Validation of the Spanish version of the Borderline Personality Disorder Checklist (BPD Checklist) in a sample of BPD patients: Study of psychometric properties

Background and objectives: Borderline Personality Disorder (BPD) is one of the most complex personality disorders (PD). The Borderline Personality Disorder Checklist (BPD Checklist) is an instrument specifically designed to assess the burden of BPD symptoms according to DSM-IV/5 criteria in the past month. Methods: Our goal was to adapt and validate the BPD Checklist in Spanish and to study its psychometric properties, i.e. reliability and validity. We administered it in a sample of BPD patients (n = 342) and in a sample of patients with other PD diagnoses (n = 190). Results: The results obtained indicated that the psychometric properties of the Spanish version of the BPD Checklist are similar to those of the original version of the instrument. The internal consistency indices were generally good to excellent. The total score and the subscales of the BPD Checklist discriminated between diagnostic samples. As expected, the subscales were associated with the scores on the SCID-II and self-rating measures. Conclusions: Our results are consistent with the original version of BPD Checklist. In general, it is an adequate instrument for clinical screening and to assess the subjective burden of BPD experienced by the patient in the past month

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Spanish version validation of the Marihuana Motives Measure in a drug-consuming adolescent sample. / Propiedades psicométricas de la versión española del Marihuana Motives Measure en población adolescente consumidora.

INTRODUCTION: Cannabis is the illicit drug mostly widely consumed by adolescents in Spain. The understanding of consumption motives is an important factor for intervention. In Spain, there are no available instruments for their evaluation, hence, the goal of this paper is to study the psychometric properties of the Marihuana Motives Measure (MMM) in a sample of adolescent consumers. MATERIAL AND METHOD: Firstly, translation and back-translation was performed. A total of 228 adolescent consumers of cannabis were evaluated. Factorial analysis was conducted, and the reliability of the total scores and of each scale of the questionnaire was studied through Cronbach's alpha. Test-retest reliability was analyzed through interclass correlations. Validity evidence of the MMM was examined through correlations between current cannabis use, subjective consumption effects measured with the Addiction Research Center Inventory (ARCI), and personality measured with the Millon Adolescent Clinical Inventory (MACI). RESULTS: High reliability was observed in total score of the MMM (Cronbach α = .86), and high and moderate reliability for each of the five factors obtained in the factorial analysis of the MMM, Social = .82, Enhancement = .72, Coping = .83, Expansion = .74, and Conformity = .64. Significant correlations were also observed between cannabis consumption motives and subjective effects, and between consumption motives and personality. CONCLUSION: The Spanish version of the MMM shows a similar factorial structure as the one obtained by the original author, and its measures are reliable and valid for the study of cannabis consumption motives in adolescent consumer population.

Introducción: El cannabis es la sustancia ilegal que más consumen los adolescentes españoles. Entender los motivos de consumo es un factor importante para la intervención. Actualmente no existe en España un instrumento para su evaluación. El objetivo del presente trabajo es estudiar las propiedades psicométricas de la versión española del cuestionario Marihuana Motives Measure (MMM) en una población de adolescentes consumidores. Material y Métodos: Se llevó a cabo una traducción y retrotraducción del MMM. Un total de 228 adolescentes consumidores de cánnabis fueron evaluados. Se realizó un análisis factorial y se estudió la fiabilidad de la puntuación total y de cada una de las escalas del cuestionario a partir del Alfa de Cronbach. El estudio de la evidencia de validez del MMM se realizó mediante el examen de las correlaciones entre el uso actual de cánnabis, los efectos subjetivos del consumo través del cuestionario ARCI (Addiction Research Center Inventory) y la personalidad, mediante el cuestionario MACI (Millon Adolescent Clinical Inventory). Resultados: Se observó una alta fiabilidad de la puntuación total del MMM (Alfa de Cronbach= 0,86) y entre alta y moderada para cada uno de los cinco factores obtenidos al realizar el análisis factorial del MMM, Social = 0,82; Enhancement = 0,72; Coping = 0,83; Expansion = 0,74; Conformity = 0,64. Además, se observaron correlaciones significativas tanto entre motivos de consumo de cannabis y efectos subjetivos, así como entre motivos de consumo y personalidad. Conclusiones: La versión española del MMM muestra una estructura factorial similar a la obtenida por el autor original y sus medidas resultan fiables y válidas para el estudio de los motivos de consumo de cánnabis en población adolescente consumidora.

Propiedades psicométricas de la versión española del Marihuana Motives Measure en población adolescente consumidora / Spanish version validation of the Marihuana Motives Measure in a drug-consuming adolescent sample

Introducción: El cannabis es la sustancia ilegal que más consumen los adolescentes españoles. Entender los motivos de consumo es un factor importante para la intervención. Actualmente no existe en España un instrumento para su evaluación. El objetivo del presente trabajo es estudiar las propiedades psicométricas de la versión española del cuestionario Marihuana Motives Measure (MMM) en una población de adolescentes consumidores. Material y Métodos: Se llevó a cabo una traducción y retrotraducción del MMM. Un total de 228 adolescentes consumidores de cánnabis fueron evaluados. Se realizó un análisis factorial y se estudió la fiabilidad de la puntuación total y de cada una de las escalas del cuestionario a partir del Alfa de Cronbach. El estudio de la evidencia de validez del MMM se realizó mediante el examen de las correlaciones entre el uso actual de cánnabis, los efectos subjetivos del consumo través del cuestionario ARCI (Addiction Research Center Inventory) y la personalidad, mediante el cuestionario MACI (Millon Adolescent Clinical Inventory). Resultados: Se observó una alta fiabilidad de la puntuación total del MMM (Alfa de Cronbach= 0,86) y entre alta y moderada para cada uno de los cinco factores obtenidos al realizar el análisis factorial del MMM, Social = 0,82; Enhancement = 0,72; Coping = 0,83; Expansion = 0,74; Conformity = 0,64. Además, se observaron correlaciones significativas tanto entre motivos de consumo de cannabis y efectos subjetivos, así como entre motivos de consumo y personalidad. Conclusiones: La versión española del MMM muestra una estructura factorial similar a la obtenida por el autor original y sus medidas resultan fiables y válidas para el estudio de los motivos de consumo de cánnabis en población adolescente consumidora

Introduction: Cannabis is the illicit drug mostly widely consumed by adolescents in Spain. The understanding of consumption motives is an important factor for intervention. In Spain, there are no available instruments for their evaluation, hence, the goal of this paper is to study the psychometric properties of the Marihuana Motives Measure (MMM) in a sample of adolescent consumers. Material and Method: Firstly, translation and back-translation was performed. A total of 228 adolescent consumers of cannabis were evaluated. Factorial analysis was conducted, and the reliability of the total scores and of each scale of the questionnaire was studied through Cronbach’s alpha. Test-retest reliability was analyzed through interclass correlations. Validity evidence of the MMM was examined through correlations between current cannabis use, subjective consumption effects measured with the Addiction Research Center Inventory (ARCI), and personality measured with the Millon Adolescent Clinical Inventory (MACI). Results: High reliability was observed in total score of the MMM (Cronbach alfa = .86), and high and moderate reliability for each of the five factors obtained in the factorial analysis of the MMM, Social = .82, Enhancement = .72, Coping = .83, Expansion = .74, and Conformity = .64. Significant correlations were also observed between cannabis consumption motives and subjective effects, and between consumption motives and personality. Conclusion: The Spanish version of the MMM shows a similar factorial structure as the one obtained by the original author, and its measures are reliable and valid for the study of cannabis consumption motives in adolescent consumer population

Cost of borderline personality disorder in Catalonia (Spain).

INTRODUCTION: The available information on the cost of illness of Borderline Personality Disorder (BPD) is overtly insufficient for policy planning. Our aim was to estimate the costs of illness for BPD in Catalonia (Spain) for 2006. METHODS: This is a multilevel cross-design synthesis study combining a qualitative nominal approach, quantitative 'top-down' analysis of multiple health databases, and 'bottom-up' data of local surveys. Both direct and indirect costs have been estimated from a governmental and societal perspective. RESULTS: Estimated year-prevalence of BPD was 0.7% (41,921 cases), but only 9.6% of these cases were treated in the mental health system (4033 cases). The baseline of the total cost of BPD in Catalonia was 45.6 million€, of which 15.8 million€ (34.7%) were direct costs related to mental health care. The cost distribution was 0.4% in primary care; 4% in outpatient mental health care; 4.7% in hospitalisation; 0.7% in emergency care; and 24.9% in pharmacotherapy. Additionally, the cost of drug addiction treatment for persons with BPD was 11.2%; costs associated with sheltered employment were 23.9% and those of crime and justice were 9.7%. Indirect costs - including temporary sick leave and premature death (suicide) - represented 20.5% of total costs. The average annual cost per patient was 11,308€. CONCLUSIONS: An under-reporting of BPD was identified by the experts in all health databases and official registries. Most of the BPD costs were not related to mental health care. Amongst the direct cost categories, pharmacotherapy had the largest proportion despite the lack of specificity for BPD. This distribution of costs reinforces the idea of BPD complexity related to an inadequate and inefficient use of health resources.

Diagnóstico del trastorno límite de la personalidad: concordancia entre el juicio clínico y la entrevista semiestructurada / Borderline personality disorder diagnosis: concordance between clinical and semiestructured interview evaluation

Fundamento y objetivo. Ningún estudio en España ha analizado la diferencia en la frecuencia del diagnóstico realizada a partir del juicio clínico y del uso de la entrevista semiestructurada en el diagnóstico del trastorno límite de la personalidad (TLP). Los objetivos del presente trabajo son: estudiarla concordancia diagnóstica del TLP en pacientes previamente diagnosticados a partir del juicio clínico mediante el uso de la entrevista clínica semiestructurada para el eje II del DSM-IV (SCID-II) y analizar si existen diferencias en la distribución de frecuencias de los trastornos psiquiátricos en función de la observación o no de concordancia diagnóstica. Material y método. En el estudio participaron 146 pacientes derivados al Programa del Trastorno Límite de Personalidad del Servicio de Psiquiatría del Hospital Universitari Vall d’Hebron durante su primer año de funcionamiento. Se realizó un estudio descriptivo de la concordancia diagnóstica del trastorno mediante la utilización de la SCID-II por profesionales con experiencia en su uso en pacientes previamente diagnosticados a partir del juicio clínico. Resultados. No se observó concordancia diagnóstica en el 30% de los pacientes incluidos en el estudio. Los resultados muestran un elevado número de trastornos en todos los pacientes en el momento del diagnóstico. Se observa un mayor número de diagnósticos de trastornos de personalidad (Z= 3,36; p=0,01) y de trastornos de ansiedad (Z=3,04; p=0,002) en el grupo de concordancia diagnóstica que en el grupo de no concordancia diagnóstica. Conclusiones. Mediante el uso de entrevistas semiestructuradas se observa un 30% menos de diagnósticos de TLP que mediante el juicio clínico (AU)

Background and objective. No study in Spain has analyzed the difference in frequencies of the diagnoses made based on clinical evaluation and semistructured interview in borderline personality disorder diagnosis (BPD). This present study aims to analyze diagnostic concordance in BPD patients previous diagnosed based on clinical evaluations using clinical semistructured interviews for DSM-IV axis II (SCID-II), and to analyze if there are differences in the distribution of frequencies of the psychiatry disorders in the diagnostic concordance group and the non-diagnostic concordance one. Material and method. The study was carried out with 146 patients referred to the Borderline Personality Disorder Program of the Psychiatric Department at the Hospital Universitari Vall d’Hebron during its first year of service. A descriptive study was designed to analyze diagnostic concordance between previous BPD clinical evaluation and semistructured interview SCID-II administered by clinical experienced interviewers. Results. Diagnostic concordance was not observed in30% of the final study patients. The results indicated that all the study patients presented a great number of psychiatry disorders. There were significant differences between the diagnostic concordance group and the non-diagnostic concordance one. A higher number of personality disorder (Z=3.36; p=0.01) and anxiety disorder (Z=3.04; p=0.002) was observed in the diagnostic concordance group. Conclusions. BPD was diagnosed 30% less when using semistructured interviews than with clinical evaluations (AU)

[Borderline personality disorder diagnosis: concordance between clinical and semiestructured interview evaluation]. / Diagnóstico del trastorno límite de la personalidad: concordancia entre el juicio clínico y la entrevista semiestructurada.

BACKGROUND AND OBJECTIVE: No study in Spain has analyzed the difference in frequencies of the diagnoses made based on clinical evaluation and semistructured interview in borderline personality disorder diagnosis (BPD). This present study aims to analyze diagnostic concordance in BPD patients previous diagnosed based on clinical evaluations using clinical semistructured interviews for DSM-IV axis II (SCID-II), and to analyze if there are differences in the distribution of frequencies of the psychiatry disorders in the diagnostic concordance group and the non-diagnostic concordance one. MATERIAL AND METHOD: The study was carried out with 146 patients referred to the Borderline Personality Disorder Program of the Psychiatric Department at the Hospital Universitari Vall d'Hebron during its first year of service. A descriptive study was designed to analyze diagnostic concordance between previous BPD clinical evaluation and semistructured interview SCID-II administered by clinical experienced interviewers. RESULTS: Diagnostic concordance was not observed in 30% of the final study patients. The results indicated that all the study patients presented a great number of psychiatry disorders. There were significant differences between the diagnostic concordance group and the non-diagnostic concordance one. A higher number of personality disorder (Z=3.36; p=0.01) and anxiety disorder (Z=3.04; p=0.002) was observed in the diagnostic concordance group. CONCLUSIONS: BPD was diagnosed 30% less when using semistructured interviews than with clinical evaluations.

Clinical characteristics and psychopathological profile of patients with vulvodynia: an observational and descriptive study.

BACKGROUND: Vulvodynia is a fairly common dermatological symptom that often interferes with the personal, social and working activities of affected women and results in a significant loss of their quality of life. It is a persistent and tedious clinical disorder which is often resistant to conventional treatments. OBJECTIVES: The aim of this study is to evaluate the main clinical signs, associated psychopathological disorders and outcome after antidepressant treatment of patients with vulvodynia. METHODS: Eighty patients were included. Clinical characteristics and psychopathological profiles were determined by appropriate instruments. The improvement of clinical symptoms after combined antidepressant drug therapy was also evaluated. RESULTS: Pain (70%), burning (63.7%), dyspareunia (57.5%) and stinging (56.2%) were the most commonly reported symptoms. Most patients (56.5%) showed anxiety, and 52.2% of them were reported as having a depression disorder. When evaluated by psychometric tools, 81.4% of patients scored >150 on the Life Event Scale, which means a risk >50% of suffering an illness in the near future, and patients' scores in the Dermatology Life Quality Index showed higher values than the mean of the Spanish validation group. After 6 months of combined treatment with escitalopram (10-20 mg/day), perfenazine (2-4 mg/day) and amytriptiline (10 mg/day), a complete remission of the clinical symptoms was achieved in 41% of patients. In contrast, only 12% of patients who did not follow drug treatment reported a complete resolution of the clinical symptoms. CONCLUSIONS: Our results seem to confirm that vulvodynia is associated with psychiatric co-morbidity such as stress and depression. The study highlights that the psychiatric treatment may be a useful option to improve clinical symptoms. Whether these patients should be evaluated for depression or be referred to a psychiatrist, remains to be investigated.