Psychometric Properties of the Spanish Version of the Panic Disorder Severity Scale.

The Panic Disorder Severity Scale (PDSS) is a well-established measure of panic symptoms but few data exist on this instrument in non north-American samples. Our main goal was to assess the psychometric properties (internal consistency, test re-test reliability, inter-rater reliability, convergent and divergent validity) and the factor structure of the Spanish version. Ninety-four patients with a main diagnosis of panic disorder were assessed with the Spanish version of PDSS, the Anxiety Sensitivity Index-3 (ASI-3), the Panic and Agoraphobia Scale (PAS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II) the PDSS self-rating form and the Clinical Global Impression-Severity scale (CGI). The Spanish PDSS showed acceptable internal consistency (α = .74), excellent test-retest (total score and items 1-6: α > .58, p .90) and medium to large convergent validity (r = .68, 95% CI [.54, .79], p < .01; r = .80, 95% CI [.70, .87], p < .01; r = .48, 95% CI [.28, .67], p < .01; BAI, PAS and ASI-3 total scores respectively). Data on divergent validity (BDI-II total score: r = .52, 95% CI [.34, .67], p < .01) suggest some need for refinement of the PDSS. The confirmatory factor analysis suggested a two-factor modified model for the scale (nested χ2 = 14.01, df = 12, p < .001). The Spanish PDSS has similar psychometric properties as the previous versions and is a useful instrument to assess panic symptoms in clinical settings in Spanish-speaking populations.

Psychometric properties of the Spanish version of the Panic Disorder Severity Scale

The Panic Disorder Severity Scale (PDSS) is a well-established measure of panic symptoms but few data exist on this instrument in non north-American samples. Our main goal was to assess the psychometric properties (internal consistency, test re-test reliability, inter-rater reliability, convergent and divergent validity) and the factor structure of the Spanish version. Ninety-four patients with a main diagnosis of panic disorder were assessed with the Spanish version of PDSS, the Anxiety Sensitivity Index-3 (ASI-3), the Panic and Agoraphobia Scale (PAS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II) the PDSS self-rating form and the Clinical Global Impression-Severity scale (CGI). The Spanish PDSS showed acceptable internal consistency (α = .74), excellent test-retest (total score and items 1-6: α > .58, p < .01) and inter-rater reliability (most intraclass correlation coefficient values for the total score were > .90) and medium to large convergent validity (r = .68, 95% CI [.54, .79], p < .01; r = .80, 95% CI [.70, .87], p < .01; r = .48, 95% CI [.28, .67], p < .01; BAI, PAS and ASI-3 total scores respectively). Data on divergent validity (BDI-II total score: r = .52, 95% CI [.34, .67], p < .01) suggest some need for refinement of the PDSS. The confirmatory factor analysis suggested a two-factor modified model for the scale (nested χ2 = 14.01, df = 12, p < .001). The Spanish PDSS has similar psychometric properties as the previous versions and is a useful instrument to assess panic symptoms in clinical settings in Spanish-speaking populations

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Treatment adherence to treatment in substance users referred from Psychiatric Emergency service to outpatient treatment.

OBJECTIVES: The main objective was to evaluate the treatment adherence of patients attended at the Psychiatric Emergency Room and referred to an Outpatient Drug Clinic. Our aim was to describe the degree of adherence and the factors related to it. METHODS: A naturalistic study was conducted through examination of the clinical records of the patients attended in the Psychiatric Emergency Room of our hospital during one year (n=5052). Inclusion criteria consisted of substance dependence meeting DSM-IV criteria, belonging to our district, referral when discharged to an Outpatient Drug Clinic, and absence of previous treatment for Drug Addiction follow-ups (n=72). We evaluated further to the center link, adherence to the deviceduring the next year. RESULTS: 33.4% of the patients referred to an Outpatient Drug Clinic didn't request for a visit. From those who requested a first appointment, 20.83% didn't attend. From those who attended the first appointment, 47.37% abandoned treatment in the first 12 months. No differences between substance of use or time of the year of referral were observed. DISCUSSION: Independently to the accessibility to the Outpatient Clinic, difficulties in the adherence to drug addiction treatment exist. Inicial adherence to drug addiction treatment is medium. Patient's attendance to the clinics are important due to it's relation with retention doubling. Efforts should be made to improve the compliance with pharmacologic and nonpharmacologic treatment.

Adherencia al tratamiento en drogodependientes remitidos desde urgencias de psiquiatría a tratamiento ambulatorio / Treatment adherence to treatment in substance users referred from Psychiatric Emergency service to outpatient treatment

Objetivo. Evaluar la adherencia de los pacientes derivados a un ambulatorio de drogodependencias accesible tras ser visitados en el servicio de urgencias de psiquiatría. Describir las variables asociadas a la adherencia y la duración de la vinculación. Metodología. Estudio naturalístico. La muestra del estudio se obtuvo a partir de la revisión de las historias clínicas de los pacientes que acudieron al Servicio de Urgencias de Psiquiatría del Hospital Universitario Vall d’Hebron (HUVH)durante un año (n=5052). Se seleccionaron aquellos que cumplían con los criterios diagnósticos de dependencia desustancias según el DSM-IV-TR, pertenecían al sector de referencia y eran derivados al alta al dispositivo de tratamiento ambulatorio de drogodependencias y no estaban vinculados a otros dispositivos de drogas (n=72). Se valoró su posterior vinculación al centro y la adherencia el siguiente año. Resultados. Un 33,4% no solicitaron visita. De los que la solicitaron un 20,83% no acudieron. Un 47,37% de los que acudieron a la primera visita abandonaron antes de los 12meses. No se observaron diferencias entre el tipo de droga o época de derivación. Discusión. Existen dificultades de adherencia al tratamiento de los pacientes con trastorno por uso de sustancias(TUS), con independencia a la accesibilidad. La vinculación inicial es media. Es importante que los pacientes acudan. Si esto sucede la retención es del doble. Se deben realizar esfuerzos para mejorar el cumplimiento del tratamiento farmacológico y no farmacológico (AU)

Objectives. The main objective was to evaluate the treatment adherence of patients attended at the Psychiatric Emergency Room and referred to an Outpatient Drug Clinic. Our aim was to describe the degree of adherence and the factors related to it. Methods. A naturalistic study was conducted through examination of the clinical records of the patients attended in the Psychiatric Emergency Room of our hospital during one year (n=5052). Inclusion criteria consisted of substance dependence meeting DSM-IV criteria, belonging to our district, referral when discharged to an Outpatient Drug Clinic, and absence of previous treatment for Drug Addiction follow-ups (n=72). We evaluated further to the center link, adherence to the device during the next year. Results. 33.4% of the patients referred to an Outpatient Drug Clinic didn’t request for a visit. From those whore quested a first appointment, 20.83% didn’t attend. From those who attended the first appointment, 47.37%abandoned treatment in the first 12 months. No differences between substance of use or time of the year of referral were observed. Discussion. Independently to the accessibility to the Outpatient Clinic, difficulties in the adherence to drug addiction treatment exist. Inicial adherence to drug addiction treatment is medium. Patient’s attendance to the clinics are important due to it’s relation with retention doubling. Efforts should be made to improve the compliance with pharmacologic and non pharmacologic treatment (AU)

Combination of aripiprazole and other psychopharmacological treatments in resistant and multi-resistant patients.

INTRODUCTION: Aripiprazole is a new antipsychotic agent that has proven safe and efficacious in controlled clinical trials. However, few published data on its effectiveness and safety when used in augmentation and combination are available. METHODS: Our study aimed to determine the functional effectiveness and safety of different combinations of aripiprazole with other psychotropics in resistant patients. All acute not selected (15) patients treated with aripiprazole and other psychotropics between February 2005 and May 2007 are included. RESULTS: Mean follow-up 20.4 days. Main diagnosis was schizophrenia (40%) and mean dose of aripiprazole was 25 mg/d. Resistant patients received initially multiple psychotropics (mean 3.3) and their functional status was very low. A significant functional improvement was observed after admission in most (12) of them. Only three patients experienced mild to moderate improvement; another three patients showed extrapyramidal symptoms. No dermatological reactions or adverse effects were observed with lamotrigine association. DISCUSIONS: The combination of aripiprazole with other psychotropics was well tolerated. No significant new adverse reactions were observed. In a short term follow-up, our results show a good tolerability of aripiprazole in combination with other psychotropics of different groups.