Predictors of suicidality among Polish university students during COVID-19 pandemic.

PURPOSE OF REVIEW: The main purpose of the study was to assess university students' mental health and identify factors associated with the risk of suicidal thoughts, plans, and attempts during coronavirus disease 2019 (COVID-19) pandemic and distance learning. RECENT FINDINGS: The study was conducted in spring 2021 and comprised 10 760 Polish students. The survey employed modified versions of the C-SSRS, CIDI, WHO-5, GAD-7, the PTSD checklist for DSM-5 and CAGE-AID Questionnaire and included questions about panic attacks, COVID-19-related information and sociodemographic characteristics. The correlates of suicidality were examined using a series of logistic regression analyses. Almost 40% students experienced any suicidal thoughts and/or behaviours in the previous month: passive ideations only (15.8%), active ideations only (7.1%), plans without attempts (15%), and attempts (1.4%). Following variables were related to the increased risk for suicide attempts: severe anxiety [odds ratio (OR) = 11.39; 95% confidence interval (CI): 1.44-90.26], panic attacks (OR = 3.21; 95% CI: 1.75-5.91), and COVID-19 hospitalisation (OR = 11.04; 95% CI: 1.17-104.59). Major depression was associated with passive and active ideations, suicide plans, but not with attempts (OR = 1.37; 95% CI: 0.45-4.13). SUMMARY: University students present a high level of adverse mental health and increased risk of STBs during COVID-19 pandemic. A suicide prevention program tailored to this population is needed during and after the pandemic.

Challenges for psychiatric health care for adults in Lower Silesia. / Wyzwania dla psychiatrycznej opieki zdrowotnej dla osób doroslych na Dolnym Slasku.

The authors, in their study, refer to the changes taking place in Polish psychiatry under the National Mental Health Program (NMHP). They present their thoughts on the restructuring of psychiatric health care for adults in Lower Silesia. They refer to the European experiences described in the book Better Mental Health Care by G. Thornicroft and M. Tansella, and in the practical and scientific dimension - to the substantive premises, derived from demographic analyzes, epidemiological indicators obtained in the EZOP study, from Maps of Health Needs and other official statistics. Lower Silesia is the fifth voivodeship in Poland in terms of population, with four psychiatric hospitals in need of restructuring, a lower than the national rate of beds per 100,000 population and a relatively high rate of the so-called common mental disorders should be included in a targeted pilot project under the NMHP. In conclusion, the authors strongly support the fastest possible implementation of the community model of psychiatric services in Lower Silesia, indicating the methodology that should accompany the transformation process, the risks that may occur, but most of all, making people aware of the benefits that society should achieve in a human and economic sense.

Development and evaluation of a risk algorithm predicting alcohol dependence after early onset of regular alcohol use.

AIMS: Likelihood of alcohol dependence (AD) is increased among people who transition to greater levels of alcohol involvement at a younger age. Indicated interventions delivered early may be effective in reducing risk, but could be costly. One way to increase cost-effectiveness would be to develop a prediction model that targeted interventions to the subset of youth with early alcohol use who are at highest risk of subsequent AD. DESIGN: A prediction model was developed for DSM-IV AD onset by age 25 years using an ensemble machine-learning algorithm known as 'Super Learner'. Shapley additive explanations (SHAP) assessed variable importance. SETTING AND PARTICIPANTS: Respondents reporting early onset of regular alcohol use (i.e. by 17 years of age) who were aged 25 years or older at interview from 14 representative community surveys conducted in 13 countries as part of WHO's World Mental Health Surveys. MEASUREMENTS: The primary outcome to be predicted was onset of life-time DSM-IV AD by age 25 as measured using the Composite International Diagnostic Interview, a fully structured diagnostic interview. FINDINGS: AD prevalence by age 25 was 5.1% among the 10 687 individuals who reported drinking alcohol regularly by age 17. The prediction model achieved an external area under the curve [0.78; 95% confidence interval (CI) = 0.74-0.81] higher than any individual candidate risk model (0.73-0.77) and an area under the precision-recall curve of 0.22. Overall calibration was good [integrated calibration index (ICI) = 1.05%]; however, miscalibration was observed at the extreme ends of the distribution of predicted probabilities. Interventions provided to the 20% of people with highest risk would identify 49% of AD cases and require treating four people without AD to reach one with AD. Important predictors of increased risk included younger onset of alcohol use, males, higher cohort alcohol use and more mental disorders. CONCLUSIONS: A risk algorithm can be created using data collected at the onset of regular alcohol use to target youth at highest risk of alcohol dependence by early adulthood. Important considerations remain for advancing the development and practical implementation of such models.

Evaluation of mental health services delivered before and after the introduction of pilot Mental Health Centers in Poland using monitoring indicators. / Ocena realizacji psychiatrycznych swiadczen zdrowotnych z okresu przed i po wprowadzeniu pilotazowych centrów zdrowia psychicznego w Polsce z wykorzystaniem wskazników monitorujacych.

OBJECTIVES: The study assessed the performance of Mental Health Centres compared to previous non-integrated mental health facilities. METHODS: The study used National Health Fund (NHF) data of individuals over 18 years treated in 27 centres (January 2017 - February 2020). Performance indicators from 19 months before (N = 124,497) and after the introduction of Mental Health Centres (N = 182,789) were compared for outpatient care, community treatment teams, inpatient wards and day wards. RESULTS: The total number of patients who received mental health care increased, compared to before the establishment of those Centres; whereas the number of hospitalisations decreased by 6% and the number of patient days per person decreased by 9%. Day care saw a 14% increase in admissions following the introduction of Mental Health Centres, with a 5% decrease in patient days per person. The proportion of patients in community care increased by 86%, in outpatient care by 62% and in day care by 14%. The number of first-time patients after the introduction of Mental Health Centres increased and the number of follow-up patients decreased. For all groups of mental disorders, the priority indicator in inpatient care decreased, while increasing in outpatient and community care for most groups of disorders. CONCLUSIONS: The results confirmed the effectiveness of the National Mental Health Protection Programme project in relation to the availability and reduction of inpatient treatment through Mental Health Centres. The methodology used in this study can be used for assessing the effectiveness of Mental Health Centre activities in subsequent stages of the pilot.

Association of Higher Rates of Type 2 Diabetes (T2DM) Complications with Psychological and Demographic Variables: Results of a Cross-Sectional Study.

Introduction: The aim of this study was to assess the relationship between the occurrence and number of T2DM complications with sociodemographic (age, sex, habitation, education), clinical (duration of diabetes, HbA1c (%), BMI) and psychological (well-being, sense of influence on the diabetes course, coping styles) variables. Methods: A total of 2574 adult patients were assessed using The Sense of Influence on the Diabetes Course Scale, WHO-5 Well-Being Index, and the Brief Method of Evaluating Coping with Disease. Hierarchical Regression Analysis was conducted with number of complications as the dependent variable and three sets of variables entered in sequential steps: (a) sociodemographic; (b) clinical and (c) psychological factors. Logistic regression analysis was used to examine the association of these variables with diabetes complications' occurrence. Results: A higher number of complications and higher odds ratios of occurrence of complications were associated with sociodemographic and clinical variables, poor well-being, low perception of influence on the diabetes course, and an emotion-oriented coping style. The logistic regression indicated that participants with HbA1c >7% (in comparison with HbA1c ≤ 7%) and with high risk of depression (in comparison with no risk of depression) had respectively 68% and 86% higher odds of developing complications. Discussion: The number of complications has weak but statistically significant relations with psychological and clinical factors. Conclusion: The results support the rationale of including the psychosocial factors in the context of diabetes management.

Social support against depression in young adults' group during COVID-19 pandemic. / Wsparcie spoleczne a przeciwdzialanie depresji w grupie mlodych doroslych w czasie pandemii COVID-19.

OBJECTIVES: The present study aimed at analyzing the prevalence of depressive symptoms in a group of learning young adults, as well as the social support as a predictor of depression in late adolescence during the COVID-19 pandemic. METHODS: An online national survey of young adults attending schools was conducted. The semi-structured questionnaire, including a section on sociodemographic data, stressors, needs and sources of support, as well as brief version of the Kutcher Adolescent Depression Scale, was distributed to young Poles. The final sample consisted of 1,500 students aged 18-23. Multivariable logistic regression assessed the relationships between support needs and sources and depressive symptoms. RESULTS: The support needs that are most commonly reported by young adults are support from loved ones (family, friends) (n = 843; 56.2%) and teachers (e.g., care, appreciation) (n = 603; 40.2%). Fifty-six per cent of Polish young adults are experiencing significant depressive symptoms (95% confidence interval [CI]: 1.82-13.96). Young adults with no social support had higher KADS score than participants reporting some form of support (b = 1.794; 95% BCa CI = 0.659, 2.947). Participants receiving support from mother, both parents and siblings had a lower severity of depressive symptoms, while young people receiving support from father had more severe symptoms. CONCLUSIONS: This study provides initial findings in terms of depressive symptoms and support needs of young adults during the COVID-19 pandemic. It is imperative for mental health services, communities and schools to provide the necessary support to young adults.

Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys.

Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful.

Relations of Well-Being, Coping Styles, Perception of Self-Influence on the Diabetes Course and Sociodemographic Characteristics with HbA1c and BMI Among People with Advanced Type 2 Diabetes Mellitus.

PURPOSE: Assessment of the relationship between psychological and sociodemographic factors with the levels of glycated hemoglobin (HbA1c) and Body Mass Index (BMI) among people with advanced type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: A total of 2574 persons, among them 1381 (53.7%) women, with type 2 diabetes, during the period of switching from biphasic mixtures of human insulin to insulin analogues. The age of participants ranged from 22 to 94 years (M = 63.5; SD = 9.58), and their treatment period was in the time frame from 2 years to 43 years (M = 10.2; SD = 6.1). Participants filled out a Scale for Perception of Self-Influence on the Diabetes Course, Well-Being Index WHO-5, two questions from the Brief Method of Evaluating Coping with a Disease. RESULTS: Statistically significant correlations were found between the HbA1c levels and (1) disease duration (rs=0.067; p < 0.001); (2) number of complications (rs = 0.191, p < 0.001) (3) the perception of self-influence on the diabetes course (rs=- 0.16; p < 0.001); (4) well-being (risk of depression) (rs=- 0.10; p < 0.001). The regression analysis showed that 7% of HbA1c variability is explained by age, a perception of self-influence on the diabetes course, the number of complications, place of residence, education, BMI. The most important findings concerning BMI were found in regression analysis, which indicated a week relationship between BMI and a number of complications, perception of self-influence on the diabetes course and coping styles (3% of the resultes' variability). The group at high risk of depression had the highest levels of HbA1c. CONCLUSION: Sociodemographic and psychological factors show weak but statistically significant relationships with the current levels of HbA1c and BMI.

Depression among young adults - risks and protective factors in the COVID-19 pandemic.

Purpose: The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic. Methods: The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms. Results: 56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression. Conclusions: The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

Previous disorders and depression outcomes in individuals with 12-month major depressive disorder in the World Mental Health surveys.

AIMS: Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes. METHODS: Data came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning. RESULTS: Among respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including previous MDD), and 64.6% (s.e. = 0.9) had at least one prior, non-MDD disorder. Previous non-depressive distress, fear and externalising disorders, but not depressive distress disorders, predicted higher impairment (OR = 1.4-1.6) and suicidality (OR = 1.5-2.5), after adjustment for sociodemographic variables. Further adjustment for MDD characteristics weakened, but did not eliminate, these associations. Associations were largely driven by current comorbidities, but both remitted and current externalising disorders predicted suicidality among respondents with 12-month MDD. CONCLUSIONS: These results illustrate the importance of careful psychiatric history taking regarding current anxiety disorders and lifetime externalising disorders in individuals with MDD.

PAID-PL-The Polish Version of the Problem Areas in Diabetes Scale: Perfect Reliability and a One-Factor Structure.

PURPOSE: The aim of this study was to assess the structure and validate the Polish version of the Problem Areas in Diabetes (PAID) scale, as the current translations of the original English version significantly vary in their psychometric properties. PATIENTS AND METHODS: Two hundred and sixteen consecutive Polish outpatients were invited to participate in this international cross-sectional study on depression in diabetes. The research was based on the demographic and clinical characteristics of the study population, including the level of glycated hemoglobin (HbA1c) and scores obtained in the Polish versions of the following questionnaires: PAID, World Health Organization-Five Well-Being Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9). The psychiatric diagnosis was conducted with the use of Mini-International Neuropsychiatric Interview (M.I.N.I.). RESULTS: Exploratory factor analyses yielded a 1-factor structure that included all 20 items. The internal consistency of the Polish version of PAID was high (Cronbach α = 0.97). There were significant positive correlation between PAID and PHQ-9 and a negative correlation between PAID and WHO-5. We also observed a negative association between PAID scores and age and a positive correlation between PAID and HbA1c levels. Patients with depression reported significantly higher PAID scores as compared with those without depressive symptoms. CONCLUSION: The Polish version of PAID has a one-factor structure and is a reliable, valid outcome measure for Polish outpatients with type 2 diabetes and it may constitute a useful instrument for screening for psychologic issues in diabetic patients during their appointments at the diabetes clinic.

Perceived helpfulness of bipolar disorder treatment: Findings from the World Health Organization World Mental Health Surveys.

OBJECTIVES: To examine patterns and predictors of perceived treatment helpfulness for mania/hypomania and associated depression in the WHO World Mental Health Surveys. METHODS: Face-to-face interviews with community samples across 15 countries found n = 2,178 who received lifetime mania/hypomania treatment and n = 624 with lifetime mania/hypomania who received lifetime major depression treatment. These respondents were asked whether treatment was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Patterns and predictors of treatment helpfulness were examined separately for mania/hypomania and depression. RESULTS: 63.1% (mania/hypomania) and 65.1% (depression) of patients reported ever receiving helpful treatment. However, only 24.5-22.5% were helped by the first professional seen, which means that the others needed to persist in help seeking after initial unhelpful treatments in order to find helpful treatment. Projections find only 22.9% (mania/hypomania) and 43.3% (depression) would persist through a series of unhelpful treatments but that the proportion helped would increase substantially if persistence increased. Few patient-level significant predictors of helpful treatment emerged and none consistently either across the two components (i.e., provider-level helpfulness and persistence after earlier unhelpful treatment) or for both mania/hypomania and depression. Although prevalence of treatment was higher in high-income than low/middle-income countries, proportional helpfulness among treated cases was nearly identical in the two groups of countries. CONCLUSIONS: Probability of patients with mania/hypomania and associated depression obtaining helpful treatment might increase substantially if persistence in help-seeking increased after initially unhelpful treatments, although this could require seeing numerous additional treatment providers. In addition to investigating reasons for initial treatments not being helpful, messages reinforcing the importance of persistence should be emphasized to patients.

A letter to the editor. Three-vote on the National Mental Health Programme. / List do Redakcji. Trójglos w sprawie Narodowego Programu Ochrony Zdrowia Psychicznego.

no summary.

Patterns of care and dropout rates from outpatient mental healthcare in low-, middle- and high-income countries from the World Health Organization's World Mental Health Survey Initiative.

BACKGROUND: There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countries. METHODS: Respondents from 13 low- or middle-income countries (N = 60 224) and 15 in high-income countries (N = 77 303) were screened for mental and substance use disorders. Cross-tabulations were used to examine the distribution of treatment and dropout rates for those who screened positive. The timing of dropout was examined using Kaplan-Meier curves. Predictors of dropout were examined with survival analysis using a logistic link function. RESULTS: Dropout rates are high, both in high-income (30%) and low/middle-income (45%) countries. Dropout mostly occurs during the first two visits. It is higher in general medical rather than in specialist settings (nearly 60% v. 20% in lower income settings). It is also higher for mild and moderate than for severe presentations. The lack of financial protection for mental health services is associated with overall increased dropout from care. CONCLUSIONS: Extending financial protection and coverage for mental disorders may reduce dropout. Efficiency can be improved by managing the milder clinical presentations at the entry point to the mental health system, providing adequate training, support and specialist supervision for non-specialists, and streamlining referral to psychiatrists for more severe cases.

COVID-19 pandemic fear, life satisfaction and mental health at the initial stage of the pandemic in the largest cities in Poland.

The study investigated whether the level of life satisfaction and general mental health was associated with COVID-19 worries at the initial stage of the COVID-19 pandemic in Poland. A cross-sectional observational study using an online questionnaire was conducted between 19 March and 27 April 2020, i.e. at the beginning of the epidemic in Poland. The study participants were residents of Poland over the age of 18 years. A total of 412 completed responses were received. The majority of respondents were women (75%), 84% respondents were mentally healthy and did not have any diagnosis of mental illnesses. Sixty-eight percent respondents indicated that they had been worried about the COVID-19 pandemic for the average of 21.75 days (SD +-16), while the median period from the onset of epidemic in Poland (20 March) to the participation in the study was 11 days. The main domains of concern included: death of loved ones (75%), severe course of illness in loved ones (72%), healthcare failure (64%), consequences of the pandemic at an individual and social level (64% and 63%, respectively). There was a significant medium decrease in the level of happiness and life satisfaction during the COVID-19 epidemic (p <.001).

People with diabetes need a lower cut-off than others for depression screening with PHQ-9.

AIMS: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and 'MDD and/or dysthymia' in people with and without type 2 diabetes. METHODS: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden's index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. RESULTS: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden's index and ≥ 5 by the two-stage method for screening for MDD and 'MDD and/or dysthymia' in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and 'MDD and/or dysthymia' among people without diabetes (Youden's index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for 'MDD and/or dysthymia' in people without diabetes. CONCLUSIONS: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.

Cut-off points for Polish-language versions of depression screening tools among patients with Type 2 diabetes.

AIMS: Screening tools can help improve the detection of depression in patients with diabetes, yet the psychometric properties of most translations of scales, which are originally published in English, have not been assessed. Thus we studied the screening performance of widely used depression measures. METHOD: We applied the cut-off points of the English-language versions of the Beck Depression Inventory (BDI); Hospital Anxiety and Depression Scale (HADS); Depression in Diabetes Self-Rating Scale (DDS-RS); Brief Self-Rating Scale of Depression and Anxiety (BS-RSDA); and Problematic Areas in Diabetes Survey (PAID), all of which were used to assess diabetes-specific distress in a sample of 101 patients with Type 2 diabetes. The Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale (HDRS) were used to diagnose depression. RESULTS: When the English cut-off points were used, the tools had varied values of both sensitivity and specificity. When the best cut-off points were used, all measures had either very good or good sensitivity. Taking into account their length, the HADS and the BS-RSDA seem to be the best among the screening tools. CONCLUSIONS: Effective initial diagnosis of depression in patients with diabetes during a routine medical visit requires the use of screening tools that have adequate cut-off points. The analyses presented in this article show that screening tools should be validated and the cut-off points that are used should be population-specific.

The Staff Attitude to Coercion Scale (SACS) - Polish adaptation. / Kwestionariusz Postaw Personelu Wobec Przymusu (SACS) ­ Polska adaptacja.

OBJECTIVES: The aim of the study was to prepare the Polish adaptation of the SACS. The scale is a self-assessment tool designed to measure staff attitudes towards direct coercion of psychiatric wards patients. METHODS: The sample consisted of 120 adults, staff from 7 psychiatric wards. The SACS is a tool created in Norway by Tonje Husum, comprising of 15 items describing psychiatric healthcare professionals attitudes towards direct coercion. The validation procedure incorporated three basic methods to be applied in the reliability analysis - the comparison of double tests with the same method, the analysis of statistical properties of test items as well as analysis of the relation of test items and subscales with the general test result. RESULTS: After a "think aloud" type pilot study and a language validation, the internal consistency was assessed. The Cronbach's alpha ranged from 0.57 to 0.81 in the subscales, and it was 0.82 for the total score. The best solution obtained in exploratory factor analysis was a three-factor model, almost identical to the original one, confirming the division into three subscales: coercion as offending (critical attitude), as care and security (pragmatic attitude) and as treatment (positive attitude). CONCLUSIONS: The psychometric characteristics of the Polish adaptation of the SACS are similar to those reported in the original version. The results allow to recommend the method for scientific research. However, further analyses are necessary to assess validity and discriminative power in larger settings.

Psychometric validation of Corah's Dental Anxiety Scale in the Polish population.

BACKGROUND: Corah's Dental Anxiety Scale (DAS) is one of the most popular psychological scales used for diagnosing odontophobia worldwide. Despite being used by Polish researchers, it has never been validated in the Polish population. Also, there are no similar tools that could be used by dentists for screening. OBJECTIVES: The aim of this study was to validate and present the psychometric properties of the Dental Anxiety Scale adapted to Polish. The scale is a self-assessment tool designed to measure odontophobia and dental anxiety. MATERIAL AND METHODS: The sample consisted of 162 adults. The adaptation to Polish of the DAS scale included a back-translation and a think-aloud study. The validation procedure incorporated 3 basic methods to be applied in the reliability analysis - the test-retest method, the statistical properties analysis of test items as well as a factor analysis. The general result of the responders was also compared to the anxiety-trait STAI scale and the neuroticism scale form IPIP-BMF-20. RESULTS: The Cronbach's α was 0.9. The solution obtained in the exploratory factor analysis was a one-factor model, explaining 76.24% of the variance of responses. The test-retest gave a strong correlation (rho = 0.69, p < 0.001). The correlations between the DAS score, the anxiety-trait STAI score and the neuroticism scale form IPIP-BMF-20 were moderate, as expected. The percent of responders with odontophobia and intense dental anxiety was almost similar to the results of other studies. CONCLUSIONS: The psychometric characteristics of the Polish adaptation of the DAS scale are similar to those reported in the original version. The results allow us to recommend the method for scientific research and patient screening. However, further analyses are necessary to assess if the scores indicating odontophobia and dental anxiety are similar in Poland and in the USA.

Validation of the Polish version of WHO-5 as a screening instrument for depression in adults with diabetes.

AIMS: The aim of this study was to validate and report the factorial analysis of the World Health Organization's 5-item Well-being Index (WHO-5) among outpatients with type 2 diabetes. We investigated the psychometric properties of the WHO-5 and its suitability for identifying potential depressive symptoms in Polish adults with diabetes. METHODS: Participants were randomly chosen among Polish diabetes outpatients and invited to participate in the cross-sectional study (N = 216). Participants completed the Polish version of the WHO-5, Problem Areas in Diabetes Scale and Patient Health Questionnaire. RESULTS: Factor analyses identified the one-factor structure of the Polish version of the WHO-5. The internal consistency of the Polish version of the WHO-5 is satisfying. With regard to convergent validity, there were significant negative associations between the WHO-5 and PAID, the PHQ-9, HbA1c and the amount of medical complications. The AUC indicates that the WHO-5 is an effective measure for identifying depressive symptoms. The optimal cut off values of ≤12 yielded the best sensitivity/specificity trade-off for identifying depression among people with diabetes. CONCLUSIONS: The Polish version of the WHO-5 is a reliable, valid outcome measure for outpatients with type 2 diabetes and can be a useful instrument for screening for depression in people with diabetes.