Measurement equivalence of PROMIS depression in Spain and the United States.

In this study, we assessed the psychometric properties of the Spanish Patient-Reported Outcomes Measurement Information System (PROMIS) Depression in an adult population-representative sample from Spain (n = 1,503). We tested unidimensionality and local independence item response theory (IRT) assumptions with confirmatory factor and bifactor models under the exploratory structural equations modeling framework. We evaluated item monotonicity assumption with Mokken scaling analysis. We calibrated the items with an IRT-graded response model and assessed score reliability and test information, and evidence of validity with regard to scores on external measures. To examine differential item functioning by age, sex, education, and country (United States vs. Spain, N = 2,271), we used ordinal logistic regression. Results support compliance with IRT assumptions. We found few signs of differential item functioning: Only one item showed country differential functioning between the United States (n = 768) and Spain, with minimal impact on the overall score. Information values were equivalent to reliabilities over 0.90 from -1 (low depression) to +4 SD (high depression) around the population score mean. Evidence of validity in relation to concurrent measures was supported by the expected correlation pattern with external variables of depression, but higher than expected correlations with anxiety were found. Results indicate that the Spanish version of PROMIS Depression is adequate for assessing and monitoring depression levels in the general population and that PROMIS Depression is especially suitable for cross-national comparisons. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

La salud mental digital. Una aproximación crítica desde la ética / Digital mental health: a critical approach from ethics

El empleo de aparatos electrónicos en salud mental no es algo nuevo. Desde que se iniciaron los procesos de industrialización y maquinización del trabajo a mediados del pasado siglo, su desarrollo no ha cesado y su extensión se ha multiplicado a todos los ámbitos. El uso de aparatos electrónicos en el campo de la salud mental se ha producido de diversas formas. Sus aplicaciones abarcan la evaluación, el tratamiento, el autocuidado y la automonitorización de las personas diagnosticadas de algún trastorno mental. El uso de dispositivos tecnológicos de última generación ha producido algunos cambios sensibles tanto en los procesos de atención como en los efectos sobre los sujetos que participan del entramado sanitario. El artículo se propone revisar de forma crítica estos aspectos: por un lado, los efectos habitualmente reportados en los múltiples estudios realizados hasta el momento; y, por otro, y mucho menos estudiados, los efectos producidos por las nuevas prácticas sobre las subjetividades en juego

The use of electronic devices in mental health is not something new. Since the beginning of the processes of industrialization and mechanization of work in the middle of the last century, its development has not ceased and It has greatly expanded Into all areas. The use of electronic devices in the field of mental health has occurred in several ways. The scope of its applications includes the evaluation, treatment, self-care, and self-monitoring of people diagnosed with a mental disorder. The use of state-of-the-art technological devices has produced some sensible changes both in the assistance processes and in the effects on the subjects that participate in the health network. The article proposes to critically review these aspects: on the one hand, the effects usually reported in the multiple studies carried out so far; and, on the other, and much less studied, the effects produced by the new practices on the subjectivities in play

Cambios formales en la entrevista psiquiátrica. ¿Qué hay de fondo? / Formal changes in the psychiatric interview. What’s the background?

En psiquiatría, más que en ninguna otra especialidad médica, el encuentro médico-paciente es el centro del proceso diagnóstico y terapéutico. Lo es por las propias peculiaridades del objeto de su estudio, la subjetividad. La actual perspectiva neopositivista en la epistemología de los síntomas mentales y neoliberal en la gestión de los servicios que se ocupan de lo psiquiátrico se han generalizado. De aquí se pueden derivar cambios fundamentales en diversos aspectos formales de la entrevista psiquiátrica que por fuerza afectan al contenido del acto médico. El lugar y tiempo empleados para hacer la entrevista, el entrevistador, la forma de entrevistar y la organización que provee el servicio y dispone los medios para la entrevista son algunos de ellos (AU)

This article is a theoretical discussion focused on the philosophical and economical issues that affect the clinical environment. It is claimed that the manner in which psychiatry’s object is regarded, as well as the management of public services, has a direct impact on the diagnostic process and therapeutical interventions. Because of the special features of psychiatry’s object, which is subjectivity, the clinical encounter with the patient is at the center of the diagnostic and therapeuthic process. The current neopositivistic view on the epistemology of mental symptoms, as well as the neoliberal way of managing psychiatric services, has spread and generalized. They have brought about fundamental changes in different formal aspects of the psychiatric interview that have an effect on the medical act. Some of these formal aspects include when and where to conduct the interview, the requested interviewer characteristics, the method of interviewing and the kind of organization that provides the services as well as manages the resources (AU)

La simplificación neopositivista del lenguaje de la psicopatología desde una perspectiva post-wittgensteiniana / Postwittgensteinian perspective on the neopositivistic oversimp lification of psychopathological language

La deriva neopositivista y operacional en psiquiatría se ha acompañado de un recorte de la terminología psicopatológica. El criterio de selección seguido, consistiría en conservar solamente aquellos términos que se refieran a fenómenos mentales cuyas descripciones puedan ser reducidas al menor nivel posible de inferencia, a descripciones del comportamiento externo o incluso a un lenguaje ordinario. En relación a este criterio, se discuten cuatro cuestiones desde una perspectiva post-wittgensteiniana: la posibilidad de un lenguaje observacional puro, la ausencia de un marco teórico único en la psicopatología, la presencia de metáforas y analogías en el lenguaje de la psicopatología y la discusión acerca de si las distinciones que establece la psicopatología representan entidades naturales (AU)

Neopositivism and operationalism in psychiatry has promoted a simplification of the psychopathological language. According to its selection criteria, the psychopathological terms that should be kept are those whose descriptions can be done in the lowest possible level of inference, in descriptions of external behavior, or else in simple lay language. Four issues are discussed in relation to this criteria from a post-wittgensteinian perspective: the possibility of a pure observational language, the absence of a unique theoretical framework in psychopathology, the presence of methapors and analogies as well as the question about the representational nature of the psychopathological language (AU)