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The global distribution of primary production and consumption by humans (fisheries) is well-documented, but we have no map linking the central ecological process of consumption within food webs to temperature and other ecological drivers. Using standardized assays that span 105° of latitude on four continents, we show that rates of bait consumption by generalist predators in shallow marine ecosystems are tightly linked to both temperature and the composition of consumer assemblages. Unexpectedly, rates of consumption peaked at midlatitudes (25 to 35°) in both Northern and Southern Hemispheres across both seagrass and unvegetated sediment habitats. This pattern contrasts with terrestrial systems, where biotic interactions reportedly weaken away from the equator, but it parallels an emerging pattern of a subtropical peak in marine biodiversity. The higher consumption at midlatitudes was closely related to the type of consumers present, which explained rates of consumption better than consumer density, biomass, species diversity, or habitat. Indeed, the apparent effect of temperature on consumption was mostly driven by temperature-associated turnover in consumer community composition. Our findings reinforce the key influence of climate warming on altered species composition and highlight its implications for the functioning of Earth's ecosystems.
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Biodiversidade , Clima , Pesqueiros , Cadeia Alimentar , Alismatales , Animais , Biomassa , Feminino , Peixes , Geografia , Aquecimento Global , Humanos , MasculinoRESUMO
There is a growing body of literature devoted to evaluating functionality when planning the psychosocial rehabilitation of patients with schizophrenia. Until recently, psychological scales have been the predominant source of information, whereas patients' perceptions about the most disruptive limitations on their daily life were not considered. The aim of this paper is to illustrate how the integration of the perspectives of patients and patients' relatives improves the evaluation of functionality. A QUAN + QUAL design was implemented collecting quantitative data from Family APGAR and BELS scales, and qualitative information by conducting focus groups. The integration of results made it possible to understand the causes of problems reported by scales, as well as improving the information captured for helping to plan patient therapies. This mixed approach has provided a more comprehensive perspective of functionality, which will be helpful in improving quality of life of patients and their relatives.
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Família , Satisfação do Paciente , Qualidade de Vida , Esquizofrenia/reabilitação , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
Many hypothesis have tried to explain the aetiology of schizophrenia, the abnormal neurodevelopmental hypothesis is one of the most widely acknowledged and is based on the presence of both prenatal and perinatal disorders, differences in IQ or the existence of genetic abnormalities, which, with the interaction of certain environmental factors, schizophrenia could occur at some point in the development. This hypothesis provides a good account of how these factors result in an alteration in the normal development and how they can lead to a disorder of schizophrenia. On the other hand, a smaller but not insignificant number of studies based on variables such as the presence of neurotoxicity in the brains of individuals with schizophrenia, alterations at the structural and brain connectivity, suggest the existence of a degenerative process in the course of this disease. In this work, we review the different factors underlying both hypotheses, some of which are difficult to categorize in either approach given the controversy and lack of consensus in their interpretation of the available data. Finally, we discuss the need for a non-exclusive alternative model to help understand the available evidence on the origin, course and consequences of the disease.
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Doenças Neurodegenerativas/complicações , Transtornos do Neurodesenvolvimento/complicações , Esquizofrenia/etiologia , HumanosRESUMO
Non-indigenous species (NIS) have the potential to colonize and become established in a wide range of coastal habitats. Species with broad environmental tolerances can quickly adapt to local conditions and expand their niches along environmental gradients, and even colonize habitats with extreme abiotic conditions. Here we report and document the distribution of eight marine NIS (four seaweed and four invertebrate species) found in tidepools along a 3000 km latitudinal gradient along the Pacific coast of Chile (18.4°S to 41.9°S). The seaweed NIS Codium fragile, Capreolia implexa, Schottera nicaeensis and Mastocarpus latissimus were mostly distributed towards high latitudes (i.e., more southerly locations), where temperatures in tidepools were low. The invertebrate NIS Anemonia alicemartinae, Ciona robusta, Bugula neritina and Bugulina flabellata were more common towards low latitudes, where high temperatures were registered in the tidepools. Across the intertidal gradient, seaweed NIS were mostly found in pools in the mid and low intertidal zone, while invertebrate NIS occurred mostly in pools from the mid and upper intertidal zones. The realized niche spaces of NIS (based on the Outlying Mean Index, OMI) in the study area were mainly influenced by environmental conditions of temperature and salinity (along the latitudinal and intertidal gradients), while other tidepool characteristics (depth, surface area, exposition, and complexity) only had minor effects. Five of the eight NIS exhibited a realized niche space coinciding with the average tidepool environmental conditions, while marginal niches were occupied by species with affinities for specific temperatures and salinities along the latitudinal and intertidal gradients. Our results indicate that physiological tolerances to environmental factors play a fundamental role in the distribution of seaweed and invertebrate NIS in tidepools along the Chilean coast. This study confirms that tidepools offer suitable conditions for some seaweed and invertebrate NIS, potentially facilitating their invasion into new natural habitats.
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Ecossistema , Espécies Introduzidas , Invertebrados , Alga Marinha , Animais , Chile , Alga Marinha/fisiologia , Invertebrados/fisiologia , Oceano Pacífico , TemperaturaRESUMO
BACKGROUND: The Screen for Cognitive Impairment in Psychiatry (SCIP) is a simple and easy to administer scale developed for screening cognitive deficits. This study presents the diagnostic-specific standardization data for this scale in a sample of schizophrenia and bipolar I disorder patients. METHODS: Patients between 18 and 55 years who are in a stable phase of the disease, diagnosed with schizophrenia, schizoaffective disorder, schizophreniform disorder, or bipolar I disorder were enrolled in this study. RESULTS: The SCIP-S was administered to 514 patients (57.9% male), divided into two age groups (18-39 and 40-55 years) and two educational level groups (less than and secondary or higher education). The performance of the patients on the SCIP-S is described and the transformed scores for each SCIP-S subtest, as well as the total score on the instrument, are presented as a percentile, z-score, T-scores, and IQ quotient. CONCLUSIONS: We present the first jointly developed benchmarks for a cognitive screening test exploring functional psychosis (schizophrenia and bipolar disorder), which provide increased information about patient's cognitive abilities. Having guidelines for interpreting SCIP-S scores represents a step forward in the clinical utility of this instrument and adds valuable information for its use.
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Transtorno Bipolar/complicações , Transtornos Cognitivos/diagnóstico , Cognição , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/complicações , Esquizofrenia/complicações , Adolescente , Adulto , Transtornos Cognitivos/complicações , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Psiquiatria , Reprodutibilidade dos Testes , Adulto JovemRESUMO
Adult individuals frequently face difficulties in attracting and keeping mates, which is an important driver of singlehood. In the current research, we investigated the mating performance (i.e., how well people do in attracting and retaining intimate partners) and singlehood status in 14 different countries, namely Austria, Brazil, China, Greece, Hungary, Italy, Japan, Peru, Poland, Russia, Spain, Turkey, the UK, and Ukraine (N = 7,181). We found that poor mating performance was in high occurrence, with about one in four participants scoring low in this dimension, and more than 57% facing difficulties in starting and/or keeping a relationship. Men and women did not differ in their mating performance scores, but there was a small yet significant effect of age, with older participants indicating higher mating performance. Moreover, nearly 13% of the participants indicated that they were involuntarily single, which accounted for about one-third of the singles in the sample. In addition, more than 15% of the participants indicated that they were voluntarily single, and 10% were between-relationships single. We also found that poor mating performance was associated with an increased likelihood of voluntary, involuntary, and between-relationships singlehood. All types of singlehood were in higher occurrence in younger participants. Although there was some cross-cultural variation, the results were generally consistent across samples.
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Comportamento Sexual , Parceiros Sexuais , Adulto , Masculino , Humanos , Feminino , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Grécia , China , JapãoRESUMO
BACKGROUND: Major depression is a psychiatric disorder characterized neuropsychologically by poor performance in tasks of memory, attention, processing speed, and executive function. The aim of this systematic review was to examine the evidence regarding the neuropsychological profile of people with major depression and to determine which of two explanatory models-the processing speed hypothesis or the cognitive effort hypothesis-has most empirical support. METHODS: We searched three relevant databases and reviewed the reference lists of the articles retrieved. The results obtained with the Trail Making Test and the Stroop Color-Word Test were reviewed for 37 studies published between 1993 and 2020. RESULTS: The empirical evidence supports both hypotheses: cognitive effort and processing speed, suggesting that depression is not only characterized by psychomotor slowing but also involves a specific deficit in executive function. DISCUSSION: We discuss potentially relevant variables that should be considered in future research in order to improve knowledge about the neurocognitive profile of depression. The main limitation of this study derives from the considerable heterogeneity of participants with MD, which makes it difficult to compare and integrate the data.
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BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) offers an internationally accepted standard for describing and assessing functioning and disability in any health condition. A specific list of ICF categories, an ICF Core Set (CS), has been developed for bipolar disorder, depression and schizophrenia. The aim of this study was to determine commonalities in the ICF-CSs for these three disorders, and to identify relevant categories for the development of tentative ICF-CSs for severe mental disorders in general. METHODS: The ICF categories of all three mental health conditions were examined and compared. RESULTS: Comparison of the Comprehensive ICF-CSs for the three mental health conditions revealed a set of 34 common categories (i.e., 10 from the Body functions component, 14 from the Activities and participation component, and 10 Environmental factors ). These categories formed the proposed Comprehensive ICF-CS for severe mental disorders. A total of 11 categories were common to the Brief ICF-CSs of the three mental health conditions, and these formed the Brief ICF-CS for severe mental disorders (i.e., 3 from the Body functions component, 6 from the Activities and participation component, and 2 Environmental factors ). All the categories included refer to key aspects of functioning for severe mental disorders. CONCLUSIONS: The proposed ICF-CSs for severe mental disorders may be applicable across a number of psychotic and affective disorders and they should prove useful for mental health services whose care remit covers a range of conditions.
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Transtorno Bipolar/fisiopatologia , Depressão/fisiopatologia , Classificação Internacional de Funcionalidade, Incapacidade e Saúde/normas , Esquizofrenia/fisiopatologia , Atividades Cotidianas , Transtorno Bipolar/classificação , Transtorno Bipolar/psicologia , Depressão/classificação , Depressão/psicologia , Avaliação da Deficiência , Indicadores Básicos de Saúde , Humanos , Transtornos Mentais/classificação , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Participação do Paciente , Esquizofrenia/classificação , Psicologia do EsquizofrênicoRESUMO
BACKGROUND: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) evaluates an individual's functioning and disability within the conceptual framework of the ICF. The present study examines the measurement properties of the WHODAS 2.0 in patients with bipolar disorder using Mokken scaling analysis (i.e., monotone homogeneity and double monotonicity models) and the graded response model. No previous studies applying these models to this instrument were found. METHODS: A sample of 291 patients with bipolar disorder (42.6% males) was tested. RESULTS: The WHODAS 2.0 domains showed strong unidimensionality, with no items being omitted. In addition, the analysis of invariant item ordering showed that the items of each domain formed a hierarchical scale, with the exception of the 'Life activities' items for employed persons or students and item D4.5 'Sexual activities' in the 'Getting along' domain. The WHODAS 2.0 domains and the whole scale also showed excellent reliability in bipolar disorder. LIMITATIONS: Although the study was limited to patients in Spain, the use of non-sample dependent procedures minimizes this limitation since the results are independent of the sample used. CONCLUSIONS: The WHODAS 2.0 contains six strong unidimensional domains that are hierarchical and reliable for detecting disability in bipolar disorder, although caution should be exercised with regard to some items.
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Transtorno Bipolar/complicações , Avaliação da Deficiência , Atividades Cotidianas , Adulto , Pessoas com Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Espanha , Estudantes , Organização Mundial da SaúdeRESUMO
El angiomiolipoma hepático es un tumor mesenquimatoso infrecuente perteneciente al grupo de los PEComas (Perivascular Epithelioid Cells), que cuenta con un potencial maligno indeterminado. Los síntomas clínicos son inespecíficos, siendo las características radiológicas principales la alta vascularización de la lesión y la presencia de tejido adiposo macroscópico. Presentamos un caso clínico de un angiomiolipoma hepático izquierdo diagnosticado por tomografía computada de manera incidental y asintomático en una paciente sin antecedentes de importancia que se sometió a hepatectomía lateral izquierda con resección completa del tumor, el cual fue negativo para malignidad y sin complicaciones.Hepatic angiomyolipoma is a mesenchymal tumor known as PEComas (Perivascular Epithelioid Cells) with unknown malignancy pattern. We present a case report of left hepatic angiomyolipoma diagnoses by computed tomography in an asymptomatic patient with no previous medical diseases. The tumor was complete resected during a left lateral hepatectomy with no complications and final histologic report was negative to cancer.
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Angiomiolipoma , Neoplasias Hepáticas , Angiomiolipoma/diagnóstico por imagem , Angiomiolipoma/cirurgia , Hepatectomia , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgiaRESUMO
BACKGROUND: The relevance of persistent cognitive deficits to the pathogenesis and prognosis of bipolar disorders (BD) is understudied, and its translation into clinical practice has been limited by the absence of brief methods assessing cognitive status in Psychiatry. This investigation assessed the psychometric properties of the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) for the detection of cognitive impairment in BD. METHODS: After short training, psychiatrists at 40 outpatient clinics administered the SCIP three times over two weeks to a total of 76 consecutive type I BD admissions. Experienced psychologists also administered a comprehensive battery of standard neuropsychological instruments to clinical sample and 45 healthy control subjects. RESULTS: Feasibility was supported by a brief administration time (approximately 15 minutes) and minimal scoring errors. The reliability of the SCIP was confirmed by good equivalence of forms, acceptable stability (ICC range 0.59 to 0.87) and adequate internal consistency (Chronbach's alpha of 0.74). Construct validity was granted by extraction of a single factor (accounting 52% of the variance), acceptable correlations with conventional neuropsychological instruments, and a clear differentiation between bipolar I and normal samples. Efficiency was also provided by the adequate sensitivity and specificity. LIMITATIONS: The sample size is not very large. The SCIP and the neurocognitive battery do not cover all potentially relevant cognitive domains. Also, sensitivity to change remains unexplored. CONCLUSION: With minimal training, physicians obtained a reliable and valid estimate of cognitive impairment in approximately 15 minutes from an application of the SCIP to type I BD patients.
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Transtorno Bipolar/diagnóstico , Transtornos Cognitivos/diagnóstico , Psicometria/métodos , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Transtorno Bipolar/psicologia , Estudos de Casos e Controles , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espanha , Adulto JovemRESUMO
OBJECTIVE: The Screen for Cognitive Impairment in Psychiatry (SCIP) is a brief scale designed for detecting cognitive deficits in several psychotic and affective disorders. This study examined the psychometric properties of the Spanish version of the SCIP in a sample of outpatients suffering schizophrenia-spectrum disorders. METHODS: Psychometric properties were evaluated in a sample of 126 stable patients with schizophrenia. Men and women 18 to 55 years of age were recruited from consecutive admissions to 40 psychiatric outpatient clinics in Spain and asked to complete a series of cognitive measures at baseline, as well as three versions of the SCIP separated by one week intervals. A matched sample of 39 healthy controls was also subjected to the baseline examination. The feasibility, reliability and validity of the SCIP was examined; concurrent validity was assessed by means of a complete neuropsychological battery. RESULTS: Average time for SCIP administration was 16.02 (SD=5.01) minutes. Test-retest reliability intra-class correlation coefficients ranged from 0.74 to 0.90, with an internal consistency Cronbach's alpha value of 0.73. The three parallel forms of SCIP were shown to be equivalent. The SCIP scales were correlated with corresponding neuropsychological instruments, with Pearson's r between 0.38 and 0.60, p<0.01. The SCIP effectively discriminated between the patient and control samples. Factor analysis revealed one significant dimension, cognitive performance, that accounted for 49.8% of the total variance. CONCLUSIONS: The Spanish version of the SCIP is a simple, brief, valid and reliable tool for detection of cognitive impairment in patients with schizophrenia by minimally trained healthcare personnel.
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Transtornos Cognitivos/diagnóstico , Comparação Transcultural , Idioma , Testes Neuropsicológicos/estatística & dados numéricos , Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adolescente , Adulto , Transtornos Cognitivos/psicologia , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Psicometria/estatística & dados numéricos , Transtornos Psicóticos/psicologia , Valores de Referência , Reprodutibilidade dos Testes , EspanhaRESUMO
Using the WHO International Classification of Functioning, Disability and Health (ICF) as a frame of reference, this study identifies the most common problems of functioning and the environmental factors that are experienced by patients with schizophrenia. An empirical cross-sectional multicentre study was conducted. Data were collected using a case record form, rated by health professionals, that contained 133 ICF categories and which also gathered clinical and sociodemographic information. A total of 127 patients with schizophrenia participated. The categories with a higher prevalence of impairment in the Body functions component were related to mental functions [e.g. b164 Higher-level cognitive functions (97.6%), b152 Emotional functions (88.2%)]. Patients also showed impairment in several categories from the Activities and participation component, reflecting restrictions and limitations in several challenging everyday activities such as solving problems (77.2%), handling stress (87.4%), looking after one's health (63.8%), informal social relationships (70.9%), economic self-sufficiency (68.5%), and leisure (79.5%). Environmental factors were most frequently scored as facilitators. Support from family (94.5%) and health professionals (99.2%), together with antipsychotic medication (96.9%) and social (85.0%) and health services (95.3%), were the most common factors for people with schizophrenia. Our study identified the most common problems in functioning and the environmental factors that are experienced by persons with schizophrenia. This kind of comprehensive approach to the assessment of functioning in schizophrenia could help to shape interventions for improving functioning in this population.
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Atividades Cotidianas , Cognição , Serviços de Saúde Mental , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Apoio Social , Serviço Social , Adaptação Psicológica , Adulto , Antipsicóticos/uso terapêutico , Estudos Transversais , Família , Feminino , Pessoal de Saúde , Humanos , Relações Interpessoais , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Classe Social , Estresse Psicológico/psicologiaRESUMO
The Screen for Cognitive Impairment in Psychiatry is a simple, fast, and easy to administer scale that has been validated in clinical and community samples. The aim of this study was to propose a polytomous scoring system for the Screen for Cognitive Impairment in Psychiatry and to demonstrate its functioning, thus providing new and complementary information regarding the utility and precision of this screening tool. Three hundred seventy-six Spanish patients diagnosed with schizophrenia spectrum disorder were evaluated. A polytomous scoring system was generated and analyzed by means of the partial credit model. Category assessment revealed optimal functioning after collapsing the 7-category system to 1 with either 5 or 4 categories, depending on the item. The proposed polytomous scoring system shows good psychometric properties and an adequate fit to the partial credit model. These results provide further confirmation of the test's utility in clinical settings and of its suitability for detecting cognitive impairment.
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Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos/normas , Psicometria/instrumentação , Esquizofrenia/complicações , Adolescente , Adulto , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/métodos , Psicometria/normas , Adulto JovemRESUMO
PURPOSE: Based on the International Classification of Functioning, Disability and Health (ICF), this paper presents the results of the process to develop the Comprehensive and Brief Core Sets for schizophrenia that allow to comprehensively describe functioning in persons with schizophrenia. METHODS: Twenty health professionals from diverse backgrounds participated in a formal and iterative decision-making process during an international consensus conference to develop these Core Sets. The conference was carried out based on evidence gathered from four preparatory studies (systematic literature review, qualitative study, expert survey, and empirical study). The first step of this decision-making and consensus process comprised of discussions and voting in working groups and plenary sessions to develop the comprehensive version. The categories of the Comprehensive ICF Core Set for schizophrenia served as the basis for the second step -a ranking and cutoff procedure to decide on the brief version. RESULTS: Of the 184 candidate categories identified in the preparatory studies, 97 categories were included in the Comprehensive Core Set for schizophrenia. A total of 25 categories were selected to constitute the Brief Core Set. CONCLUSIONS: The formal decision-making and consensus process integrating evidence from four preparatory studies and expert opinion led to the first version of the Core Sets for schizophrenia. Comprehensive and Brief Core Sets for schizophrenia may provide a common language among different health professionals and researchers, and a basic international standard of what to measure, report, and assess the functioning of persons with schizophrenia. Implications for rehabilitation Schizophrenia is a chronic mental disorder that has a tremendous impact on functioning and daily life of persons living with the disorder. The International Classification of Functioning, Disability and Health (ICF) offers an internationally recognized standard for describing the functioning status of these individuals. The Core Sets for schizophrenia have potential use in supporting rehabilitation practice such as for planning mental health services and other interventions or defining rehabilitation goals, and documenting patient care. The Core Sets for schizophrenia may also be used to promote interdisciplinary coordination and facilitate communication between members of a multidisciplinary rehabilitation team. Rehabilitation research is another potential area of application of the Core Sets for schizophrenia. This is valuable, since rehabilitation research provides crucial evidence for optimizing rehabilitation practice.
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Avaliação da Deficiência , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Esquizofrenia/complicações , HumanosRESUMO
BACKGROUND: Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. METHODS: In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). RESULTS: Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention. CONCLUSIONS: This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.
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The Screen for Cognitive Impairment in Psychiatry(SCIP) is a brief instrument designed to assess cognitive deterioration in patients with psychiatric disorders, for example, schizophrenia. This study presents the first results obtained with the Spanish version of the SCIP in its three parallel forms with a sample of university students, these results being compared with those obtained with the English version. It is concluded that although there are no form effects, and that therefore the different forms can be used without distinction, there are certain practice effects on some of the instrument's sub-scales. There is also a language effect that may be due to sample and/or cultural characteristics. Finally, in both versions intra-class correlation coefficients and factorial structure are very similar.
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Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Esquizofrenia/epidemiologia , Inquéritos e Questionários , Adolescente , Adulto , Feminino , Humanos , Idioma , Masculino , Programas de Rastreamento/métodos , Reprodutibilidade dos TestesRESUMO
The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a multidimensional instrument developed for measuring disability. It comprises six domains (getting around, self-care, getting along with others, life activities and participation in society). The main purpose of this paper is the evaluation of the psychometric properties for each domain of the WHO-DAS II with parametric and non-parametric Item Response Theory (IRT) models. A secondary objective is to assess whether the WHO-DAS II items within each domain form a hierarchy of invariantly ordered severity indicators of disability. A sample of 352 patients with a schizophrenia spectrum disorder is used in this study. The 36 items WHO-DAS II was administered during the consultation. Partial Credit and Mokken scale models are used to study the psychometric properties of the questionnaire. The psychometric properties of the WHO-DAS II scale are satisfactory for all the domains. However, we identify a few items that do not discriminate satisfactorily between different levels of disability and cannot be invariantly ordered in the scale. In conclusion the WHO-DAS II can be used to assess overall disability in patients with schizophrenia, but some domains are too general to assess functionality in these patients because they contain items that are not applicable to this pathology.
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Manual Diagnóstico e Estatístico de Transtornos Mentais , Pessoas com Deficiência , Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico , Estatísticas não Paramétricas , Atividades Cotidianas , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Autocuidado , Comportamento Social , Organização Mundial da Saúde , Adulto JovemRESUMO
BACKGROUND: The WHODAS 2.0 is an ICF-based multidimensional instrument developed for measuring disability. The present study analyzes the utility of the 36-item interviewer-administered version in a sample of patients with bipolar disorder. There is no study to date that analyses how the scale works in a sample that only comprises such patients. METHODS: A total of 291 patients with bipolar disorder (42.6% males) according to DSM-IV-TR criteria from a cross-sectional study conducted in outpatient psychiatric clinics were enrolled. In addition to the WHODAS 2.0, patients completed a comprehensive assessment battery including measures on psychopathology, functionality and quality of life. Analyses were centered on providing evidence on the validity and utility of the Spanish version of the WHODAS 2.0 in bipolar patients. RESULTS: Participation domain had the highest percentage of missing data (2.7%). Confirmatory factorial analysis was used to test three models formulated in the literature: six primary correlated factors, six primary factors with a single second-order factor, and six primary factors with two second-order factors. The three models were plausible, although the one formed by six correlated factors produced the best fit. Cronbach's alpha values ranged between .73 for the Self-care domain and .92 for Life activities, and the internal consistency of the total score was .96. Relationships between the WHODAS 2.0 and measures of psychopathology, functionality and quality of life were in the expected direction, and the scale was found to be able to differentiate among patients with different intensity of clinical symptoms and work situation. LIMITATIONS: The percentage of euthymic patients was considerable. However, the assessment of euthymic patients is less influenced by mood. Some psychometric properties have not been studied, such as score stability and sensitivity to change. CONCLUSIONS: The Spanish version of the 36-item WHODAS 2.0 has suitable psychometric properties in terms of reliability and validity when applied to patients with bipolar disorder. Disability in bipolar patients is especially prominent in Cognition, Getting along, Life activities, and Participation domains, so functional remediation interventions should emphasize these areas in order to improve the daily living activities of these patients.
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Atividades Cotidianas , Transtorno Bipolar/psicologia , Avaliação da Deficiência , Pessoas com Deficiência/psicologia , Qualidade de Vida , Autocuidado , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Organização Mundial da SaúdeRESUMO
This paper provides a map of the scientific productivity of authors affiliated to a Spanish institution and who have addressed one of the most important current topics in schizophrenia: The study of cognitive performance. A search of the Web of Science yielded 125 articles that met the inclusion criteria. In order to provide a comprehensive overview of scientific productivity, we examine several bibliometric indicators, concerning both productivity and impact or visibility. The analysis also focuses on qualitative aspects of key theoretical importance, such as the kinds of cognitive functions that are most often assessed and the tests most widely used to evaluate them in clinical practice. The study shows that interest in the subject of cognitive function in schizophrenia has increased considerably in Spain since the beginning of this century. The results also highlight the need to standardize the type of tests to be used in the cognitive assessment of patients with schizophrenia.