan Spijker, Marcus J. H. Huibers
  • Journal:
    Psychological Medicine / Volume 54 / Issue 3 / February 2024
    Published online by Cambridge University Press:
    04 September 2023, pp. 517-526
    • Article
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      • Open access
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  • Background

    Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run.

    Aims

    Compare the effects of twice weekly v. weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment.

    Methods

    Using a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16–24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II and the Longitudinal Interval Follow-up Evaluation. Intention-to-treat analyses were conducted.

    Results

    Compared with patients who received once weekly sessions, patients who received twice weekly sessions showed a significant decrease in depressive symptoms up through month 9, but this effect was no longer apparent at month 24. Patients who received CBT showed a significantly larger decrease in depressive symptoms up to month 24 compared to patients who received IPT, but the between-group effect size at month 24 was small. No differential effects between session frequencies or treatment modalities were found in response or relapse rates.

    Conclusions

    Although a higher session frequency leads to better outcomes in the acute phase of treatment, the difference in depression severity dissipated over time and there was no significant difference in relapse.

  • The survival of epidemic and sporadic MRSA on human skin mimics is determined by both host and bacterial factors

  • Valérie O. Baede, Michella M. Voet, Tanny J. K. van der Reijden, Annelies van Wengen, Deborah E. Horst-Kreft, Nicole A. Lemmens-den Toom, Mehri Tavakol, Margreet C. Vos, Peter H. Nibbering, Willem J. B. van Wamel
  • Journal:
    Epidemiology & Infection / Volume 150 / 2022
    Published online by Cambridge University Press:
    16 November 2022, e203
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  • Bacterial survival on, and interactions with, human skin may explain the epidemiological success of MRSA strains. We evaluated the bacterial counts for 27 epidemic and 31 sporadic MRSA strains on 3D epidermal models based on N/TERT cells (NEMs) after 1, 2 and 8 days. In addition, the expression of antimicrobial peptides (hBD-2, RNase 7), inflammatory cytokines (IL-1β, IL-6) and chemokine IL-8 by NEMs was assessed using immunoassays and the expression of 43 S. aureus virulence factors was determined by a multiplex competitive Luminex assay. To explore donor variation, bacterial counts for five epidemic and seven sporadic MRSA strains were determined on 3D primary keratinocyte models (LEMs) from three human donors. Bacterial survival was comparable on NEMs between the two groups, but on LEMs, sporadic strains showed significantly lower survival numbers compared to epidemic strains. Both groups triggered the expression of immune factors. Upon interaction with NEMs, only the epidemic MRSA strains expressed pore-forming toxins, including alpha-hemolysin (Hla), gamma-hemolysin (HlgB), Panton-Valentine leucocidin (LukS) and LukED. Together, these data indicate that the outcome of the interaction between MRSA and human skin mimics, depends on the unique combination of bacterial strain and host factors.

Hume's An Enquiry Concerning the Principles of Morals
  • A Critical Guide
  • Edited by Esther Engels Kroeker, Willem Lemmens
  • Published online:
    08 January 2021
    Print publication:
    07 January 2021
  • Hume considered his Enquiry Concerning the Principles of Morals to be one of his best works. In it he offers his most elegant and approachable account of the origins and scope of morality. With the hope of reaching a broad audience, he argues that morality is neither rigid nor austere, but is rather a product of sentiments that all human beings share, and which they are naturally inclined to recognize and act upon. In this Critical Guide, a team of distinguished scholars discuss each section of the Enquiry, its place in Hume's philosophy as a whole, and its historical context; their topics include the nature of morals, talents and moral virtues, benevolence, sympathy, and the sources of moral disagreement. The volume will be valuable for scholars and advanced students working on Hume.

  • Introduction

  • Edited by Esther Engels Kroeker, Universiteit Antwerpen, Belgium, Willem Lemmens, Universiteit Antwerpen, Belgium
  • Book:
    Hume's <I>An Enquiry Concerning the Principles of Morals</I>
    Published online:
    08 January 2021
    Print publication:
    07 January 2021, pp 1-12

  • Summary

    In the Introduction to this Critical Guide to Hume’s Enquiry Concerning the Principles of Morals (EPM) we bring to light several reasons for which this book merits attention, and we offer an overview of the chapters. The Guide reveals Hume’s commitment to his earlier principles but also his shift in style and focus. It contributes to a general understanding of Hume’s position in his time, as a typical Enlightenment philosopher with an unorthodox agenda, and in ours, as a thinker whose views are alive in contemporary debates. EPM was Hume’s favorite performance, and this guide supports Hume’s ambition to see EPM receive the attention and study he thought it deserved.

  • Chapter 2 - The Pride of Pericles

  • Edited by Esther Engels Kroeker, Universiteit Antwerpen, Belgium, Willem Lemmens, Universiteit Antwerpen, Belgium
  • Book:
    Hume's <I>An Enquiry Concerning the Principles of Morals</I>
    Published online:
    08 January 2021
    Print publication:
    07 January 2021, pp 33-52

  • Summary

    This chapter evaluates Hume’s positive account of benevolence in Section 2 and his critique of the selfish theories in Appendix 2 of the Enquiry Concerning the Principles of Morals. The chapter’s first part elucidates Hume’s definition of the concepts of benevolence and self-love and explains the difference between the sentiments of benevolence and humanity. In Hume’s view, this first part further highlights, the virtue of benevolence belongs to a class of social virtues distinct from justice. A second part focuses on the example of Pericles on his deathbed in Section 2 to illustrate Hume’s positive account of benevolence as well as the reductionist and skeptical suspicion of the selfish theories concerning benevolence and the social virtues. A third part offers a critical examination of Hume’s critique of the selfish theories and shows how Appendix 2 gives further evidence in favor of Hume’s nonreductionist account of benevolence and the social virtues. In the last part, focusing on the intriguing Section 9, some concluding reflections are offered on Hume’s avowal of the unorthodox character of his own benevolence-based moral theory and his appraisal of a modified self-love as constitutive of the flourishing of the sentiment of humanity.

  • The effects of once- versus twice-weekly sessions on psychotherapy outcomes in depressed patients

  • Sanne J. E. Bruijniks, Lotte H. J. M. Lemmens, Steven D. Hollon, Frenk P. M. L. Peeters, Pim Cuijpers, Arnoud Arntz, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Jos W. R. Twisk, Michael van den Boogaard, Jan Spijker, Judith Bosmans, Marcus J. H. Huibers
  • Journal:
    The British Journal of Psychiatry / Volume 216 / Issue 4 / April 2020
    Published online by Cambridge University Press:
    07 February 2020, pp. 222-230
    Print publication:
    April 2020
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  • Background

    It is unclear what session frequency is most effective in cognitive–behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression.

    Aims

    Compare the effects of once weekly and twice weekly sessions of CBT and IPT for depression.

    Method

    We conducted a multicentre randomised trial from November 2014 through December 2017. We recruited 200 adults with depression across nine specialised mental health centres in the Netherlands. This study used a 2 × 2 factorial design, randomising patients to once or twice weekly sessions of CBT or IPT over 16–24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II at baseline, before session 1, and 2 weeks, 1, 2, 3, 4, 5 and 6 months after start of the intervention. Intention-to-treat analyses were conducted.

    Results

    Compared with patients who received weekly sessions, patients who received twice weekly sessions showed a statistically significant decrease in depressive symptoms (estimated mean difference between weekly and twice weekly sessions at month 6: 3.85 points, difference in effect size d = 0.55), lower attrition rates (n = 16 compared with n = 32) and an increased rate of response (hazard ratio 1.48, 95% CI 1.00–2.18).

    Conclusions

    In clinical practice settings, delivery of twice weekly sessions of CBT and IPT for depression is a way to improve depression treatment outcomes.

  • The ‘true religion’ of the sceptic: Penelhum reading Hume’s Dialogues

  • Willem Lemmens
  • Journal:
    Canadian Journal of Philosophy / Volume 42 / Issue S1 / February 2012
    Published online by Cambridge University Press:
    01 January 2020, pp. 183-197

  • According to Terence Penelhum, Philo's confession in the last part of Hume's Dialogues Concerning Natural Religion reveals on the side of the author a reconciliatory and pacifying attitude towards the liberal moderate clergy of his days. This article investigates whether another reading of this intriguing text is not more appropriate. It defends the idea that Philo's speeches and Cleanthes’ reactions to it in the last part of the Dialogues reveal on Hume's side an attitude of mild despair and isolation towards the religious culture of eighteenth-century Scotland, in both its orthodox and more moderate form.

  • Taxation and Ethics: an Impossible Marriage?

  • from PART II - Trust and morality: tax governance in need of transparency
    • By Willem Lemmens, Full Professor of Modern Philosophy and Ethics, University of Antwerp, Belgium, Jo Badisco, Doctoral researcher, University of Antwerp
  • Bruno Peeters, Hans Gribnau, Jo Badisco
  • Book:
    Building Trust in Taxation
    Published by:
    Intersentia
    Published online:
    21 September 2018
    Print publication:
    22 February 2017, pp 119-136

  • Summary

    ABSTRACT

    Lemmens and Badisco take as their point of departure the current crisis in the realm of taxation, they seek to analyse the structuring elements at play beneath the apparent budgetary problems. The relationship between citizens and the government is under threat, and the trust both parties have in one another has severely diminished over the past decades. The authors of this chapter argue that the reason this relationship is damaged to such an extent has to do with the intrinsic moral content of taxation: taxation is more than a budgetary concern; it is a moral concern as well. Taxation is of key importance for the state as it is a means to realise what could be called the bonum commune. Citizens are expected to contribute a fair share to the state so the state can in turn put this money to use for the good of the state as a whole. Thus the organisation of the state is directly based and developed thanks to the income that is generated by taxation. This means that taxation is more than a mere budgetary concern; this makes it an ethical issue, as society as a whole is structured by means generated from the citizens. The ethical concept that can be used to analyse the relationship between the citizens and their government is trust. Trust is a form of willingness to cooperate that goes beyond a contractual relationship. It requires a mutual understanding and identification of both parties with one another. It is exactly this form of relationship that has come under serious threat in the crisis in taxation when we extrapolate this concept of trust to an institutional context. This diminished institutional trust has its ground in three factors: (1) the quality of the legislation is severely lacking – it has an ever-changing nature as well as a very high level of complexity; (2) the way in which certain players seem to be exempt from taxation or are treated differently from the general public and (3) the way in which taxation is organised – often governments resort to very aggressive tax policies with regard to citizens who willingly or unwillingly pay too little in taxes.