[Psychometric Evaluation of the Union Physio-Psycho-Social Assessment Questionnaire].

Objective To validate the Union Physio-Psycho-Social Assessment Questionnaire(UPPSAQ-70)and test its validity and reliability.Methods From April,2013 to July,2018,patients were asked to finish the computer evaluation of UPPSAQ-70 and Symptom Checklist 90(SCL-90)in Peking Union Medical College Hospital(PUMCH).Confirmatory factor analysis(CFA)was conducted on the SPSS 17.0,and the number of fixed factors was 8 factors and 3 factors.Amos 23.0 was used to verify the original 8-factor model,8-factor revision model,3-factor model,3-factor revision model,and single-factor model.Each factor of SCL-90 was used as the calibration standard to calculate the correlation coefficient between factors.The retest reliability was tested by the outpatients in PUMCH in July,2018.Results Exploratory factor analysis indicated that the 8-factor revised model included:depression,anxiety and fatigue,sleep,physical discomfort,sexual function,happiness and satisfaction,hypochondria,and social anxiety.The 3 factors revised model included that:psychological,physiological and social dimension.Confirmatory factor analysis indicated that the 8-factor modified model was superior to the 3-factor model and the single-factor model: χ 2=10 410.4,df=1862,RMSEA=0.07,CFI=0.753,and NFI=0.715.With SCL-90 as the standard criteria,except the low correlation coefficient between emotional scale and depression(r=0.600)and anxiety(r=0.520),the correlation coefficients of other symptoms were below 0.5.The chronbach's α between each factor and total score of UPPSAQ-70 was between 0.823 and 0.904,and the Chronbach's α coefficient of the whole scale was between 0.954 and 0.956 after each item was deleted.The retest reliability of the scale of 32 participants Chronbach's α was 0.847.Each item of the scale measured between one week was significantly correlated(P<0.05). Conclusion UPPSAQ-70 is a good scale for evaluating overall health status and is especially feasible in general hospitals.

Retrospective Analysis of Liaison Psychiatric Service in Elderly Inpatients in A General Hospital.

Objective To analyze liaison psychiatric service in a geriatric ward in a big general hospital and explore the way to improve accessibility of geriatric psychiatric service in general hospitals. Methods Elderly inpatients aged 65 years old or more admitted to a geriatrics ward in Peking Union Medical College Hospital in 7 years duration (January 2008 to December 2014) were enrolled in the study. Liaison psychiatrists attended ground round combined with psychiatric consultation from January 2008 to December 2009 (T1 period). Comprehensive geriatric assessment,geriatric interdisciplinary team services and psychiatric consultation were conducted from January 2010 to December 2014 (T2 period). Consultation rate,reasons for referral,psychiatric diagnoses,length of stay,and medical expense were compared between different periods.Results Among 1230 geriatric inpatients,383 patients were enrolled in liaison psychiatric service,and 511 individual consultations happened.The consultation rate for T1 and T2 were 19.7% and 33.8%,respectively (P=0.000).The dominating reasons for referral were current emotional symptoms (30.4%) and current psychiatric symptoms (28.3%) in T1 and current emotional symptoms (65.3%) and medically unexplained symptoms (12.8%) in T2 (P=0.000). For length of stay,consultation group lasted for (199.2±40.0) days,and non-consultation group lasted for (71.3±16.6) days(P=0.004) in T1;(22.0±2.4) days and (22.6±1.6) days(P=0.834) in different groups in T2 respectively. The medical expense were (243 000±44 000) RMB for consultation group and (79 000±18 000) RMB for non-consultation group(P=0.040) in T1 and (18 000±2 000) RMB and (21 000±1 000) RMB (P=0.302) in different groups in T2 respectively. The prevalence rate for psychiatric disorders revealed by liaison psychiatrists was 15.8% in T1 and 29.8%in T2 (P=0.000) in the geriatric ward. Conclusions Elderly inpatients are vulnerable population for psychiatric disorders. Therefore,psychiatrist should be an important member in geriatric interdisciplinary team. Combination of comprehensive geriatric assessment,psychiatric consultation and geriatric interdisciplinary team is very efficient model in general hospital settings to improve the accessibility of psychiatric services in elderly in China.

[Significance of sleep problems in the diagnosis of depressive and anxiety disorders].

OBJECTIVE: To explore the significance of sleep problems in the diagnosis of depressive and anxiety disorders. METHODS: A cross-sectional study was conducted through stratified convenient sampling in outpatients at our hospital from November 19, 2009 to January 19, 2010. A total of 203 outpatients (≥ 16 years old) were recruited from Department of Internal Medicine, Department of Surgery, Department of Obstetrics & Gynecology and other departments. Sleep Questionnaire was used as a screening tool for depressive and anxiety disorders. Composite international diagnostic interview (CIDI) was conducted by trained interviewers. According to diagnostic and statistical manual of mental disorders, Fourth Edition (DSM-IV) using the outcome from the logistic diagnostic procedure of CIDI as a golden standard for depressive and anxiety disorders, the validities of Sleep Questionnaire were calculated. RESULTS: According to the Sleep Questionnaire, the 12-month prevalence of any sleep problem was 31.0% (63/203). The Cronbach's α coefficient of the questionnaire was 0.764 and the area under the ROC (receiver operating characteristic) curve 0.741. With a cut-off point of 1, the sensitivity was 68.0% and the specificity 74.2% respectively. And it achieved the best composite diagnostic capacity. The positive predictive values were at least 27.0%. CONCLUSION: Sleep problem is a common complaint at a general hospital. When the duration and severity of sleep problem meet the standards of Sleep Questionnaire, a physician should be aware of possible depressive and anxiety disorders and more detailed information should be collected.