The Psychometrics of the European Portuguese Version of the Temperament and Character Inventory-Revised.

Cloninger's psychobiological model of personality integrates contributions from behavioral genetics, neurobiology, and psychology in the description of the human personality. The temperament and character inventory (TCI) is its assessment instrument. The Brazilian Portuguese version of the TCI has shown good psychometric properties. However, Portuguese spoken in Brazil presents marked and substantial differences to that spoken in Portugal, and no study has yet described the psychometrics of the European Portuguese version. The objective of this study was thus to describe the psychometric properties of the European Portuguese adult version of the TCI (the temperament and character inventory-revised (TCI-R)). This study involved 1400 Portuguese adult participants. The factorial structure of the European Portuguese version was tested using four methods: exploratory factor analysis, orthogonal procrustes rotation analysis, confirmatory factor analysis, and exploratory structural equation modeling. The integration of data coming from these methods suggested that the Portuguese version of the TCI-R presented good structural validity (as revealed by the emergence of the temperament and character structures predicted by theory) and high levels of congruence between the American and the Portuguese versions. An improvement in the goodness of fit of the models for the Portuguese population was achieved by using exploratory structural equation modeling over confirmatory factor analysis. Although some facets registered questionable consistency, all dimensions had acceptable to good consistency (all ≥ .79). These results confirm the validity of the Portuguese TCI-R and its adequacy for use in European Portuguese samples.

Validation and normative studies of the Brazilian Portuguese and American versions of the Temperament and Character Inventory - Revised (TCI-R).

BACKGROUND: The Temperament and Character Inventory (TCI) was first described in 1993. It was designed to measure the character and temperament dimensions of Cloninger's model of personality using a true-false response format. The revised TCI (TCI-R) uses a five-point-Likert format and has multiple subscales for persistence to improve its reliability. We tested the clinical validity of an original Brazilian-Portuguese translation of the TCI-R. METHODS: The 595 volunteers completed the BrP version of TCI-R, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Satisfaction with Life Scale (SWLS). RESULTS: The internal consistency was satisfactory for all dimensions (Cronbach alpha coefficients above 0.7). The cumulative variances for temperament and character were 58% and 60%. BAI was positively correlated with harm avoidance and negatively with persistence, self-directedness and cooperativeness. SWLS was correlated negatively with harm avoidance and positively with self-directedness and cooperativeness. The congruence coefficients between each facet of BrP TCI-R and the US TCI-R original data were 95% or higher (except NS1). LIMITATIONS: The main limitation of this study is the convenience sampling. CONCLUSIONS: The BrP version of the TCI-R had good psychometric properties regardless of the cultural and educational backgrounds of subjects. The present study supported the validity of the BrP translation of the TCI-R, which encourages its use in both clinical and general community samples.

Transtorno mental, indicadores demográficos e satisfação com a vida / Mental disorder, demographic variables and life satisfaction

OBJETIVO: Analisar a influência de rastreamento positivo para transtornos mentais não-psicóticos, variáveis sociodemográficas e presença de doença crônica não-psiquiátrica nos escores da Escala de Satisfação Com a Vida. MÉTODOS: Participaram do estudo os moradores de uma área atendida pelo Programa de Saúde da Família em Santa Cruz do Sul (RS). De 30 de junho a 30 de agosto de 2006 os participantes responderam ao instrumento de rastreamento psiquiátrico Self-report Questionnaire-20 items e à Escala de Satisfação Com a Vida, esta para avaliar o componente cognitivo do bem-estar subjetivo. RESULTADOS: O total de indivíduos participantes do estudo foi de 625. Ser do sexo feminino apresentou associação significativa e inversa com satisfação com a vida. O mesmo ocorreu entre escores do rastreamento psiquiátrico e da Escala de Satisfação com a Vida. Por outro lado, a idade apresentou associação significativa e positiva com a Escala. Após análise multivariada, todas as três variáveis permaneceram associadas ao desfecho. Indivíduos com doença crônica não-psiquiátrica não diferiram dos sem doença nos escores da Escala de Satisfação com a Vida. CONCLUSÕES: A associação positiva entre a Escala de Satisfação com a Vida e idade está de acordo com sua validação no Brasil. A relação inversa entre escores do instrumento de rastreamento psiquiátrico e a Escala confirma o impacto negativo dos transtornos mentais.(AU)

Transtorno mental, indicadores demográficos e satisfação com a vida / Trastorno mental, indicadores demográficos y satisfacción con la vida / Mental disorder, demographic variables and life satisfaction

OBJETIVO: Analisar a influência de rastreamento positivo para transtornos mentais não-psicóticos, variáveis sociodemográficas e presença de doença crônica não-psiquiátrica nos escores da Escala de Satisfação Com a Vida. MÉTODOS: Participaram do estudo os moradores de uma área atendida pelo Programa de Saúde da Família em Santa Cruz do Sul (RS). De 30 de junho a 30 de agosto de 2006 os participantes responderam ao instrumento de rastreamento psiquiátrico Self-report Questionnaire-20 items e à Escala de Satisfação Com a Vida, esta para avaliar o componente cognitivo do bem-estar subjetivo. RESULTADOS: O total de indivíduos participantes do estudo foi de 625. Ser do sexo feminino apresentou associação significativa e inversa com satisfação com a vida. O mesmo ocorreu entre escores do rastreamento psiquiátrico e da Escala de Satisfação com a Vida. Por outro lado, a idade apresentou associação significativa e positiva com a Escala. Após análise multivariada, todas as três variáveis permaneceram associadas ao desfecho. Indivíduos com doença crônica não-psiquiátrica não diferiram dos sem doença nos escores da Escala de Satisfação com a Vida. CONCLUSÕES: A associação positiva entre a Escala de Satisfação com a Vida e idade está de acordo com sua validação no Brasil. A relação inversa entre escores do instrumento de rastreamento psiquiátrico e a Escala confirma o impacto negativo dos transtornos mentais.

OBJECTIVE: To evaluate the impact of positive screening of non-psychotic mental disorders, sociodemographic variables, and concomitant non-psychiatric chronic diseases on the Satisfaction with Life Scale scores. METHODS: The study included residents of an area covered by the Health Family Program in Santa Cruz do Sul, Southern Brazil, between June 30 and August 30, 2006. Respondents answered a psychiatric screening tool, the Self-report Questionnaire-20, and the Satisfaction with Life Scale to assess the cognitive component of subjective well-being. RESULTS: A total of 625 respondents were included in the study. Females showed significant inverse association with life satisfaction. The same association was seen between psychiatric screening and Satisfaction with Life Scale scores. Age had a significant positive association with the Scale scores. After the multivariate analysis, these three variables remained significantly associated to the outcome. Concomitant non-psychiatric chronic diseases did not show any association with Satisfaction with Life Scale scores. CONCLUSIONS: The positive association between Satisfaction with Life Scale and age corroborates its the validation study of the Brazilian Portuguese. The inverse relationship between the psychiatric screening tool and the Satisfaction with Life Scale scores confirms the negative impact of mental disorders.

OBJETIVO: Analizar la influencia del seguimiento positivo en trastornos mentales no sicóticos, variables sociodemográficas y presencia de enfermedad crónica no siquiátrica en los puntajes de la Escala de Satisfacción Con la Vida. MÉTODOS: Participaron del estudio los habitantes de un área atendida por el Programa de Salud de la Familia en Santa Cruz del Sur (Sur de Brasil). Del 30 de junio al 30 de agosto de 2006 los participantes respondieron al instrumento de seguimiento psiquiátrico Self-report Questionnaire-20 items y a la Escala de Satisfacción Con la Vida, ésta para evaluar el componente cognitivo del bienestar subjetivo. RESULTADOS: El total de individuos participantes del estudio fue de 625. Ser del sexo femenino reflejó asociación significativa e inversa con la satisfacción con la vida. Lo mismo ocurrió entre los puntajes de seguimiento psiquiátrico y de la Escala de Satisfacción Con la Vida. Por otro lado, la edad presentó asociación significativa y positiva con la Escala. Posterior al análisis multivariado, todas las tres variables permanecieron asociadas en el resultado. Individuos con enfermedad crónica no psiquiátrica no se diferenciaron de los que no presentaron enfermedad en el puntaje de la Escala de Satisfacción Con la Vida. CONCLUSIONES: La asociación positiva entre la Escala de Satisfacción Con la Vida y edad está de acuerdo con su validez en Brasil. La relación inversa entre puntaje del instrumento de seguimiento psiquiátrico y la Escala confirma el impacto negativo de los trastornos mentales.

[Mental disorder, demographic variables and life satisfaction]. / Transtorno mental, indicadores demográficos e satisfação com a vida.

OBJECTIVE: To evaluate the impact of positive screening of non-psychotic mental disorders, sociodemographic variables, and concomitant non-psychiatric chronic diseases on the Satisfaction with Life Scale scores. METHODS: The study included residents of an area covered by the Health Family Program in Santa Cruz do Sul, Southern Brazil, between June 30 and August 30, 2006. Respondents answered a psychiatric screening tool, the Self-report Questionnaire-20, and the Satisfaction with Life Scale to assess the cognitive component of subjective well-being. RESULTS: A total of 625 respondents were included in the study. Females showed significant inverse association with life satisfaction. The same association was seen between psychiatric screening and Satisfaction with Life Scale scores. Age had a significant positive association with the Scale scores. After the multivariate analysis, these three variables remained significantly associated to the outcome. Concomitant non-psychiatric chronic diseases did not show any association with Satisfaction with Life Scale scores. CONCLUSIONS: The positive association between Satisfaction with Life Scale and age corroborates its the validation study of the Brazilian Portuguese. The inverse relationship between the psychiatric screening tool and the Satisfaction with Life Scale scores confirms the negative impact of mental disorders.

[Prevalence of mental disorders at a referral center for the Family Health Program in Santa Cruz do Sul, Rio Grande do Sul State, Brazil]. / Prevalência de transtornos mentais em indivíduos de uma unidade de referência para Programa Saúde da Família em Santa Cruz do Sul, Rio Grande do Sul, Brasil.

Among the ten leading causes of disability-adjusted life years, seven are mental disorders. Primary health care centers are crucial to public mental health policies, according to the World Health Organization. This study aimed to verify the prevalence of mental disorders among individuals seeking care at the referral center for a Family Health Program (FHP) team in Santa Cruz do Sul, Rio Grande do Sul State, Brazil, and the influence of psychiatric diagnosis on utilization of the health system. Of the 754 participants, 51.1% had a psychiatric diagnosis. Subjects with a psychiatric diagnosis showed significantly higher use of the health system in the previous 12 months. Mental disorders have a negative impact on well-being and quality of life, besides increasing the use of health resources due to untreated symptoms and because mental disorders contribute negatively to the prognosis of non-psychiatric medical conditions. These results show the importance of including mental health care in the FHP in Brazil.

Prevalência de transtornos mentais em indivíduos de uma unidade de referência para Programa Saúde da Família em Santa Cruz do Sul, Rio Grande do Sul, Brasil / Prevalence of mental disorders at a referral center for the Family Health Program in Santa Cruz do Sul, Rio Grande do Sul State, Brazil

Entre as dez primeiras causas de anos vividos com incapacidade no mundo, sete são transtornos mentais. Centros de atendimento primário são fundamentais para as políticas de saúde mental, conforme a Organização Mundial da Saúde. Este estudo tem por objetivo verificar a prevalência de transtornos mentais entre indivíduos que buscaram atendimento médico na unidade de referência de uma equipe do Programa Saúde da Família (PSF) em Santa Cruz do Sul, Rio Grande do Sul, Brasil, e verificar a influência de diagnóstico psiquiátrico na utilização de recursos da saúde. Dos 754 indivíduos que participaram do estudo, 51,1 por cento (IC95 por cento: 47,5-54,7) foram diagnosticados como portadores de diagnóstico psiquiátrico, sendo que estes utilizaram de forma significativamente mais freqüente recursos da saúde nos últimos 12 meses. Transtornos mentais representam impacto negativo na qualidade de vida e bem-estar dos portadores, assim como aumento de uso dos recursos da saúde por sintomas não tratados e por ser fator de mau prognóstico para outras doenças não-psiquiátricas. Esses resultados reforçam a necessidade da inclusão efetiva do tema saúde mental nas metas e intervenções dos PSFs no Brasil.

Among the ten leading causes of disability-adjusted life years, seven are mental disorders. Primary health care centers are crucial to public mental health policies, according to the World Health Organization. This study aimed to verify the prevalence of mental disorders among individuals seeking care at the referral center for a Family Health Program (FHP) team in Santa Cruz do Sul, Rio Grande do Sul State, Brazil, and the influence of psychiatric diagnosis on utilization of the health system. Of the 754 participants, 51.1 percent had a psychiatric diagnosis. Subjects with a psychiatric diagnosis showed significantly higher use of the health system in the previous 12 months. Mental disorders have a negative impact on well-being and quality of life, besides increasing the use of health resources due to untreated symptoms and because mental disorders contribute negatively to the prognosis of non-psychiatric medical conditions. These results show the importance of including mental health care in the FHP in Brazil.

[Mental disorders in a community assisted by the Family Health Program]. / Transtornos mentais em comunidade atendida pelo Programa Saúde da Família.

The first objective of this study was to estimate the prevalence of mood, anxiety, and somatoform disorders (MASD) using the screening tool Self-Reporting Questionnaire-20 Items (SRQ-20) in a community assisted by the Family Health Program (FHP) in Santa Cruz do Sul, Rio Grande do Sul, Brazil. The second goal was to verify associations between demographic variables and MASD. We invited all residents>14 years of age to participate. The total sample consisted of 1,122 subjects. MASD prevalence was 38% (95%CI: 35.12-40.88). Female gender, low schooling, and unemployment were independently associated with MASD. The high prevalence of MASD observed in this study confirms the relevance of these disorders for public health planning, and could also help explain the high suicide rate in Santa Cruz do Sul in the last decade (4.66 times the national rate). Finally, the study highlights the importance of including mental health in the FHP priority agenda in Brazil.

Transtornos mentais em comunidade atendida pelo Programa Saúde da Família / Mental disorders in a community assisted by the Family Health Program

O objetivo principal deste estudo é estimar a prevalência de transtornos mentais de humor, ansiedade e somatização (THAS) utilizando o Self-Reporting Questionnaire-20 Itens (SRQ-20) em comunidade atendida pelo Programa Saúde da Família (PSF) em Santa Cruz do Sul, Rio Grande do Sul, Brasil. Objetivo secundário é verificar a associação de THAS com variáveis demográficas. Todos os moradores da área do PSF avaliada maiores de 14 anos foram convidados a participar. A amostra total analisada foi composta de 1.122 indivíduos. A prevalência encontrada de THAS foi de 38 por cento (IC95 por cento: 35,12-40,88). Sexo feminino, baixa escolaridade e situação ocupacional desfavorável mostraram associação independente com THAS. A alta prevalência de THAS na área estudada demonstra a importância destes transtornos em termos de saúde pública, e pode trazer alguma contribuição para o entendimento da alta incidência de mortalidade por suicídio verificada em Santa Cruz do Sul na última década (4,66 vezes maior que a incidência nacional). Incluir o tema saúde mental nas metas e prioridades do PSF no Brasil é muito importante.

The first objective of this study was to estimate the prevalence of mood, anxiety, and somatoform disorders (MASD) using the screening tool Self-Reporting Questionnaire-20 Items (SRQ-20) in a community assisted by the Family Health Program (FHP) in Santa Cruz do Sul, Rio Grande do Sul, Brazil. The second goal was to verify associations between demographic variables and MASD. We invited all residents > 14 years of age to participate. The total sample consisted of 1,122 subjects. MASD prevalence was 38 percent (95 percentCI: 35.12-40.88). Female gender, low schooling, and unemployment were independently associated with MASD. The high prevalence of MASD observed in this study confirms the relevance of these disorders for public health planning, and could also help explain the high suicide rate in Santa Cruz do Sul in the last decade (4.66 times the national rate). Finally, the study highlights the importance of including mental health in the FHP priority agenda in Brazil.

[Performance of the Self-Reporting Questionnaire as a psychiatric screening questionnaire: a comparative study with Structured Clinical Interview for DSM-IV-TR]. / Avaliação de desempenho do Self-Reporting Questionnaire como instrumento de rastreamento psiquiátrico: um estudo comparativo com o Structured Clinical Interview for DSM-IV-TR.

The SRQ (Self-Reporting Questionnaire) is a psychiatric screening tool that originally included 30 questions. The Brazilian version of SRQ-20 (a version that includes the 20 items for non-psychotic mental disorders) was validated in the early 1980s. The objective of the present study was to validate the Brazilian version of SRQ-20 and the 5 items for alcohol-related disorders as compared to the SCID-IV-TR (Structured Clinical Interview for DSM-IV-TR) as the gold standard. The study was conducted in Santa Cruz do Sul, a small town in southern Brazil, with 485 subjects (54.8% females, mean age 40.04 years). The 5 items for alcohol-related disorders showed low sensitivity (66%). The optimum cutoff value for SRQ-20 was 7/8, with 86.33% sensitivity and 89.31% specificity. The discriminant power of SRQ-20 for psychiatric screening was 0.9, and Cronbach's alpha was 0.86.

Avaliação de desempenho do Self-Reporting Questionnaire como instrumento de rastreamento psiquiátrico: um estudo comparativo com o Structured Clinical Interview for DSM-IV-TR / Performance of the Self-Reporting Questionnaire as a psychiatric screening questionnaire: a comparativestudy with Structured Clinical Interview for DSM-IV-TR

O SRQ (Self-Reporting Questionnaire) é um instrumento de rastreamento psiquiátrico originalmente composto por 30 itens. A versão brasileira do SRQ-20 (versão com as 20 questões para rastreamento de transtornos mentais não-psicóticos) foi validada no início da década de 1980. O objetivo deste estudo foi validar a versão brasileira do SRQ-20 e dos cinco itens de rastreamento de transtorno por uso de álcool oriundos do SRQ-30, comparando com entrevista psiquiátrica usando SCID-IV-TR (Structured Clinical Interview for DSM-IV-TR) como padrão-ouro. O estudo foi conduzido em Santa Cruz do Sul, Rio Grande do Sul, Brasil, com 485 indivíduos (54,8 por cento mulheres, idade média 40,04). Os 5 itens de rastreamento de transtornos por uso de álcool mostraram sensibilidade baixa (66 por cento). O SRQ-20 apresentou como ponto de corte ideal 7/8, com sensibilidade de 86,33 por cento e especificidade de 89,31 por cento. O poder discriminante para diagnóstico psiquiátrico do SRQ-20 foi 0,91. O coeficiente Cronbach alfa foi 0,86.

The SRQ (Self-Reporting Questionnaire) is a psychiatric screening tool that originally included 30 questions. The Brazilian version of SRQ-20 (a version that includes the 20 items for non-psychotic mental disorders) was validated in the early 1980s. The objective of the present study was to validate the Brazilian version of SRQ-20 and the 5 items for alcohol-related disorders as compared to the SCID-IV-TR (Structured Clinical Interview for DSM-IV-TR) as the gold standard. The study was conducted in Santa Cruz do Sul, a small town in southern Brazil, with 485 subjects (54.8 percent females, mean age 40.04 years). The 5 items for alcohol-related disorders showed low sensitivity (66 percent). The optimum cutoff value for SRQ-20 was 7/8, with 86.33 percent sensitivity and 89.31 percent specificity. The discriminant power of SRQ-20 for psychiatric screening was 0.9, and Cronbach's alpha was 0.86.