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1.
PLoS One ; 15(1): e0227364, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31895938

RESUMEN

OBJECTIVES: Depression is a common illness with substantial economic consequences for society and a great burden for affected individuals. About 30% of patients with depression do not respond to repeated treatments. Psychiatric comorbidity is known to affect duration, recurrence and treatment outcome of depression. However, there is a lack of knowledge on the extent to which psychiatric comorbidity is identified in the clinical setting for depressed patients in secondary psychiatric care. Therefore, the aim of this study was to compare the agreement between traditional diagnostic assessment (TDA) and a structured and comprehensive diagnostic procedure (SCDP) for identification of personality and anxiety disorder comorbidity in depressed patients in secondary psychiatric care. METHODS: 274 patients aged 18-77 were referred from four secondary psychiatric care clinics in Sweden during 2012-2017. ICD-10 diagnoses according to TDA (mostly unstructured by psychiatric specialist and residents in psychiatry), were retrieved from medical records and compared to diagnoses resulting from the SCDP in the study. This included the Mini International Neuropsychiatric Interview, the Structured Interview for DSM Axis II Personality Disorders and semi-structured questions on psychosocial circumstances, life-events, psychiatric symptoms, psychiatric treatments, substance use, and suicidal and self-harm behaviour. The assessment was carried out by psychiatric specialists or by residents in psychiatry with at least three years of psychiatric training. RESULTS: SCDP identified personality disorder comorbidity in 43% of the patients compared to 11% in TDA (p<0,0001). Anxiety disorder comorbidity was identified in 58% with SCDP compared to 12% with TDA (p<0,0001). CONCLUSIONS: Important psychiatric comorbidity seems to be unrecognized in depressive patients when using TDA, which is routine in secondary psychiatric care. Comorbidities are better identified using the proposed model involving structured and semi-structured interviews together with clinical evaluations by clinical experts.


Asunto(s)
Trastornos de Ansiedad , Trastorno Depresivo , Entrevista Psicológica/métodos , Trastornos de la Personalidad , Atención Secundaria de Salud/métodos , Adolescente , Adulto , Anciano , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Comorbilidad , Trastorno Depresivo/tratamiento farmacológico , Trastorno Depresivo/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Clasificación Internacional de Enfermedades , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/epidemiología , Escalas de Valoración Psiquiátrica , Psiquiatría , Psicoterapia , Suecia , Adulto Joven
2.
Rev. psicanal ; 26(3): http://revista.sppa.org.br/index.php/RPdaSPPA/article/view/465/484, dez. 2019.
Artículo en Portugués | LILACS | ID: biblio-1049685

RESUMEN

O presente artigo apresenta uma intervenção psicanalítica feita na Casa dos Cata-ventos, localizada em Porto Alegre, RS. Esta instituição foi inspirada nas Estruturas Dolto e, assim como a Casa da Árvore, localizada no Rio de Janeiro, trabalha com crianças e adolescentes em território de vulnerabilidade social. A complexidade da intervenção está discriminada no seu processo de invenção, na aposta da palavra como instrumento civilizatório e de abertura simbólica aos silenciamentos provocados pela violência, na escuta transferencial do brincar e das dificuldades escolares e, por último, na formação/ transmissão da Psicanálise presente em todo o projeto


This article presents a psychoanalytical intervention in Porto Alegre city: Casa dos Cata-ventos (Swirl Toy House). It is inspired by Dolto´s Structures and works with children and adolescents in socially vulnerable territories, just as Casa da Árvore (Tree House) in Rio de Janeiro. The complexity of this intervention is associated with its invention process, with the bet on the word as a civilizing instrument, with symbolic opening possibilities to the silence caused by violence, with transferential listening of playing and school difficulties, and lastly with Psychoanalysis formation transmission


El presente artículo presenta una intervención psicoanalítica en Casa dos Catavientos, ubicada en Porto Alegre, RS (Casa de los Molinillos). Se inspira en las Estructuras Dolto y como en la Casa da Árvore (la Casa en el Árbol), de Rio de Janeiro, trabaja con niños y adolescentes en territorios socialmente vulnerables. La complejidad de esta intervención se encuentra en su proceso de invención, por la apuesta en la palabra como instrumento de la civilización y de apertura simbólica en los silencios provocados por la violencia, en la escucha transferencial del jugar y de las dificultades escolares y, finalmente, en la formación/transmisión del Psicoanálisis, presente en todo el proyecto


Asunto(s)
Servicios Comunitarios de Salud Mental , Entrevista Psicológica
3.
Medicine (Baltimore) ; 98(52): e18515, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31876742

RESUMEN

Although functional impairment is very common among patients with major depressive disorder (MDD) and is a necessary diagnostic criterion for MDD, clinicians have not directed their attention beyond the mood symptoms of MDD. We aimed to multi-dimensionally assess the functional abilities of patients with MDD using a standardized scale of adaptive function reported by caregivers or parents to identify the nature and degree of functional impairment in patients with MDD.This study was conducted in 40 depressive patients aged 19 to 60 years. Patients were screened according to the DSM-IV-TR and a Hamilton Depression Rating Scale score ≥8. We administered the parent/caregiver rating form of the Korean Vineland Adaptive Behavior Scale to assess functional outcomes in the patients.Patients with MDD showed significant differences in both global and domain-specific functional abilities compared to those of the normal group (all t > -6.35, P < .05) and the patients' premorbid IQ (all t > 4.30, P < .001). The number of episodes among clinical factors was negatively correlated with overall adaptive functioning (r = -0.32, P < .05) and expressive communication (r = -0.42, P < .01).Our present study replicates existing evidence showing impairment in both broad and various functional areas in patients with MDD, suggesting the importance of quantitatively assessing functional outcomes and acquiring information about functioning from informants other than patients.


Asunto(s)
Actividades Cotidianas/psicología , Trastorno Depresivo Mayor/psicología , Adaptación Psicológica , Adulto , Femenino , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Adulto Joven
4.
Psicol. ciênc. prof ; 39(2,n.esp): 112-124, ago.-nov. 2019.
Artículo en Español | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1050364

RESUMEN

Algunos/as autores/as estudian y reconocen la dificultad emocional, por parte de quienes participan en investigaciones científicas, de revivir y relatar historias cuando estas se producen en contextos de violencia sea en el ámbito que sea (escuela, pareja, trabajo, etc.). El presente trabajo expone las dificultades metodológicas surgidas en el marco de una investigación cualitativa sobre la violencia laboral en dos países, Brasil y España. El objetivo de este artículo es ofrecer a la comunidad científica y política un conjunto de estrategias metodológicas para sortear los obstáculos que aparecen en la realización de una investigación con temática sensible. Las conclusiones de este trabajo indican que es necesario revisar las prácticas metodológicas que se llevan a cabo durante el diseño e implementación del estudio, pues esto puede evitar un perjuicio a los/las participantes e investigadores/as...(AU)


Alguns autores estudam e reconhecem a dificuldade emocional, por parte daqueles que participam de pesquisas científicas, de reviver e contar histórias quando estas ocorrem em contextos de violência em qualquer ambiente (escola, casal, trabalho etc.). O presente trabalho expõe as dificuldades metodológicas que surgiram no âmbito de uma pesquisa qualitativa sobre violência no trabalho em dois países, Brasil e Espanha. O objetivo deste artigo é oferecer à comunidade científica e política um conjunto de estratégias metodológicas para superar os obstáculos que surgem na realização de pesquisas sobre temas sensíveis. As conclusões deste trabalho indicam que é necessário rever as práticas metodológicas que são realizadas durante o desenho e implementação do estudo, pois isso pode evitar danos aos participantes e pesquisadores...(AU)


Some authors study and recognize the emotional difficulty, on the part of those who participate in scientific research, of reliving and telling stories when these occur in contexts of violence in any environment (school, couple, work, etc.). The present work exposes the methodological difficulties that arose in the framework of a qualitative research on workplace violence in two countries, Brazil and Spain. The aim of this article is to offer the scientific and political community a set of methodological strategies for overcoming the obstacles that appear in carrying out research on sensitive subjects. The conclusions of this work indicate that it is necessary to review the methodological practices that are carried out during the design and implementation of the study, as this may avoid harm to participants and researchers...(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Metodologias de Evaluación de Daños/métodos , Reducción del Daño , Investigación Cualitativa , Ética en Investigación , Violencia Laboral , Entrevista Psicológica , Estrés Psicológico , Emociones , Paquetes de Atención al Paciente
5.
BMC Psychol ; 7(1): 67, 2019 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-31651367

RESUMEN

BACKGROUND: To bridge the gap between symptoms and treatment, constructing case formulations is essential for clinicians. Limited scientific value has been attributed to case formulations because of problems with quality, reliability, and validity. For understanding, communication, and treatment planning beyond each specific clinician-patient dyad, a case formulation must convey valid information concerning the patient, as well as being a reliable source of information regardless of the clinician's theoretical orientation. The first aim of the present study is to explore the completeness of unstructured psychodynamic formulations, according to four components outlined in the Case Formulation Content Coding Method (CFCCM). The second aim is to estimate the reliability of independent formulations and their components, using similarity ratings of matched versus mismatched cases. METHODS: This study explores psychodynamic case formulations as made by two or more experienced clinicians after listening to an evaluation interview. The clinicians structured the formulations freely, with the sole constraint that technical, theory-laden terminology should be avoided. The formulations were decomposed into components after all formulations had been written. RESULTS: The results indicated that most formulations were adequately comprehensive, and that overall reliability of the formulations was high (> 0.70) for both experienced and inexperienced clinician raters, although the lower bound reliability estimate of the formulation component deemed most difficult to rate - inferred mechanisms - was marginal, 0.61. CONCLUSIONS: These results were achieved on case formulations made by experienced clinicians using simple experience-near language and minimizing technical concepts, which indicate a communicative quality in the formulations that make them clinically sound. TRIAL REGISTRATION: linicalTrials.gov Identifier: NCT00423462 . https://doi.org/10.1007/s00432-018-2781-7 ., January 18, 2007.


Asunto(s)
Entrevista Psicológica , Trastornos Mentales/terapia , Psicoterapia , Humanos , Lenguaje , Trastornos Mentales/diagnóstico , Reproducibilidad de los Resultados
6.
BMC Cancer ; 19(1): 870, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477049

RESUMEN

BACKGROUND: Trauma- and stressor-related disorders pose an important threat for patients with medical conditions by negatively affecting the outcomes of the underlying somatic disease. Nevertheless, research on distress in the course of hematological cancer is sparse to date. For this patient group, however, treatment is often more toxic and invasive than for other cancer populations. A subgroup of these patients is treated with stem cell transplantation (SCT) which is associated with many stressors including spatial isolation or fear of life-threatening complications. Existing results are inconsistent and primarily based on self-report questionnaires and small samples. Moreover, diagnostic criteria of trauma- and stressor-related disorders have recently been updated. METHODS: This German cross-sectional study will recruit at total of 600 hematological cancer patients, of which 300 will have undergone either autologous or allogeneic SCT. Participants will be assessed for trauma- and stressor-related disorders (adjustment disorder and posttraumatic stress disorder) using a structured clinical interview (SCID-5) based on updated diagnostic criteria. Qualitative investigation of the reported stressors will be used for differential diagnostic investigations and to examine which stressors are experienced as most distressing. Additionally, severity of distress (i.e., general distress as well as anxious, depressive and stressor-related symptomatology) will be assessed by validated questionnaires. We will (i) provide the prevalence of trauma- and stressor-related disorders, (ii) investigate medical and sociodemographic risk factors and (iii) compare the levels of distress within the patient group (SCT vs. non-SCT) and between patients and age- and gender-matched reference groups from the German general population. DISCUSSION: This study will assess the prevalence of stressor-related disorders and the level of distress among hematological cancer patients across different treatment settings. Identification of medical and sociodemographic risk factors will help to closely monitor patients with a high risk of distress and to deliver psycho-oncological treatment as soon as possible. Comparisons between patients and norm values will be used to identify the need for psycho-oncological treatment in subgroups of hematological patients and thus help to further develop and implement tailored psycho-oncological interventions.


Asunto(s)
Supervivientes de Cáncer/psicología , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/psicología , Trasplante de Células Madre Hematopoyéticas/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología , Supervivientes de Cáncer/estadística & datos numéricos , Estudios Transversales , Alemania/epidemiología , Neoplasias Hematológicas/terapia , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Entrevista Psicológica , Prevalencia , Factores de Riesgo , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios
8.
Eat Behav ; 35: 101320, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31445189

RESUMEN

Anxiety is highly characteristic of eating disorders (ED). Despite high levels of anxiety, little is known about ED specific fears. The current study developed and tested the psychometric properties of two measures of ED fears in two samples (N = 513 undergraduates; N = 129 clinical EDs): a self-report measure (Eating Disorder Fear Questionnaire; EFQ) and interview (Eating Disorder Fear Interview; EFI). We found strong support for a five-factor EFQ consisting of subscales assessing fear of weight gain, social consequences, personal consequences, physical sensations, and social eating. We found strong support for a six-factor EFI consisting of subscales assessing fear of food, weight gain, physical sensations, personal consequences, social consequences, and exercise-related fears. Both measures had adequate to strong internal consistency and convergent, divergent, incremental, and construct validity. These measures can be used to identify ED fears that can be targeted in personalized treatment. These data show that ED fears are multifaceted and heterogeneous.


Asunto(s)
Miedo , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Entrevista Psicológica , Encuestas y Cuestionarios , Adolescente , Adulto , Ansiedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Adulto Joven
9.
J Forensic Sci ; 64(6): 1884-1888, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31287563

RESUMEN

In clinical and most forensic evaluations, "diagnosis" connotes the expectation of a DSM-5 or ICD-10 formally labeled mental condition. When the task is to evaluate the security risk a person's psychological makeup presents to an institution, such a molar diagnosis can blind the clinician and elevate the risk to a security agency. When "diagnosis" connotes achieving an understanding of a person's behavior that has raised security concerns, then a different conceptualization of the diagnostic process is required. Unlike the clinical situation, the evaluation is not being performed to benefit the person but for the purpose of assessing risk to an agency. The differences this introduces involve every aspect of the evaluation and changes the type of diagnosis expected. Not appreciating these differences can cause the clinician to fail in the task of assessing psychological tendencies that affect national security.


Asunto(s)
Empleo , Trastornos Mentales/diagnóstico , Medidas de Seguridad , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Clasificación Internacional de Enfermedades , Entrevista Psicológica , Trastornos Mentales/psicología , Pruebas Psicológicas
10.
J Forensic Leg Med ; 66: 113-116, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31277038

RESUMEN

Immigration and asylum-seeking are issues that have recently. warranted increased attention and significance. In the aftermath of terrorist attacks, people are more wary of asylum seekers who are usually held in detention centers after fleeing persecution and not for criminal or immigration charges. Asylum seekers may raise suspicions due to inconsistent statements and can be held in detention for the duration of the process and/or denied asylum. Inconsistencies may be influenced by psychiatric symptoms, cognitive abilities, the type of past trauma experienced, the questioning style of the interviewer, and are usually unrelated to dishonesty or malingering making psychiatric consult important in many of these evaluations.


Asunto(s)
Trastornos de Adaptación/diagnóstico , Entrevista Psicológica , Refugiados/psicología , Trastornos por Estrés Postraumático/diagnóstico , Adulto , Emigración e Inmigración , Femenino , Psiquiatría Forense , Humanos , Texas
11.
BMC Psychol ; 7(1): 49, 2019 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-31337443

RESUMEN

BACKGROUND: Nowadays there is a growing interest in exploring causes of fatigue symptoms and the possible linked aspects in patients with Chronic Kidney Disease (CKD) receiving hemodialysis (HD) treatment. Inflammatory processes were demonstrated to influence motivational systems functioning in chronic conditions. However, there is a lack of connection between quantitative motivational systems measure and patients self-report motivational and fatigue issue. Thus, the aim of this study was to identify an association between HD patients reward mechanisms, fatigue severity and psychosocial variables emerging from semi-structured interviews. METHODS: Interviews were held for a sample of ninety-four patients (54 males, 40 females; Mage = 62.98 ± 17.94; dialytic mean age in months = 76.55 ± 84.89) receiving chronic HD treatment and consequently analyzed by means of quantitative and qualitative analysis. Behavioral motivation systems reflecting inhibition/approach tendency to rewards were measured by Behavioral Inhibition/Activation System (BIS/BAS) scale and the fatigue severity experienced by HD patients was measured with the Fatigue Severity Scale. Scale results were correlated to psychosocial variables and topics derived from the semi-structured interviews. RESULTS: Findings highlight the presence of two effects: one related to the Behavioral Activation System (BAS) as a protective factor against the HD treatment pervasive consequences; the other one deals with the self-reported levels of fatigue that seemed to significantly interfere with patients' daily life, as a function of gender. CONCLUSIONS: Such results encourage the use of a mixed method approach to understand the complexity of the subjective experience of patients' facing chronic disease and treatments.


Asunto(s)
Actitud Frente a la Salud , Fatiga/psicología , Entrevista Psicológica/métodos , Calidad de Vida/psicología , Diálisis Renal/psicología , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Recompensa , Factores de Riesgo , Autoinforme
12.
Australas Psychiatry ; 27(4): 362-365, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31165642

RESUMEN

OBJECTIVE: This study determined the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people. METHODS: De-identified qualitative feedback from participants and psychologists regarding the cultural appropriateness of the SCID-I for Indigenous people using open-ended anonymous questionnaires was gathered. Aboriginal Medial Service staff and Indigenous Support Workers participated in a focus group. RESULTS: A total of 95.6% of participants felt comfortable during the 498 questionnaires completed. Psychologists also provided qualitative feedback for 502 (92.3%) interviews, of whom 40.4% established a good rapport with participants. Of the participants, 77.7% understood the SCID-I questions well, while 72.5% did not require any cultural allowances to reach a clinical diagnosis. CONCLUSION: When administered by a culturally safe trained psychologist, SCID-I is well tolerated in this group.


Asunto(s)
Competencia Cultural , Entrevista Psicológica/métodos , Entrevista Psicológica/normas , Trastornos Mentales/diagnóstico , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Australia/etnología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Retroalimentación , Servicios de Salud del Indígena/organización & administración , Humanos , Trastornos Mentales/etnología , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
13.
Rev Gaucha Enferm ; 40: e20180062, 2019 Jun 10.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31188983

RESUMEN

OBJECTIVE: To understand the motives behind the actions of harm reducers when working with drug users. METHOD: Qualitative research conducted in the municipality in Rio Grande do Sul (RS), Brazil, in May 2017, by means of phenomenological interviews with 17 harm reducers. We analyzed and interpreted the data using the social phenomenology of Alfred Schütz. RESULTS: Data analysis led to the following three categories: expectation of changes in the user's sphere of life, motivation at work from the recognition of their actions, and relationship with others as a life-learning experience. CONCLUSION: The reasons harm reducers work with drug users are related to the family, search for a home, employment, access to health care, rights, and stigma, as well as the positive results of their work, personal satisfaction, and learning with drug users.


Asunto(s)
Consumidores de Drogas , Reducción del Daño , Entrevista Psicológica , Motivación , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Brasil , Empleo/psicología , Familia , Femenino , Accesibilidad a los Servicios de Salud , Vivienda , Humanos , Masculino , Persona de Mediana Edad , Satisfacción Personal , Investigación Cualitativa , Estigma Social , Trabajadores Sociales/psicología , Adulto Joven
14.
J Rehabil Med ; 51(7): 532-538, 2019 07 08.
Artículo en Inglés | MEDLINE | ID: mdl-31161225

RESUMEN

OBJECTIVE: Physical activity is an essential part of managing heart failure. However, adherence to activity recommendations is low, especially in female patients. The aim of this study was to investigate the perceptions of healthcare providers regarding sex differences in physical activity, motivation, barriers, and whether adaptations in care based on sex might be meaningful. METHODS: This is a qualitative study; data were collected in semi-structured interviews with healthcare providers. The data were analysed using qualitative content analysis. RESULTS: The major overarching theme was that healthcare providers feel that "Men and women are equal, but different". This theme was explained in terms of 7 sub-themes with associated categories, as follows: "Men and women prefer and perform different physical activity regardless of health status", "Male and female heart failure patients have different motivations for, and barriers to, being active", "Factors related to differences in physical activity and physical capacity between male and female heart failure patients", "Heart failure has more impact on physical activity and physical capacity than patient's sex", and "Tailoring activity advice for heart failure patients based on sex." DISCUSSION: Healthcare providers had clear opinions regarding the existence of sex differences that might affect patients' care. Several differences were identified in male and female heart failure patients in terms of physical activity. There seems to be a conflict between fear of discriminating and the value of personalizing care.


Asunto(s)
Ejercicio Físico/fisiología , Insuficiencia Cardíaca/rehabilitación , Entrevista Psicológica/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Caracteres Sexuales
15.
Turk Psikiyatri Derg ; 30(1): 23-30, 2019.
Artículo en Turco | MEDLINE | ID: mdl-31170304

RESUMEN

OBJECTIVE: Activation syndrome (AS), as described by the U.S. Food and Drug Administration (FDA), comprises 10 bipolar associated symptoms which starts after antidepressant therapy. The aim of this study is to investigate whether there is a relationship between lifetime hypomanic symptoms and the development of AS in patients diagnosed with major depressive disorder (MDD).  METHOD: The study was conducted at Hacettepe University Faculty of Medicine Department of Psychiatry. A total of 60 consecutive outpatients diagnosed with MDD were assessed at three time points; before the initiation of antidepressant therapy (baseline), at 2nd week and at 4th week. At the initial interview the patients completed the Hypomania Checklist-32 (HCL-32) in order to assess the lifetime history of hypomanic symptoms. Barnes Akathisia Rating Scale (BARS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and Young Mania Rating Scale (YMRS) were utilized to detect the symptoms of AS at each assessment.  RESULTS: AS was detected in 25 (41.7%) patients. The most prevalent symptoms of AS were insomnia (31.7%), anxiety (25%) and irritability (15%). A significant difference was found in the HCL-32 scores of patients with and without AS. A moderate correlation between the number of AS symptoms and HSL-32 test scores were also determined.  CONCLUSION: AS development was more common among the depressed patients with lifetime history of hypomanic symptoms. Given the frequency of misdiagnosis of BPD as MDD, it would be helpful to assess the hypomanic symptoms systematically with scales similar to HSL-32 in depressive patients before prescribing antidepressant medication.


Asunto(s)
Trastorno Bipolar/diagnóstico , Trastorno Depresivo Mayor/diagnóstico , Adulto , Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Humanos , Entrevista Psicológica , Masculino , Pacientes Ambulatorios , Escalas de Valoración Psiquiátrica
16.
Turk Psikiyatri Derg ; 30(1): 51-56, 2019.
Artículo en Turco | MEDLINE | ID: mdl-31170307

RESUMEN

OBJECTIVE: In this study, we aimed to adapt the Structured Clinical Interview for DSM-5-ClinicianVersion into Turkish and to demonstrate its reliability.  METHOD: A total of 185 patients, both inpatient and outpatient, from two different university hospitals were included. Training sessions on the features and use of SCID-5/CV were held before the data collection. During the study, in order to test the diagnostic agreement and accuracy, two psychiatrists remained present at the evaluation of each participant; alternatively being interviewer and the observer. Cohen's kappa coefficient for inter-rater reliability was calculated for every diagnostic category.  RESULTS: The patient group had a mean age of 37.2 (±13.5) years and 55.7% were female. The education status was as follows: 2.7% were illiterate, 1.7% literate with no primary education, 33% had primary education, 23.8% had secondary education and 38.9% had higher education. The calculated kappa value showed excellent agreement for schizophrenia (κ=0.93), bipolar disorder (κ=0.96), major depressive disorder (κ=0.89), dysthymic disorder (κ=0.82), alcohol use disorder (κ=0.96), panic disorder (κ=0.84), agoraphobia (κ=0.85), social anxiety disorder (κ=0.95), generalized anxiety disorder (κ=0.89), obsessive compulsive disorder (κ=0.87), posttraumatic stress disorder (κ=0.89), adult attention deficit and hyperactivity disorder (κ=1.00), specific phobias (κ=0.82) and very good agreement with adjustment disorder (κ=0.78) and somatic symptom disorder (κ=0.65).  CONCLUSION: Similar to the past SCID versions, kappa values were found to be quite high and all were statistically significant. The Turkish version of SCID-5/ CV can be reliably used in both clinical practice and clinical studies.


Asunto(s)
Entrevista Psicológica , Trastornos Mentales/psicología , Escalas de Valoración Psiquiátrica , Adolescente , Adulto , Anciano , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Traducciones , Turquia , Adulto Joven
17.
Anaesthesia ; 74(10): 1240-1251, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31090927

RESUMEN

Anaesthetists experience unique stressors, and recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in-depth qualitative analysis to explore this further. We conducted semi-structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: factors enabling work satisfaction; stressors of being an anaesthetic trainee; and suggestions for improving working conditions. Factors enabling work satisfaction were patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were demanding non-clinical work-loads; exhaustion from multiple commitments; a 'love/hate' relationship, as trainees value clinical work but find the training burden immense; feeling 'on edge', even unsafe at work; and the changing way society sees doctors. Nearly all trainees discussed feeling some levels of burnout (which were high and distressing for some) and also high levels of perceived stress. However, trainees also experienced distinct elements of work satisfaction and support. Suggested recommendations for improvement included: allowing contracted hours for non-clinical work; individuals taking responsibility for self-care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Our study provides a foundation for further work to inform organisational and cultural changes, to help translate anaesthetic trainees' passion for their work into a manageable and satisfactory career.


Asunto(s)
Anestesiólogos/psicología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Depresión/epidemiología , Depresión/psicología , Satisfacción en el Trabajo , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Adulto , Femenino , Humanos , Entrevista Psicológica , Masculino , Pacientes , Satisfacción Personal , Relaciones Médico-Paciente , Autocuidado , Reino Unido/epidemiología , Tolerancia al Trabajo Programado , Adulto Joven
18.
PLoS One ; 14(5): e0216052, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31042753

RESUMEN

OBJECTIVE: To explore experiences among pregnant women diagnosed with a small-for-gestational age (SGA) fetus, and monitored by frequent ultrasounds. METHODS: We performed a qualitative study at the outpatient clinic of the Gynecology and Obstetrics department of a large academic hospital in Amsterdam. Semi-structured interviews were conducted with fifteen women, diagnosed with an SGA fetus during their pregnancy and having had at least two monitoring ultrasounds since. Themes were identified following analysis of the interview transcripts. RESULTS: Most women experienced the frequent ultrasounds as a source of support providing comfort and a feeling of safety. It was considered necessary, in the best interest of the baby, which outweighed the discomfort caused by having to come to the hospital frequently. Women described anxiety building up prior to each ultrasound, but feeling reassured and relieved afterwards. During the ultrasound a continuous explanation was preferred, which provided confirmation and a feeling of security. Women identified the uncertainty of SGA's cause and prognosis as one of the biggest challenges to cope with, for which they used different strategies. Many women expressed a need for more detailed information and counselling, including non-medical aspects of pregnancy and delivery as well. Lastly, many women reported that seeing different doctors negatively influenced the perceived quality of care. CONCLUSIONS: In general, women in this study were satisfied with the ultrasounds for their small-for-gestational age pregnancies. However, women expressed a need for additional information to help cope with a feeling of uncertainty regarding cause and prognosis. Their medical team should preferably provide this in a consistent and continuous manner.


Asunto(s)
Feto/diagnóstico por imagen , Madres/psicología , Ultrasonografía Prenatal/métodos , Adulto , Ansiedad , Consejo , Emociones , Femenino , Edad Gestacional , Humanos , Entrevista Psicológica , Países Bajos , Embarazo , Mujeres Embarazadas/psicología , Investigación Cualitativa , Incertidumbre
19.
PLoS One ; 14(5): e0216682, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31067286

RESUMEN

Many stroke survivors require care from informal carers such as family members and friends who may experience adverse impacts. This study aimed to qualitatively explore the unmet needs of carers of stroke survivors, and their preferences for interventions and support services. We conducted 24 semi-structured, qualitative interviews with carers of stroke survivors from the Hunter region, Australia. Inductive thematic analysis was used in the context of a needs-led framework to identify key themes of their unmet needs. Key unmet needs identified by carers of stroke survivors in this study centred on four main themes: (1) social relationships and support; (2) adequacy of information; (3) taking care of oneself; and (4) accessing appropriate services. Carers of stroke survivors desired the development of services which provide connectivity to information, training, education and community support; and inclusion in a community with social relationships and other carers of stroke survivors. Ongoing unmet needs often result in adverse health and quality of life outcomes for carers of stroke survivors. Co-designed programs and resources for carers, particularly relating to unmet needs in social, information, self-care and service access domains are needed.


Asunto(s)
Cuidadores/psicología , Calidad de Vida/psicología , Rehabilitación de Accidente Cerebrovascular/psicología , Adulto , Anciano , Anciano de 80 o más Años , Australia , Familia , Femenino , Amigos , Humanos , Entrevista Psicológica/métodos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Autocuidado , Apoyo Social , Accidente Cerebrovascular/fisiopatología , Sobrevivientes/psicología
20.
Int J Law Psychiatry ; 64: 1-7, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31122619

RESUMEN

Self-injurious behaviors and suicide attempts are more frequent in prison settings than in the general population and represent a crucial problem. The aims of this work are to assess the prevalence of self-injurious behaviors and suicide attempts in an Italian prison setting, to determine whether inmates could be differentiated based on profiles of psychological distress and impulsiveness, and to assess the predictive power of the proposed profiles. A sample of 1422 male inmates of a north Italian penitentiary was assessed upon admission with a clinical interview and completed a set of self-report questionnaires to assess psychological distress and impulsiveness; the number of self-injurious behaviors and suicide attempts occurring in the first year of detention was recorded. A cluster analysis approach was used. Prevalence of self-Injurious behaviors and suicide attempts is similar to what has been observed in previous work. Cluster analysis revealed four clusters: dysregulated (high impulsivity and distress), impulsive (high impulsivity and mean distress), mildly distressed (mean impulsivity and moderate distress) and well-balanced (low impulsivity and distress). The four clusters help to discriminate subjects more at risk of self-injurious behaviors and suicide attempts and are confirmed by the inclusion of risk factors such as marital status and relatives'/social support. Clinical implications are discussed.


Asunto(s)
Italia/epidemiología , Prisioneros/estadística & datos numéricos , Conducta Autodestructiva/epidemiología , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Análisis por Conglomerados , Humanos , Conducta Impulsiva , Entrevista Psicológica , Masculino , Estado Civil , Persona de Mediana Edad , Prevalencia , Prisioneros/psicología , Factores de Riesgo , Apoyo Social , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Adulto Joven
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