Chronic pain predicts a worse response to depression treatment, regardless of thyroid function or psychotropics prescribed.

BACKGROUND: Chronic pain (CP) and thyroid hormones' (TH) abnormalities are associated with depression, but the impact of pain and TH fluctuation on the response to depression treatment is uncertain. METHODS: Eighty-eight patients with major depression were evaluated before and after 6 months of specific treatment, through scales of symptoms' severity (HAM-D-17), psychomotor disturbance (CORE), and quality of life (WHOQOL-Bref). We reviewed psychiatric medications and measured TSH, T3 and T4. We used Generalized Estimating Equations to assess the interaction effect between CP and treatment time on depression severity and TH levels, and Bonferroni to compare means. RESULTS: 47.7 % of the patients had CP. Patients with and without CP did not differ at baseline. At follow-up, those with CP experienced a more modest decrease in symptoms' severity and no improvement in any domain of psychomotor disturbance, contrasting with a decrease of over 40 % from the baseline values of CORE in patients without CP (non-CP). Initial and final scores were respectively: HAM-D CP 24.06 and 19.3, Δ = -4.75; HAM-D non-CP 22.92 and 14.7, Δ = -8.21; CORE CP 5.36 and 5.24, Δ = -0.12; CORE non-CP 5.8 and 3.22, Δ = -2.57. There was no interaction with TH or life quality. Model adjustments for psychotropic drugs received and sensitivity analysis excluding somatic symptoms from severity scales did not impact the results. LIMITATIONS: Findings may not replicate in mildly depressed patients from primary care. Pain scales were not applied. CONCLUSIONS: Individuals with chronic pain showed a suboptimal response to depression treatment, regardless of the medications used or TH levels.

Which outcomes are most important to measure in patients with COVID-19 and how and when should these be measured? Development of an international standard set of outcomes measures for clinical use in patients with COVID-19: a report of the International Consortium for Health Outcomes Measurement (ICHOM) COVID-19 Working Group.

OBJECTIVES: The COVID-19 pandemic has resulted in widespread morbidity and mortality with the consequences expected to be felt for many years. Significant variation exists in the care even of similar patients with COVID-19, including treatment practices within and between institutions. Outcome measures vary among clinical trials on the same therapies. Understanding which therapies are of most value is not possible unless consensus can be reached on which outcomes are most important to measure. Furthermore, consensus on the most important outcomes may enable patients to monitor and track their care, and may help providers to improve the care they offer through quality improvement. To develop a standardised minimum set of outcomes for clinical care, the International Consortium for Health Outcomes Measurement (ICHOM) assembled a working group (WG) of 28 volunteers, including health professionals, patients and patient representatives. DESIGN: A list of outcomes important to patients and professionals was generated from a systematic review of the published literature using the MEDLINE database, from review of outcomes being measured in ongoing clinical trials, from a survey distributed to patients and patient networks, and from previously published ICHOM standard sets in other disease areas. Using an online-modified Delphi process, the WG selected outcomes of greatest importance. RESULTS: The outcomes considered by the WG to be most important were selected and categorised into five domains: (1) functional status and quality of life, (2) mental functioning, (3) social functioning, (4) clinical outcomes and (5) symptoms. The WG identified demographic and clinical variables for use as case-mix risk adjusters. These included baseline demographics, clinical factors and treatment-related factors. CONCLUSION: Implementation of these consensus recommendations could help institutions to monitor, compare and improve the quality and delivery of care to patients with COVID-19. Their consistent definition and collection could also broaden the implementation of more patient-centric clinical outcomes research.

Evaluation of major depression symptom networks using clinician-rated and patient-rated data.

BACKGROUND: Major depressive disorder (MDD) is heterogeneous, but official diagnostic classifications and widely used rating scales are based on the premise that MDD is a single disorder and that symptoms are equally important to assess severity. Also, patients and clinicians frequently diverge in how they evaluate MDD severity. In order to better understand the differences between MDD scales used by clinicians and patients in the context of MDD heterogeneity, we performed a network analysis from an approach that focuses on the interaction of symptoms rather than total score. METHODS: The Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory with 21 items (BDI) scored by the clinician or patient, respectively, were used to estimate the networks based on 794 MDD patients. The networks were estimated using software R 4.0.2 and Graphical Lasso, identifying communities of symptoms by the clique percolation method, and the mixed graphical models were used to evaluate the explained variance of each symptom. RESULTS: The networks presented different communities of symptoms and connection structure (M = 0.177, p = 0.0028). The guilt connection strength and its association with suicidal ideation was greater in the BDI network. LIMITATIONS: Transversal data from severe, chronic, or treatment resistant depression patients. CONCLUSIONS: The present study suggests that the self-rated scale may perform better when assessing association between guilt and other symptoms, especially suicidal ideation. Communities of symptoms and edges between symptoms suggest that insomnia may be an independent symptom, thus requiring specific interventions. Some similar items are strongly connected and could be collapsed.

First-time administration of the Sydney Melancholia Prototype Index (SMPI) to non-English-speaking patients: a study from Brazil.

OBJECTIVE: The Sydney Melancholia Prototype Index (SMPI) is a scale that uses a non-conventional strategy to assess melancholia status based on prototypic symptoms and illness course variables. This study aimed to evaluate the performance of the first translation of this instrument in a non-English-speaking population. METHODS: A sample comprising 106 Brazilian outpatients with depression was evaluated simultaneously with the Brazilian version of the self-rated SMPI (SMPI-SR) and clinician-rated SMPI (SMPI-CR). The kappa coefficient and t test were used to evaluate concurrent validity vs. DSM-IV, CORE system, Hamilton Depression Rating Scale-6 item (HAM-D6), and HAM-D17 assignments to a melancholic or non-melancholic class. The prevalence of melancholia as well as sensitivity and specificity were calculated across instruments. RESULTS: The prevalence of melancholia was highest using DSM-IV criteria (56.6%). The kappa agreement between SMPI-CR and DSM-IV melancholia assignment was moderate (kappa 0.44, p ≤ 0.001). SMPI-CR-assigned melancholic patients had significantly higher CORE, HAM-D17, and HAM-D6 scores. The test-retest consistency values for the SMPI were modest at best, and somewhat superior for the CR version. CONCLUSION: The Brazilian SMPI-CR presented satisfactory psychometric properties (which were superior to those of the SMPI-SR), and therefore appears to be a useful option for identifying melancholia and studying its causes and optimal treatments.

Validation of the WHOQOL-Bref instrument in Brazilian sign language (Libras).

PURPOSE: The recognition of the Brazilian Sign Language (Libras) as the official language of the Brazilian deaf, in 2002, reaffirms the linguistic and cultural particularities of the deaf population. Therefore, there is a lack of a validated instrument for assessing the Quality of Life of deaf people using Libras. With authorization from the World Health Organization (WHO), a version of the WHOQOL-Bref in Libras was developed, called WHOQOL-Bref/Libras. However, its psychometric properties have not been examined as yet. Therefore, the purpose of this work is to perform the psychometric validation of the WHOQOL-Bref/Libras. METHODS: WHOQOL-Bref/Libras and a sociodemographic questionnaire were applied to 311 deaf people from the five Brazilian regions. To assess temporal stability, the questionnaire was readministered to 52 deaf people, over an interval of 2 weeks. RESULTS: WHOQOL-Bref/Libras demonstrated satisfactory psychometric values for reliability, discriminant and construct validity, temporal stability, and internal consistency. Cronbach's alpha coefficient showed satisfactory values for each of the WHOQOL-Bref domains: Physical health (0.641), Psychological (0.705), Environment (0.710), and Overall-Bref domains (0.873). The WHOQOL-Bref/Libras is the appropriate option to assess the quality of life of deaf people who communicate through Libras. CONCLUSION: WHOQOL-Bref/Libras had a satisfactory psychometric performance; therefore, it is a valid option that will provide autonomous participation for the deaf in quality of life investigations.

Sydney Melancholia Prototype Index (SMPI): translation and cross-cultural adaptation to Brazilian Portuguese.

INTRODUCTION: Depression is possibly not a single syndrome but rather comprises several subtypes. DSM-5 proposes a melancholia specifier with phenotypic characteristics that could be associated with clinical progression, biological markers or therapeutic response. The Sydney Melancholia Prototype Index (SMPI) is a prototypic scale aimed to improve the diagnosis of melancholia. So far, there is only an English version of the instrument available. The aim of this study is to describe the translation and adaptation of the English version of the SMPI into Brazilian Portuguese. METHODS: Translation and cross-cultural adaptation of the self-report (SMPI-SR) and clinician-rated (SMPI-CR) versions into Brazilian Portuguese were done following recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). This guideline includes the following steps: preparation, forward translation, reconciliation, back translation, back translation review, harmonization, cognitive debriefing, debriefing results review, proofreading and final report. RESULTS: The Brazilian Portuguese versions of the SMPI were well-accepted by respondents. Changes in about two-thirds of the items were considered necessary to obtain the final Brazilian Portuguese version of the SMPI. CONCLUSIONS: Both versions of the SMPI are now available in Brazilian Portuguese. The instrument could become an important option to enhance studies on melancholia in Portuguese-speaking samples.

Sydney Melancholia Prototype Index (SMPI): translation and cross-cultural adaptation to Brazilian Portuguese

Abstract Introduction Depression is possibly not a single syndrome but rather comprises several subtypes. DSM-5 proposes a melancholia specifier with phenotypic characteristics that could be associated with clinical progression, biological markers or therapeutic response. The Sydney Melancholia Prototype Index (SMPI) is a prototypic scale aimed to improve the diagnosis of melancholia. So far, there is only an English version of the instrument available. The aim of this study is to describe the translation and adaptation of the English version of the SMPI into Brazilian Portuguese. Methods Translation and cross-cultural adaptation of the self-report (SMPI-SR) and clinician-rated (SMPI-CR) versions into Brazilian Portuguese were done following recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). This guideline includes the following steps: preparation, forward translation, reconciliation, back translation, back translation review, harmonization, cognitive debriefing, debriefing results review, proofreading and final report. Results The Brazilian Portuguese versions of the SMPI were well-accepted by respondents. Changes in about two-thirds of the items were considered necessary to obtain the final Brazilian Portuguese version of the SMPI. Conclusions Both versions of the SMPI are now available in Brazilian Portuguese. The instrument could become an important option to enhance studies on melancholia in Portuguese-speaking samples.

Differential biomarker signatures in unipolar and bipolar depression: A machine learning approach.

OBJECTIVE: This study used machine learning techniques combined with peripheral biomarker measurements to build signatures to help differentiating (1) patients with bipolar depression from patients with unipolar depression, and (2) patients with bipolar depression or unipolar depression from healthy controls. METHODS: We assessed serum levels of interleukin-2, interleukin-4, interleukin-6, interleukin-10, tumor necrosis factor-α, interferon-γ, interleukin-17A, brain-derived neurotrophic factor, lipid peroxidation and oxidative protein damage in 54 outpatients with bipolar depression, 54 outpatients with unipolar depression and 54 healthy controls, matched by sex and age. Depressive symptoms were assessed using the Hamilton Depression Rating Scale. Variable selection was performed with recursive feature elimination with a linear support vector machine kernel, and the leave-one-out cross-validation method was used to test and validate our model. RESULTS: Bipolar vs unipolar depression classification achieved an area under the receiver operating characteristics (ROC) curve (AUC) of 0.69, with 0.62 sensitivity and 0.66 specificity using three selected biomarkers (interleukin-4, thiobarbituric acid reactive substances and interleukin-10). For the comparison of bipolar depression vs healthy controls, the model retained five variables (interleukin-6, interleukin-4, thiobarbituric acid reactive substances, carbonyl and interleukin-17A), with an AUC of 0.70, 0.62 sensitivity and 0.7 specificity. Finally, unipolar depression vs healthy controls comparison retained seven variables (interleukin-6, Carbonyl, brain-derived neurotrophic factor, interleukin-10, interleukin-17A, interleukin-4 and tumor necrosis factor-α), with an AUC of 0.74, a sensitivity of 0.68 and 0.70 specificity. CONCLUSION: Our findings show the potential of machine learning models to aid in clinical practice, leading to more objective assessment. Future studies will examine the possibility of combining peripheral blood biomarker data with other biological data to develop more accurate signatures.

Increased Levels of Brain-Derived Neurotrophic Factor Are Associated With High Intrinsic Religiosity Among Depressed Inpatients.

Recognition of the importance of religion and spirituality in psychiatry is increasing, and several studies have shown a predominantly inverse relationship between religiosity and depression. Brain-derived neurotrophic factor (BDNF) is a widely studied brain neurotrophin responsible for synaptic plasticity, dendritic and neuronal fiber growth, and neuronal survival. The objective of the present study was to evaluate BDNF levels across high and low intrinsic religiosity (IR) in depressed inpatients. Serum BDNF levels were evaluated from 101 depressed inpatients at hospital admission and 91 inpatients at discharge. Religiosity was assessed using a validated version of the Duke University Religion Index. High IR patients had significantly higher serum BDNF at discharge than do low IR (52.0 vs. 41.3 ng/mL, P = 0.02), with a Cohen's d effect size difference of 0.56. High IR patients had a statistically significant increase in BDNF levels from admission to discharge (43.6 ± 22.4 vs. 53.8 ± 20.6 ng/mL, -1.950 (paired t-statistic), P = 0.05). The relationship between IR and BDNF levels (F = 6.199, P = 0.00) was controlled for the effects of depressive symptoms (â€…ß = 2.73, P = 0.00) and psychiatric treatments, including selective serotonin reuptake inhibitors (SSRIs) (ß = 0.17, P = 0.08), serotonin and norepinephrine reuptake inhibitors (SNRIs) (â€…ß = -0.23, P = 0.02), tricyclic antidepressants (TCAs) (â€…ß = -0.17, P = 0.10), lithium (â€…ß = 0.29, P = 0.00), anticonvulsants (â€…ß = 0.22, P = 0.03), antipsychotics (â€…ß = -0.05, P = 0.61), and electroconvulsive therapy (â€…ß = 0.00, P = 0.98). The current findings suggest a potential pathway to help understand the protective effect of religiosity in depressive disorders.

Psychometric properties of the WHOQOL-SRPB BREF, Brazilian Portuguese version

Objective: To test the reliability and the discriminant and convergent validity of the abbreviated Brazilian Portuguese World Health Organization's Quality of Life Instrument - Spirituality, Religion, and Personal Beliefs module (WHOQOL-SRPB BREF). Methods: In a sample of 404 individuals, we applied a general questionnaire, the WHOQOL-BREF, the long-form SRPB, the Brief Religious-Spiritual Coping Scale (RCOPE), and the Beck Depression Inventory (BDI). Priority was given to the 9-item SRPB assessment: its unidimensionality was tested through confirmatory factor analysis and Rasch analysis. Results: Confirmatory factor analysis of the 9-item SRPB assessment indicated an adjusted model with acceptable fit to data. In the Rasch analysis, general fit measures showed adequate performance. The 9-item SRPB assessment showed good internal consistency (alpha = 0.85), and could differentiate (discriminant validity) between religious and atheist/agnostic respondents (mean = 74.7±14.1 and 56.8±15.5, respectively; t = 6.37; degrees of freedom [df] = 402; p < 0.01) and between non-depressed and depressed respondents (mean = 76.5±12.9 and 67.1±16.5; t = 5.57; df = 190.5; p < 0.01). Correlations (convergent validity) were significant with the positive-RCOPE subscale (r = 0.58, p < 0.01) and the WHOQOL-BREF domains (Pearson coefficient ranging between 0.24 and 0.49; p < 0.01), but were in the negative direction with the negative-RCOPE subscale (r = -0.10, p < 0.05). Correlation with the long-form SRPB domain (r = 0.934) was almost perfect. Conclusion: The Brazilian Portuguese 9-item SRPB has good psychometric properties and confirmed the findings of the long-form Brazilian Portuguese version and the abbreviated English version.

Psychometric properties of the WHOQOL-SRPB BREF, Brazilian Portuguese version.

OBJECTIVE: To test the reliability and the discriminant and convergent validity of the abbreviated Brazilian Portuguese World Health Organization's Quality of Life Instrument - Spirituality, Religion, and Personal Beliefs module (WHOQOL-SRPB BREF). METHODS: In a sample of 404 individuals, we applied a general questionnaire, the WHOQOL-BREF, the long-form SRPB, the Brief Religious-Spiritual Coping Scale (RCOPE), and the Beck Depression Inventory (BDI). Priority was given to the 9-item SRPB assessment: its unidimensionality was tested through confirmatory factor analysis and Rasch analysis. RESULTS: Confirmatory factor analysis of the 9-item SRPB assessment indicated an adjusted model with acceptable fit to data. In the Rasch analysis, general fit measures showed adequate performance. The 9-item SRPB assessment showed good internal consistency (alpha = 0.85), and could differentiate (discriminant validity) between religious and atheist/agnostic respondents (mean = 74.7±14.1 and 56.8±15.5, respectively; t = 6.37; degrees of freedom [df] = 402; p < 0.01) and between non-depressed and depressed respondents (mean = 76.5±12.9 and 67.1±16.5; t = 5.57; df = 190.5; p < 0.01). Correlations (convergent validity) were significant with the positive-RCOPE subscale (r = 0.58, p < 0.01) and the WHOQOL-BREF domains (Pearson coefficient ranging between 0.24 and 0.49; p < 0.01), but were in the negative direction with the negative-RCOPE subscale (r = -0.10, p < 0.05). Correlation with the long-form SRPB domain (r = 0.934) was almost perfect. CONCLUSION: The Brazilian Portuguese 9-item SRPB has good psychometric properties and confirmed the findings of the long-form Brazilian Portuguese version and the abbreviated English version.

How do depressed patients evaluate their quality of life? A qualitative study.

BACKGROUND: This is a qualitative study that aims to investigate the effect of depressive status on responses to items on the WHO quality of life assessment instrument (WHOQOL-Bref), comparing which aspects of the individual's life he or she takes into account in responding to the items related to quality of life when depressed and when euthymic. RESULTS: Six adult women were interviewed prior to initiating treatment for a depressive episode and were then interviewed again six months later when in remission from the episode. The 'think aloud' method of cognitive interviewing was used. Based on the Wilcoxon test, the seven items that exhibited a significant change with the improvement of the depressive condition were examined in depth, and the think aloud method was used to reveal the subjects' cognitive processes. Depressive symptoms were associated with different interpretations of some items and the response scale. Also, for some items, patients chose the same response for the item both times but justified their choice differently during the depressive episode and in euthymia. CONCLUSIONS: We found that, in addition to the impact caused by depression on quality of life, there are peculiarities in the way the depressed individual makes subjective assessments. We believe that qualitative studies such as the present one may provide important support in the interpretation of quantitative results.

Bipolar Disorder Mixed Episodes: A Pragmatic Trial of a Public Health Treatment Effectiveness.

OBJECTIVES: To evaluate the effectiveness of an algorithm for the treatment of mixed episodes in bipolar disorder (BD) using the medications available under the Unified Health System (Sistema Único de Saúde) in Brazil. METHODS: The study included 107 individuals with BD in a current mixed episode, assessed biweekly for the outcomes of response and remission. The subjects were randomly assigned to start treatment with lithium, valproic acid, or carbamazepine, following a clinical protocol at a public outpatient clinic. Eligibility screening instruments, semistructured interview, and clinical psychiatric evaluation were used for diagnosis. To measure response and remission, the Hamilton Rating Scale for Depression and the Young Mania Rating Scale were used. A parameter of 50% or less in the symptom scales was used to define responses, as assessed by Kaplan-Meier time-event analysis. RESULTS: For the main outcome, response to treatment, all interventions proposed were proven to be effective, with no difference in response time for any of them. There was a lack of placebo control and blinding for intervention or outcomes. Individuals with mixed episodes in BD often face contradictory symptoms, and these inherent difficulties are the main obstacles to stabilize such a condition. CONCLUSIONS: The findings presented in this study show that the treatments available under the Unified Health System are able to reduce the overall burden of disease in terms of symptom reduction.

Psychometric properties of the EUROHIS-QOL 8-item index (WHOQOL-8) in a Brazilian sample

Objective: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample. Methods: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested. Results: Reliability showed good internal consistency (Cronbach's alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EUROHIS-QOL 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOL 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24). Conclusion: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.

Can Religious Coping and Depressive Symptoms Predict Clinical Outcome and Quality of Life in Panic Disorder? A Brazilian Longitudinal Study.

Few studies have investigated the relationship between spiritual/religious coping (S/R coping) and panic disorder (PD). This Brazilian longitudinal study evaluated if S/R coping and depressive symptoms can predict PD remission and improved quality of life (QoL). There were 101 outpatients with PD who were followed up for 12 to 16 weeks. The prevalence ratio (PR) between positive S/R coping and negative S/R coping and PD remission was assessed, as well as the association between positive S/R coping and negative S/R coping and QoL. After adjusting for confounding factors, positive S/R coping presented an inverse PR with PD remission, which was not statistically significant (0.88; p = 0.075). There was no association between S/R coping and QoL. Depressive symptoms were negatively associated with PD remission (PR = 0.97; p < 0.01) and were not predictive of a better QoL.

Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies.

OBJECTIVE: The authors examined the prospective relationship between physical activity and incident depression and explored potential moderators. METHOD: Prospective cohort studies evaluating incident depression were searched from database inception through Oct. 18, 2017, on PubMed, PsycINFO, Embase, and SPORTDiscus. Demographic and clinical data, data on physical activity and depression assessments, and odds ratios, relative risks, and hazard ratios with 95% confidence intervals were extracted. Random-effects meta-analyses were conducted, and the potential sources of heterogeneity were explored. Methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS: A total of 49 unique prospective studies (N=266,939; median proportion of males across studies, 47%) were followed up for 1,837,794 person-years. Compared with people with low levels of physical activity, those with high levels had lower odds of developing depression (adjusted odds ratio=0.83, 95% CI=0.79, 0.88; I2=0.00). Furthermore, physical activity had a protective effect against the emergence of depression in youths (adjusted odds ratio=0.90, 95% CI=0.83, 0.98), in adults (adjusted odds ratio=0.78, 95% CI=0.70, 0.87), and in elderly persons (adjusted odds ratio=0.79, 95% CI=0.72, 0.86). Protective effects against depression were found across geographical regions, with adjusted odds ratios ranging from 0.65 to 0.84 in Asia, Europe, North America, and Oceania, and against increased incidence of positive screen for depressive symptoms (adjusted odds ratio=0.84, 95% CI=0.79, 0.89) or major depression diagnosis (adjusted odds ratio=0.86, 95% CI=0.75, 0.98). No moderators were identified. Results were consistent for unadjusted odds ratios and for adjusted and unadjusted relative risks/hazard ratios. Overall study quality was moderate to high (Newcastle-Ottawa Scale score, 6.3). Although significant publication bias was found, adjusting for this did not change the magnitude of the associations. CONCLUSIONS: Available evidence supports the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region.

Psychometric properties of the EUROHIS-QOL 8-item index (WHOQOL-8) in a Brazilian sample.

OBJECTIVE: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample. METHODS: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested. RESULTS: Reliability showed good internal consistency (Cronbach's alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EUROHIS-QOL 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOL 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24). CONCLUSION: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.