RESUMO
BACKGROUND: Long-term longitudinal studies with multimodal biomarkers are needed to delve into the knowledge of preclinical AD. Subjective cognitive decline has been proposed as a risk factor for the development of cognitive impairment. Thus, including individuals with SCD in observational studies may be a cost-effective strategy to increase the prevalence of preclinical AD in the sample. OBJECTIVES: To describe the rationale, research protocols and baseline characteristics of participants in the Fundació ACE Healthy Brain Initiative (FACEHBI). DESIGN: FACEHBI is a clinical trial (EudraCT: 2014-000798-38) embedded within a long-term observational study of individuals with SCD. SETTING: Participants have been recruited at the memory clinic of Fundació ACE (Barcelona) from two different sources: patients referred by a general practitioner and individuals from an Open House Initiative. PARTICIPANTS: 200 individuals diagnosed with SCD with a strictly normal performance in a comprehensive neuropsychological battery. MEASUREMENTS: Individuals will undergo an extensive neuropsychological protocol, risk factor assessment and a set of multimodal biomarkers including florbetaben PET, structural and functional MRI, diffusion tensor imaging, determination of amyloid species in plasma and neurophthalmologic assessment with optical coherence tomography. RESULTS: Two hundred individuals have been recruited in 15 months. Mean age was 65.9 years; mean MMSE was 29.2 with a mean of 14.8 years of education. CONCLUSIONS: FACEHBI is a long-term study of cognition, biomarkers and lifestyle that has been designed upon an innovative symptom-based approach using SCD as target population. It will shed light on the pathophysiology of preclinical AD and the role of SCD as a risk marker for the development of cognitive impairment.
Assuntos
Encéfalo/diagnóstico por imagem , Cognição , Disfunção Cognitiva/diagnóstico , Estilo de Vida , Idoso , Amiloide/sangue , Compostos de Anilina , Biomarcadores/metabolismo , Encéfalo/fisiopatologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Autoavaliação Diagnóstica , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Projetos de Pesquisa , Fatores de Risco , Estilbenos , Tomografia de Coerência ÓpticaRESUMO
BACKGROUND AND OBJECTIVE: Our objectives were: To estimate the prevalence of postpartum depression (PD) by two evaluation methods: Structured Clinical Interview for DSM-IV (SCID), and self-report Edinburgh Postnatal Depression Scale (EPDS), and to identify the EPDS cut-off to provide an unbiased estimation of PD prevalence. PATIENTS AND METHOD: We report data from all women (n = 1191) attending to postnatal routine checking visits at six weeks postpartum during one year in the Gynaecology and Obstetrics Department of the Hospital Clínic of Barcelona (Spain). A two-stage method was used. In the first stage, all women selected completed the EPDS. In the second stage, all women with an EPDS score >= 9 (probable PD cases) and a randomized sample of 16% with a score < 9 were evaluated by a psychiatrist using the SCID interview to establish a psychiatric diagnosis of major and minor depression. 402 postpartum women were offered the SCID interview; 68 of them refused to participate. RESULTS: The prevalence of depression according to the SCID interview was 10.15% (CI 95%, 8.43-11.87). The prevalence of major depression was 3.6% (CI 95%, 2.55-4.67) and it was 6.5% (CI 95%, 5.14-7.95) for minor depression. An EPDS cut-off of 11/12 provided an unbiased estimation of the postpartum depression prevalence rate. CONCLUSIONS: Our results justify the need to use different EPDS cut-offs. A cut-off of 10/11 is effective for identifying the population at risk and a cut-off of 11/12 is useful to estimate the prevalence in epidemiological studies.
Assuntos
Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Prevalência , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade , Espanha/epidemiologiaRESUMO
This article presents a psychodynamic framework and research methods for investigating the significance of patients' internal representations of therapy-with-their-therapists. In this article, 2 instruments developed for this purpose--the Therapist Representation Inventory and the Intersession Experience Questionnaire--are introduced, and their psychometric characteristics are described. Also, findings from a series of studies conducted with these instruments are summarized. Finally, the types of questions these instruments appear to be well suited to are proposed for addressing in future research.