Reliability and validity of the Turkish version of comprehensive assessment of at risk mental states.

AIMS: To perform the validation of the Comprehensive Assessment at Risk Mental State (CAARMS) in Turkish. METHODS: Sixty-five volunteers (15-24 years) were enrolled in this study. Concurrent validity was performed with Spearman's Correlation Test using Brief Psychiatric Rating Scale (BPRS). Median scores of the groups were compared using Mann-Whitney U Test. Interrater reliability was assessed by intragroup correlation coefficient method. Internal consistency was studied by the calculation of Cronbach Alfa Coefficient. RESULTS: The correlation of the severity scores of the CAARMS with unusual thought content, suspiciousness, hallucinations and conceptual disorganization items of the BPRS showed that the concurrent validity was good. ROC analysis revealed that CAARMS could discriminate between individuals with UHR and healthy volunteers well. We found a good correlation between the raters. Internal consistency was at very high level. CONCLUSION: Analyses of concurrent validity, criterion validity, interrater reliability and internal consistency indicate that the Turkish version is valid and reliable.

A multinational study to pilot the modified Hypomania Checklist (mHCL) in the assessment of mixed depression.

BACKGROUND: Mixed depression is a common, dimensional phenomenon that is increasingly recognized in unipolar and bipolar disorders. We piloted a modified version of the Hypomania Checklist (mHCL-32) to assess the prevalence and clinical correlates of concurrent manic (hypo) symptoms in depressed patients. METHODS: The mHCL-32, Young Mania Rating Scale (YMRS) and Hamilton Rating Scale for Depression (HAMD-24) were utilized in the assessment of unipolar (UP=61) and bipolar (BP=44) patients with an index major depressive episode confirmed by the Structured Clinical Interview for DSM-IV (SCID). Differential mHLC-32 item endorsement was compared between UP and BP. Correlation analyses assessed the association of symptom dimensions measured by mHCL-32, YMRS and HAMD-24. RESULTS: There was no significant difference between mood groups in the mean mHCL-32 and YMRS scores. Individual mHLC-32 items of increased libido, quarrels, and caffeine intake were endorsed more in BP vs. UP patients. The mHCL-32 active-elevated subscale score was positively correlated with the YMRS in BP patients and negatively correlated with HAMD-24 in UP patients. Conversely, the mHCL-32 irritable-risk taking subscale score was positively correlated with HAMD-24 in BP and with YMRS in UP patients. LIMITATIONS: Small sample size and cross-sectional design. CONCLUSION: Modifying the HCL to screen for (hypo) manic symptoms in major depression may have utility in identifying mixed symptoms in both bipolar vs. unipolar depression. Further research is encouraged to quantify mixed symptoms with standardized assessments.

[Reliability and validity study of the Turkish version of functioning assessment short test in bipolar disorder]. / Kisa islevsellik degerlendirme ölçegi'nin Türkçe sürümünün bipolar bozuklukta güvenilirligi ve geçerligi.

OBJECTIVE: There is a need for instruments to assess the Functioning Assessment Short Test practically. In this study the goal was to to perform a reliability and validity analyses of the Functioning Assessment Short Test (FAST) in bipolar disorder. METHOD: The study was harbored 70 patients with bipolar disorder and 134 healthy control subjects. Thirteen of the patients were in the manic episode, 16 were in the depressive episode, and 41 patients were in remission. First, FAST was translated into Turkish and then it was back-translated into English. The translation was finally approved by the author of the original development study. In the concurrent validity, Bipolar Disorder Functioning Questionnaire (BBi) was used. RESULTS: In the reliability analyses, Cronbach alpha coefficient of internal consistency was calculated to be 0.960, and test-retest reliability coefficient was found to be 0.945. In the validity analyses, in the exploratory factor analysis five factors were obtained and the factor represented social functioning, occupational functioning, autonomy, cognitive functioning and financial issues. In the confirmatory factor analysis, comparative fit index was 0.912 and RMSEA value was 0.085. In the concurrent validity analyses, the domains of FAST were correlated poorly to moderately with the subscales of BBi. FAST discriminated bipolar patients with symptomatic episodes and remitted patients, healthy controls. The area under the ROC curve was found to be 0.824. CONCLUSION: These results point out that the Turkish version of Functioning Assessment Short Test can used reliably and validly in bipolar patients.

[Reliability and validity of Turkish version of COPD assessment test]. / KOAH degerlendirme testinin Türkçe geçerlilik ve güvenilirligi.

INTRODUCTION: This study is aimed to evaluate the reliability and validity of the Turkish version of chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) in seven centers. MATERIALS AND METHODS: 321 patients between 4-75 years of age, diagnosed and staged by Global Initiative for Obstructive Lung Disease (GOLD) 2011 criteria were included. The Breathlessness, Cough, Sputum scale (BCSS), mMRC (Modified Medical Research Council ) dyspnea index, St. George Respiratory Questionnaire (SGRQ), CAT and Short Form-36 (SF-36) were used concurrently. In the statistical analyses, internal consistency, item-total score correlation, explorative factor analysis, correlation with other scales were calculated. RESULTS: The mean age was 62.4 ± 8.9 years and 89.7% of the patients were male (n= 288). Mean FEV1% was 51.9 ± 19.2 and most of the patients were in Stage 3. CAT total score was 17.8 ± 9.5. In the internal consistency, Cronbach alpha coefficient was found as 0.9116 and item-total score correlation coefficients were between 0.62-0.79 and all were statistically significant (p< 0.0001). The correlation of the test-retest score calculated after two weeks with the initial score was 0.96 (p< 0.0001). In the structural validity, factor analysis with principle component analysis and varimax rotation was performed. One factor solution was achieved with eigenvalue of 4.956 and it represented 61.9% of the total variance. All the items were contained in the factor and the factor loads were between 0.71-0.85. The correlation coefficients of CAT with other indexes were moderate to good. The discrimination of CAT among disease stages has been shown to be significant (p< 0.0001) and a significant correlation was found with pulmonary function tests (p< 0.0001). CONCLUSION: It is demonstrated The Turkish version of COPD Assessment Tool is reliable and valid.

The International Society for Bipolar Disorders-Battery for Assessment of Neurocognition (ISBD-BANC).

OBJECTIVES: Although cognitive impairment is recognized as an important clinical feature of bipolar disorder, there is no standard cognitive battery that has been developed for use in bipolar disorder research. The aims of this paper were to identify the cognitive measures from the literature that show the greatest magnitude of impairment in bipolar disorder, to use this information to determine whether the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB), developed for use in schizophrenia, might be suitable for bipolar disorder research, and to propose a preliminary battery of cognitive tests for use in bipolar disorder research. METHODS: The project was conducted under the auspices of the International Society for Bipolar Disorders and involved a committee that comprised researchers with international expertise in the cognitive aspects of bipolar disorder. In order to identify cognitive tasks that show the largest magnitude of impairment in bipolar disorder, we reviewed the literature on studies assessing cognitive functioning (including social cognition) in bipolar disorder. We further provided a brief review of the cognitive overlap between schizophrenia and bipolar disorder and evaluated the degree to which tasks included in the MCCB (or other identified tasks) might be suitable for use in bipolar disorder. RESULTS: Based on evidence that cognitive deficits in bipolar disorder are similar in pattern but less severe than in schizophrenia, it was judged that most subtests comprising the MCCB appear appropriate for use in bipolar disorder. In addition to MCCB tests, other specific measures of more complex verbal learning (e.g., the California Verbal Learning Test) or executive function (Stroop Test, Trail Making Test-part B, Wisconsin Card Sorting Test) also show substantial impairment in bipolar disorder. CONCLUSIONS: Our analysis reveals that the MCCB represents a good starting point for assessing cognitive deficits in research studies of bipolar disorder, but that other tasks including more complex verbal learning measures and tests of executive function should also be considered in assessing cognitive compromise in bipolar disorder. Several promising cognitive tasks that require further study in bipolar disorder are also presented.

[What does the subjective assessment of cognitive functioning measure in bipolar disorder? Correlation with the objective assessment of cognitive functioning]. / Bipolar bozuklukta oznel bilissel degerlendirme neyi olçüyor? Nesnel bilissel degerlendirme ile bagintisi.

OBJECTIVE: Even in remission, cognitive deficits are frequently observed in bipolar disorder. Because these deficits are assessed with complex and comprehensive tests, they seem to be neglected in routine daily practice; however, assessing them with short self-rated questionnaires could be beneficial. This study aimed to investigate the correlation between objective and subjective cognitive assessment in bipolar disorder. METHOD: The study included 38 patients with bipolar disorder that were in remission for at least 6 months and 19 healthy controls. The Stroop Test and Auditory Verbal Learning Test were used for the objective assessment of cognitive functioning, and the cognitive functioning subscale of the Bipolar Disorder Functioning Questionnaire was used for the subjective assessment of cognitive functioning. Mood symptoms were assessed using the Hamilton Depression Rating Scale and Young Mania Rating Scale. RESULTS: Based on objective assessment there were significant differences in all domains of the Auditory Verbal Learning Test between the bipolar patients and healthy controls, whereas there weren't any significant difference in Stroop Test results. Based on subjective assessment there were significant differences between the bipolar patients and healthy controls in terms of cognitive functioning subscale total score and first item score, but not in terms of the other items. When the correlation between the objective and subjective cognitive assessments was investigated, total score of the cognitive functioning subscale and 2 items--1. to run simple calculations in one's mind and 2. gathering and performing what one is asked to do--were moderately to weakly correlated with immediate recall, verbal learning, recognition, retrieval, and reading shape color. No correlation was observed between the other items of the cognitive functioning subscale. CONCLUSION: Based on subjective assessment of cognitive functioning, the bipolar patients tended to over-estimate themselves. Furthermore, bipolar patients tended to report more deficits correlated with objective cognitive assessment when they had to display active performance, whereas they did not report cognitive deficits at this level when such a condition was not present.

Developing a quality of life instrument in patients with psoriasis: the Psoriasis Quality of Life Questionnaire (PQLQ).

BACKGROUND AND DESIGN: Psoriasis is a chronic skin disease which causes psychological, social and physical problems and affects quality of life. The aim of this study was to develop a quality of life instrument for patients with psoriasis which is suitable for Islamic populations. MATERIALS AND METHODS: The psychosocial and daily life problems defined by 75 patients with psoriasis, their relatives and physicians were used to construct a questionnaire, the reliability and validity of which were determined in a group of 156 patients with psoriasis. RESULTS: For reliability, Chronbach's alpha coefficient was 0.87, and item-total correlations were between 0.37 and 0.60 for internal consistency. There was high test-retest reliability (r = 0.98, P < 0.001). For validity, three factors were extracted in the principal components method for construct validity. The maximum factor loadings of each item were between 0.456 and 0.681. For convergent validity, all patients' self-ratings and Psoriasis Area and Severity Index (PASI) were correlated with the questionnaire score (P < 0.001). CONCLUSION: The questionnaire consisting of 17 items was found to be suitable for both epidemiologic and clinical trials.