Validity of Self-rating Screening Scales for the Diagnosis of Depression and Anxiety in Adult Patients With Bronchiectasis / Validez de las escalas de autoevaluación para el diagnóstico de depresión y ansiedad en pacientes adultos con bronquiectasias

Background: There are no previous studies aimed at assessing the validity of the screening scales for depression and anxiety in adult patients with bronchiectasis.Aims: To analyze the psychometric properties of Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and Hamilton Anxiety Scale and to evaluate the concordance for the diagnosis of depression and anxiety between these screening scales and the structured clinical interview in adult patients with bronchiectasis.Method: Cross sectional study. 52 patients with bronchiectasis completed HADS, BDI and Hamilton Anxiety Scale; afterwards, were individually interviewed by a mental health care professional using the structured Mini International Neuropsychiatric Interview (MINI), which evaluates for depression and anxiety according to DSM-IV criteria.Results: Based on MINI, 18 subjects (34.6%) had a diagnosis of depression and 25 (48.1%) had anxiety. Optimal cut-off values to detect depression were ≥9 for the HADS-D (sensitivity 0.833, specificity 0.971, AUC 0.962 [95% CI 0.918–1]), and 17 for BDI (sensitivity 0.889, specificity 0.912, AUC 0.978 [95% CI 0.945–1]). Optimal cut-off values to detect anxiety were ≥4 for the HADS-A (sensitivity 0.960, specificity 0.593, AUC 0.833 [95% CI 0.723–0.943]), and 17 for Hamilton Anxiety Scale (sensitivity 0.800, specificity 0.852, AUC 0.876 [95% CI 0.781–0.970]). (AU)

Contexto global: No existen estudios previos dirigidos a la evaluación de las escalas de detección de la depresión y de la ansiedad en pacientes adultos con bronquiectasias.Objetivos: Analizar las propiedades psicométricas de la escala de ansiedad y depresión hospitalaria (HADS, por sus siglas en inglés), el inventario de depresión de Beck (BDI, por sus siglas en inglés) y la escala de ansiedad de Hamilton, y evaluar la concordancia para el diagnóstico de la depresión y la ansiedad entre estas escalas de detección y la entrevista clínica estructurada en pacientes adultos con bronquiectasias.Método: Estudio transversal. Cincuenta y dos pacientes con bronquiectasias completaron la HADS, el BDI y la escala de ansiedad de Hamilton; posteriormente, un psiquiatra profesional de la salud mental les entrevistó individualmente utilizando la entrevista estructurada denominada Minientrevista neuropsiquiátrica internacional (MINI), que evalúa la depresión y la ansiedad siguiendo los criterios del DSM-IV.Resultados: Basándonos en la MINI, 18 sujetos (el 34,6%) fueron diagnosticados de depresión y 25 de ellos (el 48,1%) presentaba ansiedad. Los valores de corte óptimos para detectar depresión fueron ≥9 para la HADS-D (sensibilidad: 0,833; especificidad: 0,971; ABC: 0,962 [IC 95%: 0,918-1]) y 17 para el BDI (sensibilidad: 0,889; especificidad: 0,912; ABC: 0,978 [IC 95%: 0,945-1]). Los valores de corte óptimos para detectar ansiedad fueron ≥4 para la HADS-A (sensibilidad: 0,960; especificidad: 0,593; ABC: 0,833 [IC 95%: 0,723-0,943]) y 17 para la escala de ansiedad de Hamilton (sensibilidad: 0,800; especificidad: 0,852; ABC: 0,876 [IC 95%: 0,781-0,970]). (AU)

Validity of Self-rating Screening Scales for the Diagnosis of Depression and Anxiety in Adult Patients With Bronchiectasis.

BACKGROUND: There are no previous studies aimed at assessing the validity of the screening scales for depression and anxiety in adult patients with bronchiectasis. AIMS: To analyze the psychometric properties of Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and Hamilton Anxiety Scale and to evaluate the concordance for the diagnosis of depression and anxiety between these screening scales and the structured clinical interview in adult patients with bronchiectasis. METHOD: Cross sectional study. 52 patients with bronchiectasis completed HADS, BDI and Hamilton Anxiety Scale; afterwards, were individually interviewed by a mental health care professional using the structured Mini International Neuropsychiatric Interview (MINI), which evaluates for depression and anxiety according to DSM-IV criteria. RESULTS: Based on MINI, 18 subjects (34.6%) had a diagnosis of depression and 25 (48.1%) had anxiety. Optimal cut-off values to detect depression were ≥9 for the HADS-D (sensitivity 0.833, specificity 0.971, AUC 0.962 [95% CI 0.918-1]), and 17 for BDI (sensitivity 0.889, specificity 0.912, AUC 0.978 [95% CI 0.945-1]). Optimal cut-off values to detect anxiety were ≥4 for the HADS-A (sensitivity 0.960, specificity 0.593, AUC 0.833 [95% CI 0.723-0.943]), and 17 for Hamilton Anxiety Scale (sensitivity 0.800, specificity 0.852, AUC 0.876 [95% CI 0.781-0.970]). CONCLUSION: The self-rating screening scales HADS, BDI and Hamilton Anxiety Scale are reliable tools to screen for depression and anxiety in adult patients with bronchiectasis. However, the use of specific cut-off values may improve the diagnostic accuracy of the previous scales in this specific group of patients.

An extraordinary chiral exchange-bias phenomenon: engineering the sign of the bias field in orthogonal bilayers by a magnetically switchable response mechanism.

Isothermal tuning of both the magnitude and the sign of the bias field has been achieved by exploiting a new phenomenon in a system consisting of two orthogonally coupled films: SmCo5 (out-of-plane anisotropy)-CoFeB (in-plane anisotropy). This has been achieved by using the large dipolar magnetic field of the SmCo5 layer resulting in the pinning of one of the branches of the hysteresis loop (either the ascending or the descending branch) at a fixed field value while the second one is modulated along the field axis by varying the orientation of an externally applied magnetic field. This means the possibility of controlling the sign of the bias field in a manner not reported to date. Moreover, modulation of the bias field strength is possible by varying the thickness of a spacer between the SmCo5 and CoFeB layers. This study shows that the observed phenomena find their origin in the competition between the artificially induced anisotropies in both layers, resulting in a reversible chiral bias effect that allows the selection of the initial sign of the bias field by switching (upwards/downwards) the magnetization in the SmCo5 film.

Needs, Perceived Support, and Hospital Readmissions in Patients with Severe Mental Illness.

People with severe mental illness have multiple and complex needs that often are not addressed. The purpose of this study was to analyse needs and support perceived and the relationship with hospital readmission. We assessed 100 patients with severe mental illness at discharge from an acute inpatient unit in terms of needs (Camberwell Assessment of Needs), clinical status (The Brief Psychiatric Rating Scale), and social functioning (Personal and Social Performance); we also followed up these patients for 1 year. The group of patients who were readmitted had more total needs than did the non-readmitted, in addition to more unmet needs, although the differences were not significant. The highest risk factor for rehospitalisation was the number of previous admissions. In addition, the help of informal carers in alleviating psychological distress was associated with the risk of readmission. The main conclusion concerns the role of the psychological support provided by informal networks in preventing readmission.

Emergence of the Stoner-Wohlfarth astroid in thin films at dynamic regime.

The Stoner-Wohlfarth (SW) model is the simplest model that describes adequately the magnetization reversal of nanoscale systems that are small enough to contain single magnetic domains. However for larger sizes where multi-domain effects are present, e.g., in thin films, this simple macrospin approximation fails and the experimental critical curve, referred as SW astroid, is far from its predictions. Here we show that this discrepancy could vanish also in extended system. We present a detailed angular-dependent study of magnetization reversal dynamics of a thin film with well-defined uniaxial magnetic anisotropy, performed over 9 decades of applied field sweep rate (dH/dt). The angular-dependent properties display a gradual transition from domain wall pinning and motion-like behaviour to a nucleative single-particle one, as dH/dt increases. Remarkably, in the high dynamic regime, where nucleation of reversed domains is the dominant mechanism of the magnetization reversal (nucleative regime), the magnetic properties including the astroid become closer to the ones predicted by SW model. The results also show why the SW model can successfully describe other extended systems that present nucleative regime, even in quasi-static conditions.

Direct observation of temperature-driven magnetic symmetry transitions by vectorial resolved MOKE magnetometry.

Angle- and temperature-dependent vectorial magnetometry measurements are necessary to disentangle the effective magnetic symmetry in magnetic nanostructures. Here we present a detailed study on an Fe(1 0 0) thin film system with competing collinear biaxial (four-fold symmetry) and uniaxial (two-fold) magnetic anisotropies, carried out with our recently developed full angular/broad temperature range/vectorial-resolved magneto-optical Kerr effect magnetometer, named TRISTAN. The data give direct views on the angular and temperature dependence of the magnetization reversal pathways, from which characteristic axes, remanences, critical fields, domain wall types, and effective magnetic symmetry are obtained. In particular, although the remanence shows four-fold angular symmetry for all investigated temperatures (15 K-400 K), the critical fields show strong temperature and angular dependencies and the reversal mechanism changes for specific angles at a given (angle-dependent) critical temperature, showing signatures of an additional collinear two-fold symmetry. This symmetry-breaking is more relevant as temperature increases to room temperature. It originates from the competition between two anisotropy contributions with different symmetry and temperature evolution. The results highlight the importance of combining temperature and angular studies, and the need to look at different magnetic parameters to unravel the underlying magnetic symmetries and temperature evolutions of the symmetry-breaking effects in magnetic nanostructures.

Note: Vectorial-magneto optical Kerr effect technique combined with variable temperature and full angular range all in a single setup.

Here, we report on a versatile full angular resolved/broad temperature range/vectorial magneto optical Kerr effect (MOKE) magnetometer, named TRISTAN. Its versatility relies on its capacity to probe temperature and angular dependencies of magnetization reversal processes without the need to do any intervention on the apparatus during measurements. The setup is a combination of a vectorial MOKE bench and a cryostat with optical access. The cryostat has a motorized rotatable sample holder with azimuthal correction. It allows for simultaneous and quantitative acquisition of the two in-plane magnetization components during the hysteresis loop at different temperatures from 4 K up to 500 K and in the whole angular range, without neither changing magnet orientation nor opening the cryostat. Measurements performed in a model system with competing collinear biaxial and uniaxial contributions are presented to illustrate its capabilities.