Gender differences in quality of life and the course of schizophrenia: national study.

BACKGROUND: Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly. AIMS: To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia. METHOD: The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort. RESULTS: A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93-0.99; adjusted HR = 0.96, 95% CI 0.93-0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93-1.02; adjusted HR = 0.97, 95% CI 0.93-1.02). CONCLUSIONS: Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.

Croatian Version of the Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50): Cross-Cultural Adaptation and Psychometric Evaluation.

(1) Background: Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) was originally designed for Spanish-speaking regions, and translations validated for several languages. The aim of the study was to adapt and verify the psychometric characteristics of SAHLSA-50 in the Croatian context; (2) Methods: The cross-sectional study included 590 respondents from the general population older than 18 years of age. Health literacy was measured by two scales: SAHLCA-50 and the Croatian version of the Newest Vital Sign screening test (NVS-HR), which was used as a measure of concurrent validity. Subjective Health Complaints (SHC) and Satisfaction with Life Scale (SWLS) questionnaires were also used to assess convergent validity; (3) Results: Internal consistency reliability of SAHLCA-50 was high and corresponds to the findings of the authors of the original research. The Cronbach alpha coefficient for SAHLCA-50 version was 0.91. The correlation of SAHLCA-50 with the NVS-HR test speaks in favor of concurrent validity. Correlation between health literacy and SHC speaks for convergent validity, just as was expected, while correlation with life satisfaction was not observed; (4) Conclusions: The SAHLCA-50 test can be a good and quick tool to assess health literacy of the adult population in the Croatian language. HL can affect the health and quality of life of the individual and the wider community.

Psychometric evaluation of the Hamburg Nightmare Questionnaire (HNQ).

Background: Nightmares are a widespread phenomenon. In comparison to the general population, they occur in mentally ill and especially in traumatized individuals with an increased frequency. Despite the high prevalence, there is no short questionnaire in the German language that is able to characterize nightmares, to differentiate between different nightmare types and to assess their impact on daytime functioning. Objective: The Hamburg Nightmare Questionnaire (HNQ) has been developed as a short self-rating instrument to fill this gap. Method: Psychometric characteristics of the HNQ were evaluated in a sample of 707 German soldiers passing through the standard diagnostics of the Center for Mental Health at the German Armed Forces Hospital Hamburg. Results: The results of this study show satisfactory psychometric characteristics as a sound factorial structure and adequate internal consistency for the HNQ as well as initial indications of the construct validity of its subscales. Conclusions: The HNQ is a reliable and economic tool for the assessment of posttraumatic nightmares in clinical as well as research settings.

Antecedentes: Las pesadillas son un fenómeno ampliamente generalizado. En comparación con la población general, las pesadillas ocurren con una mayor frecuencia en personas con enfermedad mental y, especialmente, en personas traumatizadas. A pesar de su alta prevalencia, no existe ningún cuestionario breve en idioma alemán que sea capaz de caracterizar las pesadillas, diferenciarlas en tipos, y evaluar su impacto sobre la funcionalidad durante el periodo de vigilia.Objetivo: Se desarrolló el Cuestionario de Pesadillas de Hamburgo (HNQ, por sus siglas en inglés) como un instrumento de valoración breve auto-aplicado para subsanar esta brecha.Método: Se evaluaron las características psicométricas del HNQ a partir de una muestra de 707 soldados alemanes que eran sometidos a los diagnósticos estándar del Centro para la Salud Mental del Hospital de Hamburgo de las Fuerzas Armadas Alemanas.Resultados: Los resultados de este estudio mostraron características psicométricas satisfactorias, tales como una firme estructura factorial y una adecuada consistencia interna para el HNQ, así como indicadores iniciales de la validez del constructo de sus subescalas.Conclusiones: El HNQ es una herramienta confiable y económica para la evaluación de pesadillas postraumáticas tanto en el ámbito clínico como en el de investigación.

Short Assessment of Health Literacy (SAHL) in Portugal: development and validation of a self-administered tool.

The goal of this study was to adapt, improve and validate a short, self-administered health literacy assessment tool for European Portuguese-speaking adults. Health literacy tools are of great importance to health authorities and professionals, as low or inadequate health literacy, that is, a limited capacity to handle health-related information, is associated with higher morbidity and mortality. The 18-item Short Assessment of Health Literacy for Brazilian Portuguese-speaking adults (SAHLPA-18) was adapted into European Portuguese. The European Portuguese tool (SAHLPA-23) includes five additional items. The SAHLPA-23 was tested in a convenience sample of 503 participants from two Portuguese regions. Socio-demographic data, literacy and cognitive indicators were collected. Participants also completed a questionnaire on comprehension of written health materials. Construct validity was assessed through correlations between SAHLPA-23 scores and education, literacy, and cognitive variables and score on the comprehension questionnaire. The psychometric properties of the new tool were compared with those of the SAHLPA-18. The mean SAHLPA-18 and SAHLPA-23 scores were 13.9 (77.2%; SD=2.9) and 18.3 (79.6%; SD=3.8), respectively. Both tools showed adequate reliability (Cronbach's α>0.7). SAHLPA-23 was more highly correlated with all study variables than SAHLPA-18. Although both instruments displayed acceptable discriminative power, SAHLPA-23 had better accuracy than SAHLPA-18 (DeLong's method: ΔAUC=0.09, Z=3.36; P<0.001). The SAHLPA-23 is an independent, feasible and innovative tool for estimation of health literacy in the Portuguese adult population.

18REST: a short RIASEC-interest measure for large-scale educational and vocational assessment.

The construction of the 18REST, a short 18-item inventory to describe students' position on John Holland's RIASEC interest types, is documented. The instrument is meant to be used in large-scale assessment in education and on the labor market, supplementing information on school achievement and social-emotional skills. This research was carried out in Brazil, initially with two independent samples composed by adolescents and adults. The 18REST's psychometric properties are compared to those of the more extended RIASEC item pool and confirmed in a new independent undergraduate sample. Despite differences between genders were found as expected, invariance measurement across gender was indicated. Different ways to use the 18REST in large-scale assessment are discussed.

18REST: a short RIASEC-interest measure for large-scale educational and vocational assessment

Abstract The construction of the 18REST, a short 18-item inventory to describe students' position on John Holland's RIASEC interest types, is documented. The instrument is meant to be used in large-scale assessment in education and on the labor market, supplementing information on school achievement and social-emotional skills. This research was carried out in Brazil, initially with two independent samples composed by adolescents and adults. The 18REST's psychometric properties are compared to those of the more extended RIASEC item pool and confirmed in a new independent undergraduate sample. Despite differences between genders were found as expected, invariance measurement across gender was indicated. Different ways to use the 18REST in large-scale assessment are discussed.

Blended internet care for patients with severe mental illnesses: An open label prospective controlled cohort pilot study.

INTRODUCTION: This paper reports first experiences while providing blended (combined face-to-face and internet-based) flexible assertive community treatment (FACT) to outpatients with severe mental illnesses (SMI). The aim was to compare treatment satisfaction, clinical outcome and quality of life in the short term (3 months) of patients receiving blended FACT with those receiving conventional FACT. METHOD: This pilot study was designed as an open label prospective controlled cohort study. 47 SMI patients were found eligible and non-randomly allocated to Blended FACT (n = 25) or to conventional FACT (n = 22). Data were collected at baseline and at a 3-month follow-up. Measures included were the Dutch Mental Health Care Thermometer, Health of the Nation Outcome Scales (HONOS), Manchester Short Assessment of Quality of Life (MANSA), EuroQoL 5 dimensional (EQ5D) and the Mental Health Confidence Scale (MHCS). RESULTS: At a three months follow-up, patients reported slightly improved quality of life (EuroQoL 5 dimensional, Wald χ2(1) = 6.80, p = 0.01; MANSA, Wald χ2(1) = 4.02, p = 0.05) and self-efficacy beliefs regarding their mental health problems (MHCS, Wald χ2(1) = 3.71, p = 0.05). HONOS scores did not change over time, Wald χ2(1) = 2.34, p = 0.13. Satisfaction scores were on average between satisfactory - good (BI: M = 7.50, SD = 1.54; CAU: M = 7.53 SD = 0.96; on a 1-10 scale). These results did not differ between the two study groups. CONCLUSION: It appears acceptable to patients to provide blended FACT with SMI, with outcomes comparable to face-to-face FACT. A future high quality trial is warranted to establish (cost-)effectiveness of blended FACT.

Psychiatric morbidity, functioning and quality of life in young people at clinical high risk for psychosis.

OBJECTIVE: Recent studies suggest that psychotic-like experiences may also act as markers for non-psychotic psychiatric disorders, which may indicate that the focus of research in individuals at high risk (HR) for psychosis needs updating. In this study we thoroughly examined the clinical and functional characteristics of a consecutive cohort of young people at HR for psychosis and compared them to a matched sample of healthy volunteers. METHOD: Between February 2010 and September 2012 60 help-seeking HR individuals, aged 16-35, were recruited from CAMEO Early Intervention in Psychosis Service, Cambridgeshire, UK. Forty-five age- and gender-matched healthy volunteers were randomly recruited from the same geographical area. Sociodemographic, psychiatric morbidity, functioning and quality of life measures were compared between both groups. RESULTS: HR individuals suffered a wide range of DSM-IV psychiatric disorders, mainly within the affective and anxiety diagnostic spectra. In comparison to healthy volunteers, young people at HR reported more suicidal ideation/intention, depressive and anxiety symptoms and presented with remarkably poor functioning and quality of life. CONCLUSION: The presence of co-morbid moderate or severe depressive and anxiety symptoms was common in our sample of young people at enhanced risk for psychosis. A HR mental state may be associated not only with an increased risk for psychosis, but also other psychiatric disorders. Our findings may have implications for the future implementation of therapeutic interventions that this population could benefit from.