Consideraciones sobre la psicoprofilaxis obstétrica familiar / Considerations on the family obstetric psycoprophylaxis

RESUMEN El gran desarrollo del programa materno infantil en Cuba y la gran atención que a este se brinda hace que muchos médicos limitan a la embarazada al reposo y todavía hay muchas mujeres que se enfrentan al parto sin un entrenamiento previo. Por la importancia de este tema en materia de salud materno infantil se realizó esta revisión bibliográfica con el propósito de aumentar el nivel de conocimientos de los profesionales sobre los beneficios de la misma y lograr un trabajo en equipo del personal que integre el programa, para de esta manera, conseguir el máximo beneficio para las madres, bebés y sus familias. Está demostrado que le hace bien a la mujer embarazada y al bebé. Una gestante preparada es una gestante colaboradora. Por tanto, el entrenamiento junto a hábitos sanos de vida conllevara a que la embarazada tenga un parto en las mejores condiciones físicas y psíquicas, para de esta forma lograr un hijo sano, fuerte y una gran gratificación para toda la familia. La participación activa del padre conseguirá mayor armonía familiar (AU).

SUMMARY The great development of the maternal-infantile program in Cuba and the great attention provided to this, leads to the limitation of pregnant women to rest by doctors, and there are still many women facing the childbirth without a previous training. Due to the importance of this topic in the matter of maternal-infantile health, the authors carried out the current bibliographical review with the purpose of increasing the level of the professionals' knowledge about its benefits and of achieving a team work of the staff integrating the program, and that way, to get the maximum benefit for mothers, babies and their families. It is proved that it makes well to pregnant woman and to the baby. A trained pregnant woman is a collaborative pregnant woman. Therefore, training together with healthy life habits leads pregnant women to childbirth in the better physical and health conditions, delivering this way a healthy, strong child and achieving a great gratification for the whole family. The father's active participation will get bigger family harmony (AU).

Establishing reliability and validity for mental health screening instruments in resource-constrained settings: Systematic review of the PHQ-9 and key recommendations.

Mental illness is one of the largest contributors to the global disease burden. The importance of valid and reliable mental health measures is crucial in order to accurately measure said burden, to capture symptom improvement, and to ensure that symptoms are appropriately identified and quantified. This is of particular importance in low and middle-income countries (LMICs), where the burden of mental illness is relatively high, and there is heterogeneity in linguistic, racial, and ethnic groups. Using the PHQ-9 as an illustrative example, this systematic review aims to provide an overview of existing work and highlight common validation and reporting practices. A systematic review of published literature validating the use of the PHQ-9 in LMICs as indexed in the PubMed and PsychInfo databases was conducted. The review included n = 49 articles (reduced from n = 2,349). This manuscript summarizes these results in terms of the frequency of reporting on important procedures and in regards to the types of reliability and validity measured. Then, building off of the existing literature, we provide key recommendations for measure validation in LMICs, which can be generalized for any type of measure used in a setting in which it was not initially developed.

Brazilian Vegetarian Population-Influence of Type of Diet, Motivation and Sociodemographic Variables on Quality of Life Measured by Specific Tool (VEGQOL).

The adoption of a vegetarian diet has been associated with positive health outcomes. However, few studies evaluate the effect of this eating pattern on quality of life. Moreover, no specific instrument for the vegetarian population to measure the quality of life is available worldwide. Therefore, this study aimed to elaborate and validate a specific questionnaire to measure the quality of life in vegetarians. The Specific Vegetarian Quality of Life Questionnaire (VEGQOL) was constructed based on other instruments and studies related to vegetarianism. The content and semantic validation were performed by a group of experts, followed by a pilot study to evaluate the questionnaire acceptability and reproducibility. Discriminant validation was tested using the WHOQOL as the gold standard measure (Pearson correlation ranging from 0.302 of the domain 3 to 0.392 of the domain 2). Afterward, a nationwide survey was conducted using VEGQOL. Content and semantic validation selected 19 of the initial 30 items. VEGQOL presented good reproducibility (Cohen's Kappa coefficient ranging from 0.361 to 0.730 and intraclass correlation coefficient of 0.820) and internal consistency (0.708), both adequate to evaluate the quality of life in vegetarians. The sample size (n = 5014 individuals, error of 3% at a level of significance of 5%) and distribution was representative of the Brazilian vegetarian population. In general, the quality of life of Brazilian vegetarians was considered satisfactory (VEGQOL cut off points 70-80). Among different types of vegetarians, the vegans showed better results with a VEGQOL mean value of 79.2 ± 10.7. Older individuals, the ones who adopted the diet for a longer time (VEGQOL mean value of 75.8 ± 12.7) and the ones who had other vegetarians in their social network (VEGQOL mean value of 74.6 ± 12.2) also had a better quality of life score. Individuals who adopted it for ethical or health reasons had a higher quality of life score. The questionnaire produced in this study is a useful tool for future research in this area. Results were better for vegans and for the ones who adopt the diet for ethical or health reasons.

[Introduction to symptom networks in psychopathology]. / Introduction aux réseaux de symptômes en psychopathologie.

In this article, we present the main methodological principles of symptom networks in psychopathology. It is a topological approach linking entities from different scales of analysis of an individual (from genetics to behavior, via cerebral connectivity). They are an alternative to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and Research Domain Criteria (RDoC), but they do not exclude them. Symptom networks exceed or circumvent some limits of these classifications. Furthermore, they contribute to the stratification and organization of these nosologies. Behind the originality of its methodology, this program proposes a redefinition of mental illness which modifies the conception of psychiatry. But their future is still uncertain: they must take on an epistemological and methodological challenge. At the same time, they have to convince the community of mental health researchers and clinicians of their utility and value.

TITLE: Introduction aux réseaux de symptômes en psychopathologie. ABSTRACT: Nous présentons dans cet article les grands principes méthodologiques des réseaux de symptômes en psychopathologie. Ceux-ci pourraient constituer une approche alternative au manuel diagnostique et statistique des troubles mentaux (DSM) et aux Research Domain Criteria (RDoC), sans les exclure pour autant. Les réseaux de symptômes dépassent ou contournent certaines limites de ces classifications, mais leur avenir est encore incertain : ils devront relever des défis épistémologiques et méthodologiques, tout en parvenant à convaincre la communauté de chercheurs et de cliniciens en santé mentale de leur utilité et de leur qualité.

A Brief Measure of Unbearable Psychache.

OBJECTIVE: Psychache has been proposed to cause suicide when it becomes unbearable. However, existing measures of psychache do not directly target unbearable psychache. Thus, the purpose of the current study was to provide initial validation for a brief measure of unbearable psychache. METHOD: Three items were selected to create the Unbearable Psychache Scale (UP3). Psychometric properties were assessed in two populations: (1) an online sample composed of 1,006 adults (53% male) from various locations in the United States and (2) a sample of 190 psychiatric inpatient adults (47% male) from a hospital in Western Canada. RESULTS: In both samples, the UP3 demonstrated excellent internal reliability, and strong convergent and predictive validity. Additionally, the UP3 predicted significant variance in suicidal ideation over and above documented correlates of suicidal ideation including general psychache, hopelessness, perceived burdensomeness, and low belongingness. CONCLUSIONS: The UP3 is a brief, psychometrically sound measure of unbearable psychache that may be well-suited for use in research protocols and clinical assessments.

Final year pre-registration student nurses perceptions of which taught theoretical knowledge is important for practice.

This research illuminates the perceptions of eighteen final year undergraduate pre-registration student nurses, to understand what theoretical knowledge was perceived to be useful during their pre-registration nursing education, and what was not. The research adopted a qualitative phenomenological approach, and utilised a sample size of eighteen final year student nurses as the data source. The data collection method consisted of semi-structured interviews and the study took place at a Higher Education Institution within the North West of England approved to provide pre-registration nurse education. Participants provided their data during their final year of their undergraduate pre-registration nursing programme, via semi-structured, digitally recorded interviews, which were transcribed verbatim. The transcribed interviews were then analysed using Interpretive Phenomenological Analysis. The findings generated three themes, these were; important knowledge to learn for everyday practice, irrelevant for my future role, and, can we have some more? Findings demonstrate what aspects of the taught curriculum student nurses perceive to be of use to their practice, and why they perceive this to be the case. This affects how student nurses approach their learning during their nursing education. In addition it was clear what participants perceived was not useful for their practice and why this was the case. Additionally, participants offered suggestions of what they would also like adding to their curriculum, and provided insights for what they would like adding to the curriculum, which can be used for enhancing this. This is useful when developing future curricula to understand which aspects student nurses learn in a deep and superficial way. This can provide a useful insight for to ensure that patient care is not compromised.

Implicit Cognitions as a Behavioral Marker of Suicide Attempts in Adolescents.

Using self-harm Implicit Association Tests (IATs), we sought to test whether (1) suicidal adolescents show implicit identification with self-harm and whether (2) IATs are reliable and sensitive to psychiatric change and (3) predict future suicide attempts. We administered 6 self-harm IATs to 71 adolescents from a psychiatric inpatient unit and assessed suicidal behaviors at admission, discharge and 3 months after discharge. Results were in the expected direction for each IAT but not statistically significant. After aggregating trials across IATs, suicide attempters showed increased implicit identification with self-harm, compared with non-suicidal controls. IATs showed good reliability and sensitivity to psychiatric change but did not prospectively predict suicide attempts. Adolescent suicide attempters may have stronger implicit associations with self-harm than non-suicidal controls.

Calibrating facial morphs for use as stimuli in biological studies of social perception.

Studies of human social perception become more persuasive when the behavior of raters can be separated from the variability of the stimuli they are rating. We prototype such a rigorous analysis for a set of five social ratings of faces varying by body fat percentage (BFP). 274 raters of both sexes in three age groups (adolescent, young adult, senior) rated five morphs of the same averaged facial image warped to the positions of 72 landmarks and semilandmarks predicted by linear regression on BFP at five different levels (the average, ±2 SD, ±5 SD). Each subject rated all five morphs for maturity, dominance, masculinity, attractiveness, and health. The patterns of dependence of ratings on the BFP calibration differ for the different ratings, but not substantially across the six groups of raters. This has implications for theories of social perception, specifically, the relevance of individual rater scale anchoring. The method is also highly relevant for other studies on how biological facial variation affects ratings.

Implementing the International Committee on Mental Health in Cystic Fibrosis (ICMH) guidelines: Screening accuracy and referral-treatment pathways.

BACKGROUND: The International Committee on Mental Health (ICMH) published screening guidelines in Cystic Fibrosis (CF). This work 1) evaluated the sensitivity of the recommended screening tools against the 'gold standard' clinical psychological assessment and 2) investigated referral and treatment pathways. METHODS: Ninety-six participants (79 caregivers; 17 adolescents with CF) completed the screening tools prior to formal assessment. Agreement between screening data and psychological assessment was evaluated, sensitivity analyses performed and referral pathways tracked. RESULTS: All participants with an elevated screen (moderate/severe range) were subsequently assessed as requiring treatment for major depression/anxiety disorders. However, many were referred for treatment without elevated scores. Hence, sensitivity was poor with the recommended threshold score of 10, but with a threshold of 5 the sensitivity was 76% for adults and 46% for adolescents. The area under the ROC curve (diagnostic test ability) was 0.89 for caregivers but lower at 0.68 for adolescents. CONCLUSION: Mental health screening is complex, particularly in adolescents. Nonetheless, it is a first valuable step to improve mental health care in CF. The need for psychological support is greater than anticipated by the TIDES study.

Quality science from quality measurement: The role of measurement type with respect to replication and effect size magnitude in psychological research.

The quality of psychological studies is currently a major concern. The Many Labs Project (MLP) and the Open-Science-Collaboration (OSC) have collected key data on replicability and statistical effect sizes. We build on this work by investigating the role played by three measurement types: ratings, proportions and unbounded (measures without conceptual upper limits, e.g. time). Both replicability and effect sizes are dependent on the amount of variability due to extraneous factors. We predicted that the role of such extraneous factors might depend on measurement type, and would be greatest for ratings, intermediate for proportions and least for unbounded. Our results support this conjecture. OSC replication rates for unbounded, 43% and proportion 40% combined are reliably higher than those for ratings at 20% (effect size, w = .20). MLP replication rates for the original studies are: proportion = .74, ratings = .40 (effect size w = .33). Original effect sizes (Cohen's d) are highest for: unbounded OSC cognitive = 1.45, OSC social = .90); next for proportions (OSC cognitive = 1.01, OSC social = .84, MLP = .82); and lowest for ratings (OSC social = .64, MLP = .31). These findings are of key importance to scientific methodology and design, even if the reasons for their occurrence are still at the level of conjecture.

The Low-Event Task Subjective Situation Awareness (LETSSA) technique: Development and evaluation of a new subjective measure of situation awareness.

Situation awareness (SA) is an important component of an individual's ability to function in a complex environment. As such, it is essential to have effective measures of an individual's SA. The most widely used subjective measure of SA is the Situation Awareness Rating Technique [SART]. However, SART has been criticised for not predicting performance or objective SA, and being highly correlated with workload. This paper describes the development and testing of a new subjective measure of SA, the Low-Event Task Subjective Situation Awareness (LETSSA) measure. To evaluate LETSSA a train simulator study was conducted with 23 novice and 26 expert freight train drivers. LETSSA was able to detect differences in manipulated SA and was comparable to an established objective SA measure (SAGAT). LETSSA was significantly associated with performance but not significantly associated with workload. While further validation is required, LETSSA shows promise as an effective subjective measure of SA.

Análisis psicométrico de la Escala de Afecto Positivo y Negativo (PANAS) en mujeres sobrevivientes de cáncer de mama / Positive and Negative Affection Scale (PANAS) in Women Who Survived Breast Cancer

Objetivo: Determinar las propiedades psicométricas de la Escala de Afectos Positivos y Negativos (PANAS), en una muestra de mujeres sobrevivientes de cáncer de mama. Métodos: Se trabajó con una muestra no probabilística intencional conformada por 115 personas. Se realizó el análisis de la confiabilidad y validez del instrumento. Para el procesamiento de los datos se empleó la estadística descriptiva, pruebas no paramétricas (Tau-b de Kendall, U de Mann Whitney), así como técnicas específicas para el análisis factorial exploratorio. Resultados: Se obtuvieron dosfactores (afecto positivo y afecto negativo) que, agruparon los ítems correspondientes a una y otra escala de modo claro y diferenciado. Dos ítems obtuvieron bajas cargas factoriales (temeroso y alerta). La confiabilidad para la escala estado, fue: afecto positivo=.91 y afecto negativo=.82, y para rasgo: afecto positivo =.91 y afecto negativo=.84. Conclusiones: La Escala de Afectos Positivos y Negativos, mostró excelentes propiedades psicométricas que coinciden con reportes de estudios similares, así como la versión original. Se recomienda que los ítems que obtuvieron bajas cargas factoriales sean modificados con vistas a otros procesos de adaptación y validación(AU)

Objective: Determine the psychometric qualities of Positive and Negative Affection Scale (PANAS) in a sample of women who survived breast cancer. Methods: The current study used a non- probabilistic intentional sample composed of 115 people. The analysis of reliability and validity of the instrument was carried out. Descriptive statistics, non-parametric tests (Kendalls Tau-b, Mann Whitneys U), as well as specific techniques for the exploratory factorial analysis were used for data processing. Results: Two factors (positive affection and negative affection) were found, which put the correspondent items of each scale into groups, in a differentiated clear way. Two items got low factorial associations (frightened and alert). The reliability for the state scale was: positive affection = .91, and negative affection = .82, and for feature: positive affection = .91, and negative affection = .84. Conclusions: The Positive and Negative Affection Scale showed excellent psychometric qualities which coincide with similar studies reported, as well as with the original version. It is recommended that those items which got low factorial associations should be modified with a view to other adaptation and validity processes(AU)

Caracterización psicológica de escolares con diabetes mellitus tipo 1 a través de sus representaciones gráficas / Psychological characterization of school children with type 1 diabetes mellitus through graphic representations

Introducción: la diabetes mellitus tipo 1 constituye una enfermedad crónica que afecta la salud física del paciente y su funcionamiento psicológico y social.Objetivo: caracterizar psicológicamente a 30 escolares con diabetes mellitus tipo 1, de la provincia de Pinar del Río, Cuba, a través de sus representaciones gráficas.Métodos: se realizó una investigación de tipo exploratoria-descriptiva, metodología cualitativa y cuantitativa. El diseño de investigación fue no experimental y transversal, con el empleo del método clínico y técnicas como la revisión de las historias clínicas, las entrevistas sociopsicológicas, la observación y las técnicas proyectivas.Resultados: se constató presencia de angustia, autoestima disminuida, rasgos obsesivos, ansiedad, inhibición de la respuesta emocional, estrés, dificultades en la comunicación y en el contacto físico con los amigos y familiares. Se sintieron hipervigilados, controlados y monitoreados por las personas que los rodean.Conclusiones: el dibujo constituye un medio de expresión de las características psicológicas de la muestra, emergen alteraciones en la esfera emocional, además de la existencia de redes sociales que se constituyen en fortalezas, pero que no llegan a convertirse en factores de protección para el desarrollo de la capacidad de resiliencia(AU)

Introduction: type 1 diabetes mellitus is a chronic disease that affects physical health of the patient and his/her social psychological functioning.Objective: to psychologically characterize 30 school children with type 1 diabetes mellitus from Pinar del Rio province, Cuba through graphic representations.Methods: exploratory-descriptive type research study using the qualitative and quantitative methodology. The research design was non-experimental cross-sectional and used the clinical method and techniques such as medical history checking, socio-psychological interviews, observation and projective techniques.Results: presence of anguish, low self-esteem, obsession, anxiety, inhibited emotional response, stress, and difficulties in communication and physical contact with friends and relatives was observed. They felt excessively watched, controlled and monitored by surrounding people.Conclusions: drawing is a way of expression of the psychological characteristics of the sample; alterations in the emotional area emerge in addition to the existence of social networks that represent strengths but do not finally become protective factors for the development of the resilience capacity(AU)

Caracterización psicológica de escolares con diabetes mellitus tipo 1 a través de sus representaciones gráficas / Psychological characterization of school children with type 1 diabetes mellitus through graphic representations

Introducción: La diabetes mellitus tipo 1 constituye una enfermedad crónica que afecta la salud física del paciente y su funcionamiento psicológico y social. Objetivo: caracterizar psicológicamente a 30 escolares con diabetes mellitus tipo 1, de la provincia de Pinar del Río, Cuba, a través de sus representaciones gráficas.Métodos: se realizó una investigación de tipo exploratoria-descriptiva, metodología cualitativa y cuantitativa. El diseño de investigación fue no experimental y transversal, con el empleo del método clínico y técnicas como la revisión de las historias clínicas, las entrevistas sociopsicológicas, la observación y las técnicas proyectivas.Resultados: se constató presencia de angustia, autoestima disminuida, rasgos obsesivos, ansiedad, inhibición de la respuesta emocional, estrés, dificultades en la comunicación y en el contacto físico con los amigos y familiares. Se sintieron hipervigilados, controlados y monitoreados por las personas que los rodean.Conclusiones: el dibujo constituye un medio de expresión de las características psicológicas de la muestra, emergen alteraciones en la esfera emocional, además de la existencia de redes sociales que se constituyen en fortalezas, pero que no llegan a convertirse en factores de protección para el desarrollo de la capacidad de resiliência(AU)

Introduction: Type 1 diabetes mellitus is a chronic disease that affects physical health of the patient and his/her social psychological functioning.Objective: to psychologically characterize 30 school children with type 1 diabetes mellitus from Pinar del Rio province, Cuba through graphic representations.Methods: exploratory-descriptive type research study using the qualitative and quantitative methodology. The research design was non-experimental cross-sectional and used the clinical method and techniques such as medical history checking, socio-psychological interviews, observation and projective techniques.Results: presence of anguish, low self-esteem, obsession, anxiety, inhibited emotional response, stress, and difficulties in communication and physical contact with friends and relatives was observed. They felt excessively watched, controlled and monitored by surrounding people.Conclusions: drawing is a way of expression of the psychological characteristics of the sample; alterations in the emotional area emerge in addition to the existence of social networks that represent strengths but do not finally become protective factors for the development of the resilience capacity(AU)

Changes in treated incidence of borderline personality disorder in denmark: 1970-2009.

OBJECTIVES: To investigate whether there are any trends in treated incidence of borderline personality disorder (BPD) in Danish psychiatric hospitals based on different diagnostic systems from 1970 to 2009. METHODS: All patients diagnosed with BPD for the first time as a main or an auxiliary diagnosis treated in in- or outpatient facilities in Danish psychiatric hospitals were identified through the Danish Psychiatric Central Research Register. Age-standardized, sex-specific, and standardized rates were calculated for the International Classification of Diseases (ICD), Eighth Revision, diagnostic period from 1970 to 1993 and the ICD-10 diagnostic period from 1994 to 2009. RESULTS: The incidence for BPD in females as a main or an auxiliary diagnosis increased linearly from 1970 to 2009 (ß = 0.69 per 100 000 per year [95% CI 0.66 to 0.73]). The rates for males also increased linearly from 1970 to 1993 (ß = 0.37 [95% CI 0.30 to 0.43]) followed by a linearly decrease (ß = -0.22 [95% CI -0.29 to -0.15]) in the ICD-10 period from 1994 to 2009. The increase in females with BPD after the mid-1990s is smaller when controlling for outpatients mandatorily registered from 1995. CONCLUSION: The lack of defined criteria for BPD in ICD-8 may have been interpreted broadly to mean Kernberg's overarching concept of borderline personality organization, resulting in similar rates for males and females. However, in ICD-10, clinicians using the more narrow criteria for emotionally unstable personality disorder (borderline type), tended to diagnose BPD more commonly in women. These results suggest the importance of using specific criteria in diagnosing. They also suggest the importance of stability in the diagnostic criteria for BPD and other disorders.

Objectifs : Rechercher s'il y a des tendances dans l'incidence du trouble de la personnalité limite (TPL) traité dans des hôpitaux psychiatriques danois selon différents systèmes diagnostiques, de 1970 à 2009. Méthodes : Tous les patients ayant reçu un diagnostic de TPL pour la première fois comme diagnostic principal ou auxiliaire et traités comme patients externes ou hospitalisés d'hôpitaux psychiatriques danois ont été identifiés grâce au registre danois central de recherche en psychiatrie. Les taux normalisés selon l'âge, le sexe, ont été calculés avec la Classification internationale des maladies (CIM), 8e révision, pour la période diagnostique de 1970 à 1993 et la CIM-10 pour la période diagnostique de 1994 à 2009. Résultats : L'incidence du TPL chez les femmes comme diagnostic principal ou secondaire a augmenté de façon linéaire de 1970 à 2009 (ß = 0,69 par 100 000 par an [IC à 95 % 0,66 à 0,73]). Les taux chez les hommes ont aussi augmenté de façon linéaire de 1970 à 1993 (ß = 0,37 [IC à 95 % 0,30 à 0,43]), suivis d'une décroissance linéaire (ß = ­0,22 [IC à 95 % ­0,29 à ­0,15]) dans la période utilisant la CIM-10 entre 1994 et 2009. L'augmentation du TPL chez les femmes est plus faible après le milieu des années 1990, après contrôle pour les patients externes obligatoirement inscrits depuis 1995. Conclusion : L'absence de critères définis du TPL dans la CIM-8 peut avoir été interprétée sommairement comme équivalant au concept déterminant de Kernberg sur l'organisation de personnalité limite, donnant suite à des taux semblables pour les hommes et les femmes. Cependant, dans la CIM-10, les cliniciens utilisant des critères plus ciblés pour le trouble de personnalité émotionnellement instable (de type limite) tendaient à diagnostiquer le TPL plus souvent chez les femmes. Ces résultats suggèrent l'importance d'utiliser des critères diagnostiques spécifiques. Ils suggèrent aussi l'importance de la stabilité des critères diagnostiques du TPL et d'autres troubles.

[The Flourishing Scale (FS) by Diener et al. is now available in an authorized German version (FS-D): application in mind-body medicine]. / Die Flourishing Scale (FS) von Diener et al. liegt jetzt in einer autorisierten deutschen Fassung (FS-D) vor: Einsatz bei einer Mind-Body-medizinischen Fragestellung.

BACKGROUND: The Flourishing Scale (FS) of Ed Diener et al. was translated into German, tested, and validated for the first time in a German-speaking population, as part of an interventional study. METHODS: The FS is a short 8-item questionnaire. Items were constructed from various areas that describe subjective psychological wellbeing. RESULTS: The German version of FS (FS-D) proved to be a stable, reliable, and valid measuring tool for psychological flourishing in patients of a mind-body medical outpatient clinic. Basic parameters of the original scale could be verified. CONCLUSION: Additionally, relations between flourishing, mindfulness, sense of coherence, and health-related quality of life (as well as mind-body medicine) are demonstrated.

Diagnostic criteria for psychosomatic research and somatic symptom disorders.

The Diagnostic Criteria for Psychosomatic Research (DCPR) were introduced in 1995 by an international group of investigators to expand the traditional domains of the disease model. The DCPR are a set of 12 'psychosomatic syndromes' which provide operational tools for psychosocial variables with prognostic and therapeutic implications in clinical settings. Eight syndromes concern the main manifestations of abnormal illness behaviour: somatization, hypochondriacal fears and beliefs, and illness denial. The other four syndromes (alexithymia, type A behaviour, demoralization and irritable mood) refer to the domain of psychological factors affecting medical conditions. This review describes the conceptual bases of the DCPR and the main findings concerning their application, with particular reference to the incremental information they added to the customary psychiatric classification. The DCPR were also compared with the provisional DSM-5 somatic symptom disorders. The DCPR were found to be more sensitive than DSM-IV in identifying subthreshold psychological distress and characterizing patients' psychological response to medical illness. DSM-5 somatic symptom disorders seem to neglect important clinical phenomena, such as illness denial, resulting in a narrow view of patients' functioning. The additional information provided by the DCPR may enhance the decision-making process.

Depression and the medicalization of sadness: conceptualization and recommended help-seeking.

BACKGROUND: Critiques of the validity of the DSM diagnostic criteria for depressive disorder argue that it fails to differentiate between abnormal sadness due to internal dysfunction or depression (sadness without an identifiable cause), and normal sadness (sadness with a clear cause). AIMS: and METHODS: A population survey was undertaken in adult education centres in Spain aiming to explore beliefs about depression and normal sadness. Two hypothetical case vignettes portrayed individuals experiencing deep sadness, both fulfilling criteria for major depressive disorder (DSM-IV), one with a clear cause, the other without an identifiable cause. Three hundred and forty-four (344) questionnaires were obtained (95% response rate). RESULTS: Participants statistically significantly differentiated between the sadness-with-cause vignette, seen more frequently as a normal response, while the one without a cause was seen as pathological. Help-seeking behaviour recommendations followed this distinction: a medical option was statistically significantly more common when there was no cause for sadness. Socio-cultural variation in how people understand and deal with sadness was also found. CONCLUSIONS: This study emphasizes the importance of taking into account the context in which depressive symptoms occur as it seems that the absence of an appropriate context is what makes people conceptualize them as abnormal. It also raises questions about the lack of face validity of the current diagnostic classification for depressive disorder that exclusively uses descriptive criteria.

[Depressive frustration at vascular diseases of a brain in patients of elderly and senile age].

According to inspection of 206 patients of 60 years old and elder on the basis of neurologic department of the Geriatric Center of Republican Hospital No 3 high prevalence of depression of small and average degree in the persons of advanced age suffering from cerebrovascular diseases is revealed. To estimate the expressiveness of depression the Hamilton's scale including 17 parameters was used.