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1.
East Asian Arch Psychiatry ; 30(2): 39-43, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32611825

RESUMO

BACKGROUND: The DSM-IV and the DSM-5 eliminated the importance of the syndromal identity of melancholic depression in favour of a dimensional model within the domain of major depressive disorders. Melancholic depression was excluded from DSM as a distinct disorder owing to the impact of ageing, genetics, and course of illness. We challenge these assertions using retrospective data collected from patients with depression. METHOD: Electronic medical records of 1073 patients with depressive-spectrum disorders in 12 centres across Germany spanning from January 2010 to June 2013 were retrospectively reviewed. The diagnosis of melancholia was made using the Hamilton Depression Rating Scale 21 items (HAMD-21). Patients were followed up every 2 weeks and yearly until discharge from inpatient units. The final dataset consisted of 1014 patients; each had received a minimum of two complete observations. RESULTS: At baseline, patients with melancholic depression had higher HAMD-21 score than did patients with non-melancholic depression (32.6 vs 23.13, p < 0.001). At the final visit, patients with melancholic depression responded to treatment more often than did patients with non-melancholic depression (81.3% vs 69.04%, p = 0.0156), whereas the two groups were comparable in terms of remission status (50.55 vs 48.68%, p = 0.1943). The relapse rate was higher in patients with melancholic depression than in patients with non-melancholic depression after 1 year (60% vs 45.01%, p = 0.0599), 2 years (77.78% vs 60.36%, p = 0.0233), and 4 years (80% vs 64.45%, p = 0.0452). CONCLUSION: Melancholic depression has an identifiable constellation of symptoms and it is not just a severe form of major depression. Melancholic depression is not the result of age-related or pathoplastic changes. We advocate including melancholia as its own illness entity in the next edition of the DSM.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo/diagnóstico , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Recidiva , Indução de Remissão , Estudos Retrospectivos , Fatores de Tempo
2.
East Asian Arch Psychiatry ; 30(2): 44-47, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32611826

RESUMO

OBJECTIVES: The aim of the present study was to assess the reliability and validity of the Persian version of the State-Trait Anxiety Inventory Form Y (STAI-Y) among high school students. METHODS: A sample of 492 high school students in Kermanshah city, Iran were randomly selected via multistage sampling. They were asked to complete the STAI-Y and Beck Anxiety Inventory (BAI) to determine the correlation coefficients. Data analysis was performed via descriptive statistics, factor analysis, Cronbach's coefficient alpha, and Pearson correlation coefficient. RESULTS: In the Persian version of STAI-Y, the Cronbach's alpha for internal consistency was 0.886 for trait anxiety and 0.846 for state anxiety. The convergent validity between STAI-Y and BAI was 0.612 for trait anxiety and 0.643 for state anxiety (p < 0.001). CONCLUSION: The reliability, internal consistency, and validity of the Persian version of the STAI-Y is good among high school students in Kermanshah.


Assuntos
Ansiedade/diagnóstico , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Estudantes/psicologia , Adolescente , Feminino , Humanos , Irã (Geográfico) , Masculino , Psicometria , Reprodutibilidade dos Testes , Instituições Acadêmicas , Adulto Jovem
3.
East Asian Arch Psychiatry ; 30(2): 48-51, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32611827

RESUMO

OBJECTIVE: To evaluate the validity and reliability of a Thai version of the Short Mood and Feelings Questionnaire (SMFQ). METHODS: The present study included 23 children with depressive disorders (diagnosis made by child psychiatrists) and 74 children with no depressive disorders. All children and their parents were asked to complete the Thai versions of the SMFQ, Children's Depression Inventory, and Mood and Feelings Questionnaire. Criterion validity, convergent validity, reliability, and parent-child agreement of the SMFQ were measured. RESULTS: With a cut-off score of 9, the child-rated SMFQ yielded a sensitivity of 87.0% and specificity of 86.5%, whereas the parent-rated SMFQ yielded a sensitivity of 82.6% and a specificity of 89.2%. The correlation coefficient between the child-rated and parent-rated versions was 0.75, and the correlation coefficients between the Thai Children's Depression Inventory and the child-rated and parent-rated versions were 0.86 and 0.74, respectively. Respectively for the child-rated and parent-rated versions, the Cronbach's alpha was 0.90 and 0.923, and the intra-class correlation coefficient was 0.61 and 0.75. The Bland-Altman plot showed that 92.9% and 85.7% of the child and parent test-retest answers were within limits of agreement. CONCLUSION: The Thai version of SMFQ has a high degree of psychometric validity and reliability.


Assuntos
Afeto , Transtorno Depressivo/diagnóstico , Emoções , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Pais/psicologia , Psicometria , Reprodutibilidade dos Testes , Tailândia
4.
Epidemiol Psychiatr Sci ; 29: e134, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32484148

RESUMO

AIMS: To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. METHODS: People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. RESULTS: In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. CONCLUSION: This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Programas de Rastreamento/métodos , Qualidade de Vida , Estresse Psicológico/etiologia , Adulto , Idoso , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Angústia Psicológica , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
5.
PLoS One ; 15(4): e0231647, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32302340

RESUMO

Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.


Assuntos
Alcoolismo/psicologia , Depressão/psicologia , Comportamento de Busca de Ajuda , Relações Interpessoais , Suicídio/psicologia , Adulto , Alcoolismo/epidemiologia , Comorbidade , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Autorrelato/estatística & dados numéricos , Suicídio/prevenção & controle
6.
BMC Public Health ; 20(1): 418, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228553

RESUMO

BACKGROUND: Knowledge of the relationship between men's health and violence is flawed by narrow and faulty conceptualization and measurement of violence that often results in attribution of health problems to one form or type of violence without consideration of other exposures. Our purpose is to describe the development and initial testing of the Cumulative Lifetime Violence Severity scale designed for use in health research to measure men's perceptions of the severity of their cumulative lifetime violence. METHODS: We framed the dimensions of violence severity as: type (physical, psychological, sexual), timing (childhood, adulthood), focus (perpetrator, target), context, frequency, and degree of distress. Items reflecting these dimensions were vetted by local experts including individuals who identified as men, with particular attention to meaningful language for men. The measure was pretested, revised to 64 items, and tested for test-retest reliability prior to use in a study of 685 English-speaking Eastern Canadian men, ages 19 to 65 years. We used Principal Components Analysis to illuminate the underlying dimensionality of the items. RESULTS: Principal Components Analysis yielded a 44-item 11 component solution that accounted for 64.06% of variance with good model fit and a Cronbach's alpha of .92. All dimensions of our conceptualization of violence severity were reflected in the components, except Adult Target Sexual Violence. Convergent validity between the Cumulative Lifetime Violence Severity-44 Scale and a global lifetime violence rating scale was r = .750 (p < .001) and concurrent validity was moderate and significant between the Cumulative Lifetime Violence Severity-44 scale and measures of mental health problems commonly experienced by people with violence histories. CONCLUSIONS: The Cumulative Lifetime Violence Severity-44 scale shows promise as the first comprehensive measure of cumulative lifetime violence for health research that considers gender, individual distress and experiences as both perpetrator and target. Next steps include further exploratory analysis with a more diverse sample of men and confirmatory factor analysis.


Assuntos
Exposição à Violência/estatística & dados numéricos , Homens/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Índice de Gravidade de Doença , Adulto , Idoso , Canadá , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Reprodutibilidade dos Testes , Adulto Jovem
7.
PLoS One ; 15(3): e0229978, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155206

RESUMO

Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they either studied a much older cohort or, more seriously, failed to account for potential confounding. We leverage data from a nationally representative cohort of American men who were in grades 7-12 in the 1994-95 school year to estimate the effect of playing football in adolescent on depression in early adulthood. We control for several potential confounders related to subjects' health, behavior, educational experience, family background, and family health history through matching and regression adjustment. We found no evidence of even a small harmful effect of football participation on scores on a version of the Center for Epidemiological Studies Depression scale (CES-D) nor did we find evidence of adverse associations with several secondary outcomes including anxiety disorder diagnosis or alcohol dependence in early adulthood. For men who were in grades 7-12 in the 1994-95 school year, participating or intending to participate in school football does not appear to be a major risk factor for early adulthood depression.


Assuntos
Comportamento do Adolescente/psicologia , Depressão/epidemiologia , Futebol Americano/psicologia , Esportes Juvenis/psicologia , Adolescente , Adulto , Depressão/diagnóstico , Depressão/psicologia , Seguimentos , Futebol Americano/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de Risco , Instituições Acadêmicas/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem , Esportes Juvenis/estatística & dados numéricos
8.
Postgrad Med ; 132(7): 595-600, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32133914

RESUMO

Objectives: To examine the diagnostic utility of the 'attended alone' (AA) and 'attended with' (AW) signs for the diagnosis of major and minor neurocognitive disorder. Methods: Consecutive unselected new outpatient referrals (N = 1209) to a dedicated cognitive disorders clinic over a 5-year period (2015-2019 inclusive) were observed for the AA and AW signs. Criterion diagnoses were by usual clinic assessment using standard (DSM-5) diagnostic criteria. Results: AW proved to be very sensitive for the identification of major and minor neurocognitive disorder but with generally low positive predictive values. In the subgroup of patients attending with more than one informant, the AW2+ sign, positive predictive value was higher and likewise with increasing patient age where the prevalence of AW was higher. Diagnostic utility of AW and AA was independent of patient gender. Conclusion: AW and AA are easily observed and categorized signs. AW has a high sensitivity for cognitive impairment while AA has a high positive predictive value for its absence.


Assuntos
Transtornos Cognitivos/diagnóstico , Testes Neuropsicológicos/normas , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Sensibilidade e Especificidade , Inquéritos e Questionários
9.
Trials ; 21(1): 14, 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31907006

RESUMO

BACKGROUND: People experiencing their first episode of psychosis are often deficient in vitamin D. Observational studies have reported an association between low vitamin D concentrations and poorer subsequent health outcomes in psychosis. A vitamin D deficiency in neonates and children has been linked to a later increased risk of schizophrenia and psychotic-like experiences. This trial aims to examine the effect of high-dose vitamin D supplementation on outcomes in early psychosis. We hypothesise that vitamin D supplementation will be associated with better mental health outcomes. METHODS/DESIGN: The DFEND study is a multicentre double-blind placebo-controlled parallel-group trial of vitamin D supplementation in people with early psychosis. Patients with an ICD-10 diagnosis of functional psychosis will be randomised in a 1:1 ratio to receive either 120,000 IU/month of vitamin D (cholecalciferol) or a matched placebo for 6 months. The primary outcome is the total Positive and Negative Syndrome Scale (PANSS) score at the 6-month follow-up for all patients. Secondary outcomes include assessment of mood (Calgary Depression Scale), general function (Global Assessment of Functioning), cardiovascular risk (body mass index, waist circumference, C-reactive protein, cholesterol and HbA1c) and vitamin D levels at the 6-month follow-up. Additionally, 3- and 6-month total PANSS scores will be analysed for those with inadequate vitamin D levels at the baseline. DISCUSSION: The DFEND study is the first trial to examine whether vitamin D supplementation in early psychosis is associated with better mental health outcomes. The findings of this study may help to resolve the clinical equipoise regarding the benefits and cost-effectiveness of routine vitamin D supplementation in people with psychosis. TRIAL REGISTRATION: ISRCTN, ISRCTN12424842. Registered on 25 February 2015.


Assuntos
Suplementos Nutricionais , Neuroproteção/efeitos dos fármacos , Transtornos Psicóticos/tratamento farmacológico , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/administração & dosagem , Adulto , Ensaios Clínicos Fase II como Assunto , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Neuroproteção/fisiologia , Placebos/administração & dosagem , Placebos/efeitos adversos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Transtornos Psicóticos/sangue , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Vitamina D/efeitos adversos , Vitamina D/sangue , Vitamina D/fisiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/psicologia , Adulto Jovem
10.
J Trauma Acute Care Surg ; 88(1): 113-120, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31856020

RESUMO

BACKGROUND: Traumatic injury is not only physically devastating, but also psychologically isolating, potentially leading to poor quality of life, depression and posttraumatic stress disorder (PTSD). Perceived social support (PSS) is associated with better outcomes in some populations. What is not known is if changes in PSS influence long-term outcomes following nonneurologic injury. We hypothesized that a single drop in PSS during recovery would be associated with worse quality of life. METHODS: This is a post hoc analysis of a prospectively collected database that included patients 18 years or older admitted to a Level I trauma center with Injury Severity Score (ISS) of 10 or higher, and no traumatic brain or spinal cord injury. Demographic and injury data were collected at the initial hospital admission. Screening for depression, PTSD, and Medical Outcomes Study Short Form 36 Mental Composite Score (MCS) were obtained at the initial hospitalization, 1, 2, 4, and 12 months postinjury. The Multidimensional Scale of Perceived Social Support (MSPSS) was obtained at similar time points. Patients with high MSPSS (>5) at baseline were included and grouped by those that ever reported a score ≤5 (DROP), and those that remained high (STABLE). Outcomes were determined at 4 and 12 months. RESULTS: Four hundred eleven patients were included with 96 meeting DROP criteria at 4 months, and 97 at 1 years. There were no differences in sex, race, or injury mechanism. The DROP patients were more likely to be single (p = 0.012 at 4 months, p = 0.0006 at 1 year) and unemployed (p = 0.016 at 4 months, and p = 0.026 at 1 year) compared with STABLE patients. At 4 months and 1 year, DROP patients were more likely to have PTSD, depression, and a lower MCS (p = 0.0006, p < 0.0001). CONCLUSION: Patients who have a drop in PSS during the first year of recovery have significantly higher odds of poor psychological outcomes. Identifying these socially frail patients provides an opportunity for intervention to positively influence an otherwise poor quality of life. LEVEL OF EVIDENCE: Therapeutic, Prognostic and Epidemiological, Level III.


Assuntos
Depressão/diagnóstico , Qualidade de Vida , Apoio Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Ferimentos e Lesões/terapia , Adulto , Depressão/epidemiologia , Depressão/etiologia , Depressão/psicologia , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Recuperação de Função Fisiológica , Medição de Risco , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Centros de Traumatologia/estatística & dados numéricos , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/psicologia , Adulto Jovem
11.
Ren Fail ; 42(1): 30-39, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31847666

RESUMO

Background: Although arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD), the association between vascular access types and quality of life is not well-known. We investigated the relationships between HD vascular access types and all-cause mortality, health-related quality of life (HRQOL) and the degree of depression in a large prospective cohort.Methods: A total of 1461 patients who newly initiated HD were included. The initial vascular access types were classified into AVF, arteriovenous graft (AVG), and central venous catheter (CVC). The primary outcomes were all-cause mortality and HRQOL and depression. The secondary outcome was all-cause hospitalization. Kidney Disease Quality of Life Short Form 36 (KDQOL-36) and Beck's depression inventory (BDI) scores were measured to assess HRQOL and depression.Results: Among 1461 patients, we identified 314 patients who started HD via AVF, 76 via AVG, and 1071 via CVC. In the survival analysis, patients with AVF showed significantly better survival compared with patients with other accesses (p < .001). The AVF and AVG group had higher KDQOL-36 score and lower BDI score than CVC group at 3 months and 12 months after the initiation of HD. The frequency of hospitalization was higher in patients with AVG compared to those with AVF (AVF 0.7 vs. AVG 1.1 times per year) (p = .024).Conclusions: The patients with AVF had better survival rate and low hospitalization rate, and the patients with AVF or AVG showed both higher HRQOL and lower depression scores than those with CVC.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Depressão/diagnóstico , Falência Renal Crônica/terapia , Diálise Renal/efeitos adversos , Adulto , Idoso , Derivação Arteriovenosa Cirúrgica/instrumentação , Derivação Arteriovenosa Cirúrgica/psicologia , Cateteres de Demora/efeitos adversos , Cateteres Venosos Centrais/efeitos adversos , Depressão/etiologia , Depressão/psicologia , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Estimativa de Kaplan-Meier , Falência Renal Crônica/mortalidade , Falência Renal Crônica/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Qualidade de Vida , Diálise Renal/instrumentação , Diálise Renal/métodos , República da Coreia/epidemiologia , Fatores de Risco , Autorrelato/estatística & dados numéricos , Índice de Gravidade de Doença , Taxa de Sobrevida , Grau de Desobstrução Vascular
12.
East Asian Arch Psychiatry ; 29(4): 103-111, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31871306

RESUMO

BACKGROUND: The Obsessive-Compulsive Inventory-Revised (OCI-R) is a psychometrically sound and valid self-report measure for evaluating the severity of six dimensions of obsessive-compulsive symptoms: washing, obsessing, hoarding, ordering, checking, and neutralising. We aimed to validate the Chinese version of the OCI-R (C-OCI-R) in patients with obsessive-compulsive disorder (OCD) in Hong Kong. METHODS: The C-OCI-R was forward and backward translated and reviewed by an expert panel and a focus group. The internal consistency and test-retest reliability (2-week interval) were examined. Confirmatory factor analysis was used to examine the construct validity of the C-OCI-R. Concurrent validity was examined by the correlation between the C-OCI-R and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), whereas divergent validity was examined by the correlation of the C-OCI-R with the Beck Depression Inventory-Second Edition and the Hamilton Depression Rating Scale. RESULTS: 130 OCD patients were recruited. The C-OCI-R showed excellent internal consistency (Cronbach's alpha = 0.92) and test-retest reliability (Spearman's rho correlation coefficient = 0.96). The original six-factor model was supported by confirmatory factor analysis. Concurrent validity and divergent validity were established. However, the neutralising subscale may need further development, and the divergent validity of the obsessing subscale was unsatisfactory. The structure of OCD symptoms was similar in Chinese and western patients. CONCLUSION: The C-OCI-R is a valid and reliable measure for assessing the severity of obsessive-compulsive symptoms in local Chinese patients with OCD.


Assuntos
Transtorno Obsessivo-Compulsivo/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Autorrelato , Adulto , Análise Fatorial , Feminino , Hong Kong , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Tradução
13.
East Asian Arch Psychiatry ; 29(4): 112-117, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31871307

RESUMO

OBJECTIVE: To investigate associations of the five early maladaptive schemas (EMS) domains with depression severity by comparing patients with persistent depressive disorder (PDD), patients with major depressive disorder (MDD), and controls with no psychiatric disorders. METHODS: Patients with PDD (n = 30), patients with MDD (n = 24), and controls with no psychiatric disorders (n = 30) were recruited. Participants were assessed using the Mini-International Neuropsychiatric Interview 5.0 version (MINI), the Beck Depression Inventory-Second Edition (BDI-II), and the Young Schema Questionnaire-3rd Edition Short Form (YSQ-S3). RESULTS: The five EMS domains (YSQ-S3 score) significantly correlated with depression severity (BDI-II score), with correlation coefficients ranging from 0.583 to 0.788. After controlling for age, education, and sex, the two best predictors of depression severity were domains 'over-vigilance and inhibition' and 'disconnection and rejection'. For domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition, the total YSQ-S3 score was significantly higher in the PDD group than both the MDD and control groups. For the domain of impaired limits, the total YSQ-S3 score was significantly higher in both the PDD and MDD groups than the control group. CONCLUSION: All five EMS domains correlated significantly with depression severity. PDD and MDD differed in psychopathology. The EMS domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition may be specific risk factors for PDD.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Taiwan
14.
Nurs Clin North Am ; 54(4): 561-567, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31703781

RESUMO

Postpartum depression (PPD) affects10% to 20% of women within the first year after birth and 25% beyond the first year. PPD, despite advances in diagnosis and treatment, remains underdiagnosed and misunderstood. Women do not always display signs of PPD while in care for delivery of the infant and may not discuss mood changes to their primary care provider at discharge and first post-delivery appointment. Identifying screening and treatment options for non-mental health providers was the purpose of this article.


Assuntos
Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Programas de Rastreamento , Papel do Profissional de Enfermagem/psicologia , Depressão Pós-Parto/epidemiologia , Tratamento Farmacológico , Feminino , Humanos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de Risco
15.
Neurol Res ; 41(11): 1001-1007, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31588880

RESUMO

Objectives: Increased attention is being paid to Asian medicine in balanced total health care. We investigated the effects of mixed exercise including yoga ('Yoga-plus') among elderly individuals. Methods: A total of 385 subjects (72 males and 313 females, 75.5 ± 8.7 years old) participated in a 12-month (M) exercise program at a health and welfare center, a day service center, and a nursing home. Cognitive, affective, and physical functions, and activities of daily living (ADL), were compared at baseline (0M), 6M and 12M of exercise intervention. Results: Mean scores on the frontal assessment battery, clock drawing test, cube copying test, letter fluency, and category fluency significantly improved after the Yoga-plus intervention, while mini-mental state examination, Hasegawa dementia score-revised, and trail-making test performance were relatively stable. Affective scores on the geriatric depression scale (GDS), apathy scale (AS) and Abe's behavioral and psychological symptoms of dementia were not significantly affected by exercise therapy, but subgroups with higher baseline GDS (GDS ≥ 5) and AS (AS ≥ 16) scores showed a significant improvement after intervention. One-leg standing time and 3-m timed up and go test performance significantly improved after 12M intervention. Discussion: Yoga-plus improved cognitive, affective, ADL, and physical functions in a local elderly population, particularly among below-baseline individuals, indicating the benefits of dementia prevention among elderly individuals.


Assuntos
Atividades Cotidianas , Cognição/fisiologia , Estudos de Tempo e Movimento , Ioga , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/terapia , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Equilíbrio Postural/fisiologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Estudos Retrospectivos
16.
East Asian Arch Psychiatry ; 29(3): 81-86, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31566183

RESUMO

OBJECTIVE: This study aimed to examine the association between five personality traits and late-onset depression in Hong Kong older people. METHODS: This cross-sectional study included a convenience sample of 40 older people with late-onset depression (LOD) and 54 non-depressed elderly controls. The patients were assessed using the NEO Five Factor Inventory (for personality), the Hamilton Depression Rating Scale (for depression severity), the Mini-Mental State Examination (for cognitive function), the Lawton Instrumental Activities of Daily Living (for functioning), and the Cumulative Illness Rating Scale (for number of physical illnesses). RESULT: The LOD group had a higher Hamilton Depression Rating Scale score (18.9 vs 3.7, p < 0.001), lower Mini Mental State Examination score (24.9 vs 26.4, p = 0.004), and lower Instrumental Activities of Daily Living scale score (21.9 vs 23.7, p = 0.013). On the NEO Five Factor Inventory, the LOD group had a higher neuroticism score (30.7 vs 17.5, p < 0.001) and lower scores on extraversion (19.0 vs 26.4, p < 0.001), openness (18.9 vs 21.5, p = 0.026), and conscientiousness (29.1 vs 33.8, p < 0.001). Neuroticism was the only significant predictor of LOD (odds ratio = 2.325, p = 0.001) and the only significant factor associated with depression severity (ß = 0.581, p = 0.003). CONCLUSIONS: The personality trait of neuroticism is associated with LOD and its severity. Assessment of personality traits should be included in the assessment of people with depression.


Assuntos
Depressão/psicologia , Transtornos de Início Tardio/psicologia , Personalidade , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hong Kong , Humanos , Masculino , Inventário de Personalidade/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos
17.
Medicina (Kaunas) ; 55(9)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31491990

RESUMO

Background and Objectives: The comorbid association between type 2 diabetes mellitus (T2DM) and a psychological profile characterized by depression and/or anxiety has been reported to increase the risk of coronary heart disease (CAD), the most striking macrovascular complication of diabetes. The purpose of the present study was to quantify anxiety, depression and the presence of type D personality, and to correlate the scores obtained with cardiovascular risk factors and disease severity in diabetic patients. Materials and methods: The retrospective study included 169 clinically stable diabetic patients divided into two groups: group 1 without macrovascular complications (n = 107) and group 2 with CAD, stroke and/or peripheral vascular disease (n = 62). A biochemical analysis and an assessment of psychic stress by applying the Hospital Anxiety and Depression Scale (HADS)and the Type D scale (DS-14) to determine anxiety, depression and D personality scores were done in all patients. Statistical analysis was made using SPSSv17 and Microsoft Excel, non-parametric Kruskal-Wallis and Mann-Whitney tests. Results: Following application of the HAD questionnaire for the entire group (n = 169), anxiety was present in 105 patients (62.2%), and depression in 96 patients (56.8%). Group 2 showed significantly higher anxiety scores compared to group 1 (p = 0.014), while depression scores were not significantly different. Per entire group, analysis of DS-14 scores revealed social inhibition (SI) present in 56 patients (33%) and negative affectivity (NA) in 105 patients (62%). TheDS-14 SI score was significantly higher in group 2 compared to group 1 (p = 0.036). Type D personality, resulting from scores above 10 in both DS-14 parameter categories, was present in 51 patients of the study group (30%). There was a direct and significant correlation (r = 0.133, p = 0.025) between the Hospital Anxiety and Depression Scale-Anxiety (HAD-A) score and the LDL-c values. Conclusions: The results of this study demonstrated that more than a half of patients with diabetes had anxiety and/or depression and one third had Type D personality, sustaining that monitoring of emotional state and depression should be included in the therapeutic plan of these patients. New treatment strategies are needed to improve the well-being of diabetic patients with psychological comorbidities.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Psicometria/normas , Estresse Psicológico/classificação , Idoso , Ansiedade/classificação , Ansiedade/psicologia , Comorbidade/tendências , Depressão/classificação , Depressão/psicologia , Diabetes Mellitus Tipo 2/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Psicometria/instrumentação , Psicometria/métodos , Estudos Retrospectivos , Fatores de Risco , Estresse Psicológico/psicologia , Inquéritos e Questionários
18.
Subst Abuse Treat Prev Policy ; 14(1): 40, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533766

RESUMO

BACKGROUND: Emotional distress is common among illicit drug users, and it can negatively affect treatment outcomes and increase the risk of relapse. Nonetheless, instruments that properly measure emotional distress are lacking. Therefore, this study investigated the factor structure of the Arabic Depression Anxiety Stress Scale-21 (DASS-21) in that population. METHODS: The DASS-21 and the Self-stigma of Alcohol Dependence Scale (SSAD) were completed by 149 inpatient Egyptian drug users. The DASS-21 was examined using exploratory factor analysis, partial confirmatory factor analysis, and parallel analysis. For validation testing, correlations between stigma scores and DASS scores were computed. RESULTS: A one-factor solution provided the best fit to the DASS-21 data. Four items with low loadings were removed. The resulting DASS-17 was also unidimensional, and its reliability was high (0.88). On the validation tests, the DASS scores correlated with the stigma scores as hypothesized. CONCLUSION: Subscales of the Arabic version of the DASS-21 do not differentiate between depression and anxiety. A modified 17-item version (the DASS-17) was suitable for measuring overall distress, and the results of convergent validation testing indicated that it was superior to the DASS-21.


Assuntos
Usuários de Drogas/psicologia , Pacientes Internados/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Adulto , Egito , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
19.
Int J Neuropsychopharmacol ; 22(11): 681-697, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31563956

RESUMO

INTRODUCTION: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. METHODS: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. RESULTS: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.


Assuntos
Progressão da Doença , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Esquizofrenia/diagnóstico , Adulto , Europa (Continente) , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Esquizofrenia/classificação , Esquizofrenia/fisiopatologia , Síndrome de Sotos , Adulto Jovem
20.
Med Care ; 57(11): 890-897, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31415337

RESUMO

BACKGROUND: Anxiety is one of the most prevalent mental disorders and accounts for substantial disability as well as increased health care costs. This study examines the minimally important difference (MID) and responsiveness of 6 commonly used anxiety scales. METHODS: The sample comprised 294 patients from 6 primary care clinics in a single VA medical center who were enrolled in a telecare trial for treatment of chronic musculoskeletal pain and comorbid depression and/or anxiety. The measures assessed were the Patient Reported Outcomes Measurement Information System (PROMIS) 4-item, 6-item, and 8-item anxiety scales; the Generalized Anxiety Disorder 7-item scale (GAD-7); the Symptom Checklist anxiety subscale (SCL); the Posttraumatic Stress Disorder Checklist (PCL); the Short Form (SF)-36 Mental Health subscale; and the SF-12 Mental Component Summary (MCS). Validity was assessed with correlations of these measures with one another and with measures of quality of life and disability. MID was estimated by triangulating several methods. Responsiveness was evaluated by comparing: (a) the standardized response means for patients who reported their mood as being better, the same, or worse at 3 months; (b) the area under the curve for patients who had improved (better) versus those who had not (same/worse). RESULTS: Convergent and construct validity was supported by strong correlations of the anxiety measures with one another and moderate correlations with quality of life and disability measures, respectively. All measures differentiated patients who reported global improvement at 3 months from those who were unchanged, but were less able to distinguish worsening from no change. The area under the curves showed comparable responsiveness of the scales. The estimated MID was 4 for the PROMIS scales; 3 for the GAD-7; 6 for the PCL; 9 for the SF-36 mental health subscale; 5 for the MCS score, and 0.3 for the SCL anxiety scale. CONCLUSIONS: Six commonly used anxiety scales demonstrate similar responsiveness, and estimated MIDs can be used to gauge anxiety change in clinical research and practice.


Assuntos
Ansiedade/diagnóstico , Diferença Mínima Clinicamente Importante , Medidas de Resultados Relatados pelo Paciente , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Ansiedade/complicações , Depressão/complicações , Depressão/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/psicologia , Reprodutibilidade dos Testes
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