Rationale and study design of an early care, therapeutic education, and psychological intervention program for the management of post-intensive care syndrome and chronic pain after COVID-19 infection (PAIN-COVID): study protocol for a randomized controlled trial.

BACKGROUND: Critically ill patients with COVID-19 are an especially susceptible population to develop post-intensive care syndrome (PICS) due to acute respiratory distress syndrome (ARDS). Patients can suffer acute severe pain and may have long-term mental, cognitive, and functional health deterioration after discharge. However, few controlled trials are evaluating interventions for the prevention and treatment of PICS. The study hypothesis is that a specific care program based on early therapeutic education and psychological intervention improves the quality of life of patients at risk of developing PICS and chronic pain after COVID-19. The primary objective is to determine whether the program is superior to standard-of-care on health-related quality of life at 6 months after hospital discharge. The secondary objectives are to determine whether the intervention is superior to standard-of-care on health-related quality of life, incidence of chronic pain and degree of functional limitation, incidence of anxiety, depression, and post-traumatic stress syndrome at 3 and 6 months after hospital discharge. METHODS: The PAINCOVID trial is a unicentric randomized, controlled, patient-blinded superiority trial with two parallel groups. The primary endpoint is the health-related quality of life at 6 months after hospital discharge, and randomization will be performed with a 1:1 allocation ratio. This paper details the methodology and statistical analysis plan of the trial and was submitted before outcome data were available. The estimated sample size is 84 patients, 42 for each arm. Assuming a lost to follow-up rate of 20%, a sample size of 102 patients is necessary (51 for each arm). DISCUSSION: This is the first randomized clinical trial assessing the effectiveness of an early care therapeutic education, and psychological intervention program for the management of PICS and chronic pain after COVID-19. The intervention will serve as proof of the need to implement early care programs at an early stage, having an incalculable impact given the current scenario of the pandemic. TRIAL REGISTRATION: This study is being conducted in accordance with the tenets of the Helsinki Declaration and has been approved by the authors' institutional review board Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona (approval number: HCB/2020/0549) and was registered on May 9, 2020, at clinicaltrials.gov ( NCT04394169 ).

Cognitive biases are associated with clinical and functional variables in psychosis: A comparison across schizophrenia, early psychosis and healthy individuals

Objective: We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology.MethodsThree groups were studied: schizophrenia (N=63), ROP (N=43) and healthy adolescents (N=45). Cognitive biases were assessed with the Cognitive Biases Questionnaire for Psychosis (CBQ). Positive, negative and depressive symptoms were assessed with the PANSS and Calgary Depression Scale (ROP; schizophrenia) and with the CAPE-42 (healthy adolescents). Cannabis use was registered. The association between CBQ and psychopathology scales was tested with multiple linear regression analyses.ResultsPeople with schizophrenia reported more cognitive biases (46.1±9.0) than ROP (40±5.9), without statistically significant differences when compared to healthy adolescents (43.7±7.3). Cognitive biases were significantly associated with positive symptoms in both healthy adolescents (Standardized β=0.365, p=0.018) and people with psychotic disorders (β=0.258, p=0.011). Cognitive biases were significantly associated with depressive symptoms in healthy adolescents (β=0.359, p=0.019) but in patients with psychotic disorders a significant interaction between schizophrenia diagnosis and CBQ was found (β=1.804, p=0.011), which suggests that the pattern differs between ROP and schizophrenia groups (positive association only found in the schizophrenia group). Concerning CBQ domains, jumping to conclusions was associated with positive and depressive symptoms in people with schizophrenia and with cannabis use in ROP individuals. Dichotomous thinking was associated with positive and depressive symptoms in all groups.ConclusionsCognitive biases contribute to the expression of positive and depressive symptoms in both people with psychotic disorders and healthy individuals. (AU)

Objetivo: Investigamos la presencia de sesgos cognitivos en personas con psicosis de reciente comienzo (ROP), esquizofrenia y adolescentes sanos, y exploramos las asociaciones potenciales entre estos sesgos y la psicopatología.MétodosSe estudiaron tres grupos: esquizofrenia (N=63), ROP (N=43) y adolescentes sanos (N=45). Los sesgos cognitivos se evaluaron utilizando Cognitive Biases Questionnaire for Psychosis (CBQ). Los síntomas positivos, negativos y depresivos se evaluaron utilizando las escalas PANSS and Calgary Depression Scale (ROP; esquizofrenia) y CAPE-42 (adolescentes sanos). Se registró el consumo de cannabis. La asociación entre CBQ y las escalas de psicopatología se probó utilizando un análisis de regresión lineal múltiple.ResultadosLas personas esquizofrénicas reportaron más sesgos cognitivos (46,1±9) que las personas con ROP (40±5,9), sin diferencias estadísticamente significativas en la comparación con los adolescentes sanos (43,7±7,3). Los sesgos cognitivos se asociaron significativamente a los síntomas positivos, tanto en adolescentes sanos (β=0,365 estandarizada; p=0,018) como en personas con trastornos psicóticos (β=0,258; p=0,011). Los sesgos cognitivos se asociaron significativamente a síntomas depresivos en adolescentes sanos (β=0,359; p=0,019), pero en pacientes con trastornos psicóticos se encontró una interacción significativa entre diagnóstico de esquizofrenia y CBQ (β=1,804; p=0,011), lo cual sugiere que el patrón difiere entre los grupos de ROP y esquizofrenia (solo se encontró asociación positiva en el grupo de esquizofrenia). En cuanto a los dominios de CBQ, el adoptar conclusiones se asoció a síntomas positivos y depresivos en las personas esquizofrénicas y que consumen cannabis en los individuos con ROP. El pensamiento dicótomo se asoció a síntomas positivos y depresivos en todos los grupos. (AU)

The Effect of Child Sexual Abuse on Social Functioning in Schizophrenia Spectrum Disorders.

The objective of this study was to explore social functioning in schizophrenic patients who have suffered child sexual abuse (CSA) in comparison with those who have not suffered from it in a Spanish sample of 50 patients with schizophrenia or schizoaffective disorder. The Quality of Life (QOL) Scale, the Childhood Trauma Questionnaire (CTQ-SF), and the NEO Five Factor Inventory (NEO-FFI) were administered in this study. We found a CSA prevalence of 22% in our sample. Results showed that QOL global scores reduced by 9.34% at a statistically significant level (p = .037) in sexually abused patients in comparison with those who did not report experiencing sexual abuse. Regression analysis in the QOL scales showed no differences in intrapsychic foundation scores or in the social relations scale. Scores in the instrumental role scale were reduced by 4.42 points in patients with CSA (p = .009). Neither neuroticism nor extraversion results differ between the trauma group and those who did not suffer trauma. Clinical implications of these results are discussed.

Cognitive biases are associated with clinical and functional variables in psychosis: A comparison across schizophrenia, early psychosis and healthy individuals.

OBJECTIVE: We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology. METHODS: Three groups were studied: schizophrenia (N=63), ROP (N=43) and healthy adolescents (N=45). Cognitive biases were assessed with the Cognitive Biases Questionnaire for Psychosis (CBQ). Positive, negative and depressive symptoms were assessed with the PANSS and Calgary Depression Scale (ROP; schizophrenia) and with the CAPE-42 (healthy adolescents). Cannabis use was registered. The association between CBQ and psychopathology scales was tested with multiple linear regression analyses. RESULTS: People with schizophrenia reported more cognitive biases (46.1±9.0) than ROP (40±5.9), without statistically significant differences when compared to healthy adolescents (43.7±7.3). Cognitive biases were significantly associated with positive symptoms in both healthy adolescents (Standardized ß=0.365, p=0.018) and people with psychotic disorders (ß=0.258, p=0.011). Cognitive biases were significantly associated with depressive symptoms in healthy adolescents (ß=0.359, p=0.019) but in patients with psychotic disorders a significant interaction between schizophrenia diagnosis and CBQ was found (ß=1.804, p=0.011), which suggests that the pattern differs between ROP and schizophrenia groups (positive association only found in the schizophrenia group). Concerning CBQ domains, jumping to conclusions was associated with positive and depressive symptoms in people with schizophrenia and with cannabis use in ROP individuals. Dichotomous thinking was associated with positive and depressive symptoms in all groups. CONCLUSIONS: Cognitive biases contribute to the expression of positive and depressive symptoms in both people with psychotic disorders and healthy individuals.

Free Thyroxine Concentrations Moderate the Response to a Cognitive Remediation Therapy in People With Early Psychosis: A Pilot Randomized Clinical Trial.

INTRODUCTION: Cognitive deficits are a cause of functional disability in psychotic disorders. Cognitive remediation therapy (CRT) might be applied to improve these deficits. We conducted a pilot study to explore whether thyroid hormones might predict the response to CRT in patients with recent-onset psychosis (ROP). METHODS: Twenty-eight stable ROP outpatients (9 women) were randomized to receive computerized CRT (N=14) or treatment as usual (TAU) (N=14), over three months. Both cognitive and thyroid functions were assessed at the baseline and after those three months to all patients. A full cognitive battery (CANTAB) was administered before and after the treatment. Serum levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured. FT4 concentrations were recoded into a dichotomic variable (FT4 group) based on the median of the sample (1.2 ng/dL). Data were analyzed on an intention-to-treat basis with linear mixed models. Afterwards, we offered CRT to all participants from the TAU group and seven enrolled CRT, reassessing them when finished. Secondary analyses were repeated in a sample of 14 participants who completed the CRT (either from the beginning or after the TAU period) and attended at least one third of the sessions. RESULTS: The linear mixed models showed a significant time x CRT x FT4 group effect in two cognitive tasks dealing with executive functions and sustained attention (participants with higher FT4 concentrations worsened executive functions but improved sustained attention after CRT). In the secondary analysis including all patients assigned to CRT, higher FT4 concentrations were associated with a poorer response in verbal memory but a better response in spatial working memory. CONCLUSIONS: Free thyroxine concentrations moderate the response to a CRT in patients with early psychosis.

Cognitive Biases Questionnaire for Psychosis (CBQp): Spanish Validation and Relationship With Cognitive Insight in Psychotic Patients.

Introduction: Cognitive biases are key factors in the development and persistence of delusions in psychosis. The Cognitive Biases Questionnaire for Psychosis (CBQp) is a new self-reported questionnaire of 30 relevant situations to evaluate five types of cognitive biases in psychosis. In the context of the validation of the Spanish version of the CBQp, our objectives were to (1) analyze the factorial structure of the questionnaire with a confirmatory factor analysis (CFA), (2) relate cognitive biases with a widely used scale in the field of delusion cognitive therapies for assessing metacognition, specifically, Beck's Cognitive Insight Scale (BCIS) (1), and, finally, (3) associate cognitive biases with delusional experiences, evaluated with the Peters Delusions Inventory (PDI) (2). Materials and Methods: An authorized Spanish version of the CBQp, by a translation and back-translation procedure, was obtained. A sample of 171 patients with different diagnoses of psychoses was included. A CFA was used to test three different construct models. Associations between CBQp biases, the BCIS, and the PDI were made by correlation and mean differences. Comparisons of the CBQp scores between a control group and patients with psychosis were analyzed. Results: The CFA showed comparative fit index (CFI) values of 0.94 and 0.95 for the models with one, two, and five factors, with root mean square error of approximation values of 0.031 and 0.029. The CBQp reliability was 0.87. Associations between cognitive biases, self-certainty, and cognitive insight subscales of the BCIS were found. Similarly, associations between total punctuation, conviction, distress, and concern subscales of the PDI were also found. When compared with the group of healthy subjects, patients with psychoses scored significantly higher in several cognitive biases. Conclusion: Given the correlation between biases, a one-factor model might be more appropriate to explain the scale's underlying construct. Biases were associated with a greater frequency of delusions, distress, conviction, and concern as well as worse cognitive insight in patients with psychosis.

Improvement in cognitive biases after group psychoeducation and metacognitive training in recent-onset psychosis: A randomized crossover clinical trial.

Metacognitive training (MCT) improves cognitive biases in psychosis. We aimed to explore whether the effectiveness of the combination of psychoeducation and MCT group treatments on cognitive biases differed if the combination was started by psychoeducation or by MCT. Fourty-nine stable patients with a recent-onset psychosis were randomized to two different sequences: MCT + psychoeducation vs psychoeducation + MCT. Cognitive biases, psychopathology symptoms, insight and functioning were assessed. Cognitive biases and depressive symptoms improved with both group interventions, without differential effects between both sequences. Our study suggests that MCT and psychoeducation are useful in improving cognitive biases and depressive symptoms in recent-onset psychosis.

Consumo de sustancias y diferencias de género en personas afectas de un primer episodio psicótico: impacto en los porcentajes de reingreso / Substance abuse and gender differences in first episode psychosis: impact on hospital readmissions

Introducción. El estudio de diferencias de género en primeros episodios psicóticos (PEPs) ha aportado resultados controvertidos en los últimos años. El consumo de sustancias es la principal comorbilidad en PEPs, y se ha relacionado con un peor pronóstico y con una mayor gravedad sintomática. Objetivos. Explorar las diferencias de género en PEPs en relación con el consumo de sustancias, así como su relación con los reingresos hospitalarios. Metodología. Analítico y prospectivo (18 meses). Resultados. Incluimos 141 pacientes (31,2% mujeres), con una edad media de 26,1 años, mayoritariamente diagnosticadas de trastorno esquizofreniforme (32,6%). Un 58,9% presentan algún consumo problemático de sustancias. Encontramos diferencias significativas de género en la edad de inicio, de ingreso en el programa, el estado civil y la convivencia, y diferencias en el consumo de sustancias actual y la frecuencia de consumo. El género, la duración de la psicosis no tratada, los antecedentes psiquiátricos, la edad de inicio o el consumo de sustancias previo no fueron factores predictores de reingreso. El porcentaje de reingreso hospitalario fue del 24,8%, sin diferencias de género. Entre los motivos más frecuentes de ingreso se encuentran el abandono del tratamiento (66,7%) y el consumo de sustancias (44,4%), siendo mayor en los hombres el consumo de sustancias como motivo de reingreso. Conclusiones. Existen diferencias de género en PEPs. Los hombres inician más tempranamente los síntomas, con peores resultados funcionales. El consumo de sustancias en hombres es mayor y representa un importante motivo de reingreso hospitalario. Intervenciones terapéuticas dirigidas a prevenir su efecto son necesarias desde las primeras fases (AU)

Introduction. There have been controversial results in the study of gender differences in first episode psychosis (FEP). Substance abuse is the main existing comorbidity in FEP, and has been associated with worse prognosis and greater symptom severity. Objectives. To explore gender differences in FEP in relation to drug abuse, and their relationship with hospital readmissions. Methodology. Descriptive and prospective study (18 months). Results. We included 141 patients (31.2% women), aged 26.1 years on average, mostly diagnosed with schizophreniform disorder (32.6%). A percentage of 58.9 had problematic use of drugs. Gender significant differences were found in age of onset, age at entry to the programme, marital status and cohabitation, and percentage differences were revealed in current drug abuse and frequency of consumption. Gender, duration of untreated psychosis, psychiatric history, age of onset and previous drug use were not predictors of re-entry. Hospital readmission rate was 24.8%, with no gender differences. The most common reasons for admission were abandonment of treatment (66.7%) and drug abuse (44.4%). Drug abuse was higher in the men than in the women as a reason for re-admission. Conclusions. There are gender differences in FEP. Men have an earlier onset of symptoms and have worse functional outcomes. Drug abuse in men is higher and represents a major cause of hospital readmission. Therapeutic interventions to prevent the effects of drug abuse are necessary from the early stages of the illness (AU)

Substance abuse and gender differences in first episode psychosis: Impact on hospital readmissions. / Consumo de sustancias y diferencias de género en personas afectas de un primer episodio psicótico: impacto en los porcentajes de reingreso.

INTRODUCTION: There have been controversial results in the study of gender differences in first episode psychosis (FEP). Substance abuse is the main existing comorbidity in FEP, and has been associated with worse prognosis and greater symptom severity. OBJECTIVES: To explore gender differences in FEP in relation to drug abuse, and their relationship with hospital readmissions. METHODOLOGY: Descriptive and prospective study (18 months). RESULTS: We included 141 patients (31.2% women), aged 26.1 years on average, mostly diagnosed with schizophreniform disorder (32.6%). A percentage of 58.9 had problematic use of drugs. Gender significant differences were found in age of onset, age at entry to the programme, marital status and cohabitation, and percentage differences were revealed in current drug abuse and frequency of consumption. Gender, duration of untreated psychosis, psychiatric history, age of onset and previous drug use were not predictors of re-entry. Hospital readmission rate was 24.8%, with no gender differences. The most common reasons for admission were abandonment of treatment (66.7%) and drug abuse (44.4%). Drug abuse was higher in the men than in the women as a reason for re-admission. CONCLUSIONS: There are gender differences in FEP. Men have an earlier onset of symptoms and have worse functional outcomes. Drug abuse in men is higher and represents a major cause of hospital readmission. Therapeutic interventions to prevent the effects of drug abuse are necessary from the early stages of the illness.

Spanish adaptation of the Beck Cognitive Insight Scale (BCIS) for schizophrenia.

INTRODUCTION: The Beck Cognitive Insight Scale has been designed to evaluate the cognitive insight capacity, that is to say, the practice of self-reflectiveness as a meta-cognitive mechanism for examining and analysing the disorder's symptoms, it also permits a continuous re-evaluation of inadequate interpretations. METHODOLOGY: The aim of this study is to examine the psychometric properties, the dimensional structure and the internal validity of the Spanish version of Beck's Cognitive Scale of Insight (BCIS). In this paper we also analyse its relation with the Positive and Negative Symptoms Scale (PANSS). The Cognitive Insight Scale was translated and adapted to Spanish with 129 in- and out-schizophrenic patients. RESULTS: Principal component analysis showed a two-factor structure that was similar to the original one, recognizable as self-reflectiveness (R) and self-certainty (C) with similar reliability as the American version. Self-reflectiveness and the R-C index correlated with loss of insight of the PANSS scale. In general, BCIS showed significant associations with the PANSS subscales. Out patients scored self-reflectiveness and R-C index signicantly higher than in-patients and lower in self-certainty. CONCLUSION: Psychometric properties obtained with the adapted Spanish version of BCIS guarantee the adequate evaluation of cognitive insight.

Adaptación española de la Escala de Insight Cognitivo de Beck (EICB) en esquizofrénicos / Spanish Adaptation of the Beck Cognitive Insight Scale (BCIS) for Schizophrenia

Introducción. La Escala de Insight Cognitivo de Beck ha sido diseñada para evaluar la capacidad de insight cognitivo esto es, la práctica de la auto-reflexión como mecanismo metacognitivo de examen y análisis de los síntomas de la enfermedad que permite la reevaluación continua de interpretaciones inadecuadas. Metodología. Este estudio examina las propiedades psicométricas, la estructura dimensional y la validez interna de la versión española de la Escala de Insight Cognitivo de Beck (EICB). Igualmente se analiza su relación con la Escala de Síndrome Positivo y Negativo en Esquizofrenia (PANSS). La escala de Insight Cognitivo fue traducida y adaptada al castellano en 129 pacientes esquizofrénicos ingresados y no ingresados. Resultados. El análisis de componentes principales mostró una estructura de dos factores semejantes a la original reconocibles como auto-reflexión (R) y auto-certeza (C), con similar fiabilidad a la versión americana. Auto-reflexión y el índice R-C correlacionaron con pérdida de insight de la PANSS. En general la EICB se asoció significativamente con subescalas de la PANSS. Los pacientes comunitarios puntuaron significativamente más alto en autoreflexión y el índice R-C que los ingresados y más bajo en autocerteza. Conclusión. Las propiedades psicométricas obtenidas con la versión española adaptada de la EICB garantizan la adecuada evaluación del insight cognitivo (AU)

Introduction. The Beck Cognitive Insight Scale has been designed to evaluate the cognitive insight capacity, that is to say, the practice of self-reflectiveness as a meta-cognitive mechanism for examining and analysing the disorder’s symptoms, it also permits a continuous reevaluation of inadequate interpretations. Methodology. The aim of this study is to examine the psychometric properties, the dimensional structure and the internal validity of the Spanish version of Beck’s Cognitive Scale of Insight (BCIS). In this paper we also analyse its relation with the Positive and Negative Symptoms Scale (PANSS). The Cognitive Insight Scale was translated and adapted to Spanish with 129 in- and out- schizophrenic patients. Results. Principal component analysis showed a two factor structure that was similar to the original one, recognizable as self-reflectiveness (R) and self-certainty (C) with similar reliability as the American version. Self-reflectiveness and the R-C index correlated with loss of insight of the PANSS scale. In general, BCIS showed significant associations with the PANSS subscales. Out patients scored self-reflectiveness and R-C index signicantly higher than in-patients and lower in self-certainty. Conclusion: Psychometric properties obtained with the adapted Spanish version of BCIS guarantee the adequate evaluation of cognitive insight (AU)

Adaptation and validation of the quality-of-life scale: Satisfaction with Life Domains Scale by Baker and Intagliata.

OBJECTIVES: There are few quality-of-life instruments specifically for schizophrenia; thus, the objective of our study is to adapt and validate the Satisfaction with Life Domains Scale (SLDS) by Baker and Intagliata. METHOD: This is a validation study in which the subjects were evaluated on 2 occasions (24-48 hours). The sample is composed of people with schizophrenia from 18 to 65 years old and who were seen in one of the following centers: Sant Joan de Déu-SSM, Hospital Clínic, Hospital de Mataró and Hospital Pere Mata. The SLDS was administered, along with Positive and Negative Syndrome Scale, the Clinical General Impression for Schizophrenia, Global Assessment of Function, Disability Assessment Scale--short version, Beck Cognitive Insight, and the Strauss and Carpenter Prognostic Scale. The Cronbach alpha test was carried out, and the intraclass correlation coefficient was used to assess test-retest reliability, along with Pearson correlations for discriminating validity. RESULTS: The intraclass correlation coefficients oscillated between 0.51 and 0.83. The SLDS did correlate with any of the other instruments with the exception of the Positive and Negative Syndrome Scale general subscale and the Strauss and Carpenter prognostic scale. CONCLUSIONS: The Spanish version of the SLDS was shown to be valid and reliable and provides a fast and specific measure for schizophrenia.

Adaptation and validation of the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia.

INTRODUCTION: The aim of this study was to validate the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia (Strauss and Carpenter, 1977). METHOD: We performed a multicenter, longitudinal, descriptive study. Forward and backtranslation of the original scale was performed. The sample was composed of persons diagnosed with schizophrenia aged between 18 and 65 years. We calculated interrater reliability, construct validity according to the Global Assessment Scale (GAS), Satisfaction with Life Domains Scale (SLDS), the Global Clinical Impression-Schizophrenia (GCI) scale, The World Health. Organization Short Disability Assessment Schedule (WHO-DAS) and the Positive and Negative Syndrome Scale (PANSS), and predictive validity at the 1-year follow-up using three criterion measures of the GCI, WHO-DAS and GAS scales. RESULTS: The internal consistency coefficient (Cronbach's alpha) was 0.70. The intraclass correlation coefficient ranged from 0.54 to 0.99, except for item 5 (resources for the current treatment), which was -0.13. The correlation between the distinct scales (measuring construct validity) was significant, with a p-value of < 0.01, except for the SLDS, which showed a higher p-value (p<0.05). The Strauss-Carpenter score correlated with all three scores at 1 year (GCI, GAS and WHO-DAS) with an alpha of less than 0.01, showing good predictive validity. CONCLUSIONS: The Spanish adaptation of the Strauss and Carpenter prognostic scale is reliable and valid and allows a more severe disease course to be predicted.

[Adaptation and validation into Spanish of Schedule for the Deficit Syndrome]. / Adaptación y validación en castellano del Inventario para la Esquizofrenia Deficitaria.

BACKGROUND AND OBJECTIVE: Schizophrenia is a high prevalent disorder associated with huge economic and sanitary costs. Negative symptoms represent the main prognostic factors, thus to identify them is important to design effective guidelines of treatment. The Schedule for the Deficit Syndrome (SDS) is the only validated method to evaluate those symptoms as primary and stable. We propose its adaptation and validation into Spanish. PATIENTS AND METHOD: Patients diagnosed of schizophrenia attended at 2 different hospitals were evaluated with SDS (Spanish version) and PANSS (Positive and Negative Symptom Scale). Stable patients were reevaluated 6 months later. One rater acted as gold standard while two 2 raters, naïve to SDS, evaluated patients too. RESULTS: Twenty-one patients were evaluated (15 men). Raters agreed ranged from kappa = 0.79 to kappa = 0.89 with gold standard and kappa = 0.90 between them. Kappa ranged from 0.60-0.70 for severity criteria and 0.78-0.90 for primary criteria. Temporal stability at 6 months between raters was kappa = 0.72 and 0.87. We also evaluated interclass correlation index and homogeneity of construct. CONCLUSIONS: After a brief training with the Spanish version of SDS, is fast and feasible to categorize patients into deficit or non-deficit forms of schizophrenia.

Adaptación y validación en castellano del Inventario para la Esquizofrenia Deficitaria / Adaptation and validation into Spanish of Schedule for the Deficit Syndrome

Fundamento y objetivo: La esquizofrenia es un trastorno frecuente, que ocasiona enormes costes tanto económicos como asistenciales. Los síntomas negativos son los principales marcadores pronósticos, así que identificarlos es clave para diseñar planes asistenciales efectivos. El Inventario para la Esquizofrenia Deficitaria (SDS) es el único método validado para evaluar estos síntomas como primarios y estables. Se propone su adaptación y validación en castellano. Pacientes y método: Se evaluó mediante el SDS (versión castellana) y PANSS (Escala de Síntomas Positivos y Negativos) a pacientes diagnosticados de esquizofrenia procedentes de 2 centros hospitalarios. Al cabo de 6 meses se revaluó a los pacientes estables. Un evaluador ejercía de referencia y otros 2, sin experiencia con el SDS, puntuaban las escalas. Resultados: Se incluyó a 21 pacientes (15 varones). Los evaluadores obtuvieron acuerdos de * = 0,79 y * = 0,89 con el evaluador de referencia y * = 0,90 entre sí. Los rangos de kappa fueron de 0,60-0,70 para el criterio de gravedad y de 0,78-0,90 para el criterio primario. La estabilidad temporal (6 meses) entre los evaluadores fue de * = 0,72 y 0,87. Asimismo, se evaluaron otros índices de concordancia (coeficiente de correlación interclase) y de homogeneidad del constructo. Conclusiones: Tras un breve entrenamiento con el SDS en castellano, se concluye que este método es rápido, factible y fiable para categorizar a los pacientes con esquizofrenia en deficitarios y no deficitarios

Background and objective: Schizophrenia is a high prevalent disorder associated with huge economic and sanitary costs. Negative symptoms represent the main prognostic factors, thus to identify them is important to design effective guidelines of treatment. The Schedule for the Deficit Syndrome (SDS) is the only validated method to evaluate those symptoms as primary and stable. We propose its adaptation and validation into Spanish. Patients and method: Patients diagnosed of schizophrenia attended at 2 different hospitals were evaluated with SDS (Spanish version) and PANSS (Positive and Negative Symptom Scale). Stable patients were reevaluated 6 months later. One rater acted as gold standard while two 2 raters, naïve to SDS, evaluated patients too. Results: Twenty-one patients were evaluated (15 men). Raters agreed ranged from * = 0.79 to * = 0.89 with gold standard and * = 0.90 between them. Kappa ranged from 0.60-0.70 for severity criteria and 0.78-0.90 for primary criteria. Temporal stability at 6 months between raters was * = 0.72 and 0.87. We also evaluated interclass correlation index and homogeneity of construct. Conclusions: After a brief training with the Spanish version of SDS, is fast and feasible to categorize patients into deficit or non-deficit forms of schizophrenia