Intensity of mental health treatment of cancer-related psychopathology: the predictive role of Early Maladaptive Schemas.

PURPOSE: With the limited availability of mental healthcare, it is of utmost importance to provide care that matches the needs of patients: short if possible, but also more intense when necessary. This study explored whether Early Maladaptive Schemas (EMSs) play a predictive role in the intensity of needed mental health treatment of cancer-related psychopathology. METHODS: EMSs were assessed before mental health treatment in 256 patients who sought help at a specialized mental health care centre for those affected by cancer in the Netherlands. Data about treatment indication and intensity of mental health treatment were collected. Univariate and multivariate logistic regression analysis were used to assess the predictive value of the EMSs total score and specific domains on treatment indication and treatment intensity. RESULTS: The presence of more severe EMSs predicted an indication for a more intense mental health treatment before start of the treatment, and actual more intense mental health treatment. The domain Impaired Autonomy and Performance appeared to be conceptually close to the domain Disconnection and Rejection, we left the latter out in our multivariate analysis and then found that Impaired Autonomy was the best predictor of intensity of mental health treatment. CONCLUSION: Our findings imply that assessing EMSs could help to identify patients who will receive more treatment time.

Cross-cultural validity of the Yale-Brown Obsessive Compulsive Scale.

Some psychometric properties of an adaptation of the Yale-Brown Obsessive Compulsive Scale for use in the Netherlands (Y-BOCS-NL) were examined in 65 psychiatric inpatients. The factorial invariance of two-dimensional systems were determined, namely Severity and Disturbance versus Obsessions and Compulsions, with the latter performing substantially better than the former in different respects. All further analyses were therefore focused on the Obsessions and Compulsions prototype. Inter-rater agreement was established in four inpatients by 39 raters at different institutions and found to be excellent. Internal consistency was also excellent. Concurrent and divergent validity were examined and established by correlating the Y-BOCS-NL with the Padua Inventory, the Burns Perfectionism Scale and state and/or trait measures of, among others, hostility, anxiety, depression, irrational fears and assertiveness. The Obsessions and Compulsions dimensions were lowly intercorrelated and showed evidence of clearly different patterns of correlations with external measures (divergent validity).