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1.
Psychiatr Danub ; 31(Suppl 3): 434-437, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488767

RESUMO

The notion of "mixity" of the dysphoric phases of the bipolarity includes the most insidious symptoms of the bipolar spectrum of mood disorders: the overlapping between depression-restlessness-irritability-grief-tension-anxiety can cause worsening of the mood disorders and in the most acute phases may cause increased risk of major behavioural disruption including murder and suicide. The early utilization of the rating scale on mixed states, "GT-MSRS", which can demonstrate the level of "mixity" of the mood disorder, can prevent this.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Ansiedade/psicologia , Depressão/psicologia , Pesar , Homicídio/psicologia , Humanos , Humor Irritável , Agitação Psicomotora/psicologia , Suicídio/psicologia
2.
Psychiatr Danub ; 31(Suppl 3): 490-496, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488778

RESUMO

BACKGROUND: Differentiating Borderline Personality Disorder (BPD) from Bipolar Disorder (BD) represents a very difficult challenge for clinicians. Dysphoria could be a possible key to differentiate these disorders. We currently define dysphoria as a complex and disorganized emotional state with proteiform phenomenology, characterized by a multitude of symptoms. Among them irritability, discontent, interpersonal resentment and surrender prevail. These dimensions can be detected using the Neapen Dysphoria Scale - Italian version (NDS-I). Dysphoria role in BPD has been highlighted by the recent theorization of the Interpersonal Dysphoria Model, according to which dysphoria could represent the "psychopathological organizer" of the BPD. On the other side, dysphoria role in BD has not yet been established. This is simply considered as an aspect, and not fundamental, of the symptomatology characterizing BD, especially in mixed states patients. The phenomenological analysis of the dimensional spectrum of dysphoria within BPD and DB could provide a valuable aid in the differential diagnosis between BPD and BD. AIMS: The aim of this paper is to verify if the dimensional spectrum of dysphoria differs between Borderline Personality Disorder (BPD) and Bipolar Disorder Spectrum (BD) through an observational comparative study SUBJECTS AND METHODS: In this study, 65 adult patients, males and females between the ages of 18 and 65, were enrolled from the Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), Italy, from January 1st 2018 to April 30th 2019. We have formed 2 groups. A BPD group composed of 33 patients (19 female patients, representing approximately 57.6% of the sample) and a BD group composed of 32 patients (18 Female patients, representing approximately 56.2% of the sample). Patient's comorbid with BD and BPD have been excluded from the study. After a preliminary assessment to exclude organic and psychiatric comorbidity, and after at least 72 hours from hospitalization, we administered them the Neapen Dysphoria Scale - Italian Version (NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have carried out a comparison between disorders groups selected and their NDS-I total score and subscales (irritability, discontent, interpersonal resentment, surrender); For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent samples, by setting a significance level p<0.05. CONCLUSIONS: This study allowed us to explore and analyze dysphoria dimensions expressions in BPD and BD. Despite the small sample analyzed, the results show a significant different dimensional spectrum expression of the dysphoria between the two disorders. In particular, Irritability and Interpersonal Resentment dimensions show greater interest in BPD than BD spectrum. Further studies with a larger and stratified sample are needed to confirm these results.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Pacientes Internados/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Adulto Jovem
3.
Artigo em Russo | MEDLINE | ID: mdl-31317897

RESUMO

The author analyzes K. Conrad's concept of constitutional types based on the suggested differences in ontogenetic development of picnic and leptosomic physique, athletics and asthenics and also dysplastics. K. Conrad's typology is compared with the typology of Italian school of clinical anthropometry and E. Kretschmer's concept of constitutions. K. Conrad's criteria for the division of primary and secondary constitutions are delineated, one of the basic criteria are set by the differences in the physique proportions and tissue development. The different physiological characteristics of picnic and leptosomic constitutions as well as their cardinal mental differences are described. The special description of mental characteristics of the asthenic-hypoplastic type and some dysplastic constitutions is presented. Manic-depressive psychosis is considered by K. Conrad as a diathesis because due to the conservative constitutional development the mental disease in picnics is capable for compensation, schizophrenia is related to the system diseases, the normal leptosomic constitution is a 'milieu' which contributes to the manifestation of schizophrenia due to the peculiarities of ontogenetic constitutional development designated by K. Conrad as propulsive. As a result of this, the disease leads to the defect.


Assuntos
Transtorno da Personalidade Antissocial , Transtorno Bipolar , Esquizofrenia , Esportes , Transtorno da Personalidade Antissocial/diagnóstico , Astenia , Transtorno Bipolar/diagnóstico , Humanos , Esquizofrenia/diagnóstico
5.
Tijdschr Psychiatr ; 61(6): 384-391, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31243748

RESUMO

BACKGROUND: There is an average 10-year delay in diagnosing bipolar disorder, hampering the application of effective therapeutic interventions.
AIM: To investigate factors contributing to early recognition.
METHOD: We give a stage-oriented overview of the opportunities for early recognition.
RESULTS: Recognition in stage 0 (at-risk) and stage 1 (prodromal) is yet impossible. In stage 2 (syndromal) there are opportunities for better recognition in patients presenting with depression by conducting a thorough (collateral) psychiatric assessment, family history and by applying additional screening tools. CONCLUSIONS There are opportunities for better recognition of bipolar disorder in the syndromal stage.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/psicologia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Escalas de Graduação Psiquiátrica
6.
Br J Sports Med ; 53(12): 746-753, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097458

RESUMO

Bipolar and psychotic disorders are relatively common and likely to have a significant impact on quality of life and functioning which, in the context of elite sport, includes a potential negative impact on sporting performance. For this narrative review article, the literature on bipolar and psychotic disorders in elite athletes was comprehensively searched, and little empirical research was found. A diagnosis of bipolar or psychotic disorders may be challenging in elite athletes because of complicating factors related to the modifying role of exercise and potential precipitating impact of substance use. Medications used to treat bipolar and psychotic disorders may have side effects particularly problematic for elite athletes. Future research should be tailored to the specific characteristics and needs of elite athletes and to the sporting context in which the disorders may arise. Specifically, further research is needed on the prevalence and incidence of these conditions in elite athletes and the impact of both the disorders and their treatments on sporting performance.


Assuntos
Atletas/psicologia , Transtorno Bipolar/epidemiologia , Transtornos Psicóticos/epidemiologia , Desempenho Atlético , Transtorno Bipolar/diagnóstico , Humanos , Prevalência , Transtornos Psicóticos/diagnóstico , Qualidade de Vida
7.
Behav Ther ; 50(3): 531-543, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31030871

RESUMO

Both reward sensitivity and impulsivity are related to the development and course of bipolar spectrum disorders (BSDs) and have been implicated in other disorders and negative functional outcomes such as substance abuse, obesity, suicidal behaviors, and risk-taking. Furthermore, according to the transactional component of the Behavioral Approach System (BAS)/reward hypersensitivity theory of BSDs, people with reward hypersensitivity should experience more BAS-relevant events, and thus, are more vulnerable to mood symptoms and episodes via stress generation. Impulsivity may exacerbate stress generation in individuals at risk for BSDs based on exhibiting reward hypersensitivity. The current study examined whether impulsivity explained the generation of stress and subsequent mood symptoms beyond what is explained by reward sensitivity alone. Participants were 131 Moderate BAS and 216 High BAS sensitivity adolescents (M = 18.43 years, SD = 1.40), who completed baseline measures of reward sensitivity and impulsivity, as well as follow-up measures of life events and mood symptoms. Results from linear regression analyses indicated that higher baseline impulsivity predicted behavior-dependent, but not behavior-independent, life events. Furthermore, path analyses suggested that the effect of BAS group on depression symptoms at next follow-up was partly explained via the indirect effect of impulsivity and negative behavior-dependent life events. We did not find these effects for behavior-independent or positive-dependent events or for prediction of hypomanic symptoms. The findings suggest that impulsivity may account for stress generation of negative events that precede depression.


Assuntos
Comportamento do Adolescente/psicologia , Transtorno Bipolar/psicologia , Depressão/psicologia , Comportamento Impulsivo , Acontecimentos que Mudam a Vida , Recompensa , Adolescente , Afeto/fisiologia , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Comportamento Impulsivo/fisiologia , Estudos Longitudinais , Masculino , Autoimagem
9.
Rev Assoc Med Bras (1992) ; 65(3): 361-369, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30994834

RESUMO

BACKGROUND: There is no strong evidence on the link between inflammatory profile and pattern of drug treatment response in depressive patients that could result in Coronary Artery Disease occurrence. OBJECTIVE: This study aimed to compare the subclinical atherosclerosis markers, inflammatory profile, and BDNF production in Resistant Depression (RD) or Bipolar Affective Disorder (BAD) patients under conventional treatment. METHODS: The population evaluated was comprised of 34 RD, 43 BAD, and 41 controls. Subclinical atherosclerosis markers were evaluated using ultrasonography, tomography, and exercise stress test. Plasma concentrations of TNFα, IL-1ß, IL-6, and BDNF were measured using Luminex100™. The usCRP concentration was measured using turbidimetric immunoassay. IL1B, IL6, and TNFA expression were determined using TaqMan®. For the statistical analysis, the significance level was established at p<0.05. RESULTS: Concerning subclinical atherosclerosis markers, only O2 consumption was reduced in the BAD group (p = 0.001). Although no differences were found in gene expression, BDNF and IL-1ß plasma concentration was increased in the RD group (p = 0.002 and p = 0.005, respectively) even with an antidepressant treatment, which suggests that these drugs have no effect in IL-1ß secretion and that the inflammasome may play a role in therapy response. CONCLUSION: Taken together, both BDNF and IL-1ß plasma concentrations could be used to the early identification of RD patients.


Assuntos
Transtorno Bipolar/sangue , Fator Neurotrófico Derivado do Encéfalo/sangue , Transtorno Depressivo Resistente a Tratamento/sangue , Interleucina-1beta/sangue , Adulto , Anti-Inflamatórios/uso terapêutico , Antidepressivos/uso terapêutico , Aterosclerose/sangue , Biomarcadores/sangue , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Índice de Massa Corporal , Transtorno Depressivo Resistente a Tratamento/diagnóstico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Feminino , Humanos , Interleucina-6/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reação em Cadeia da Polimerase em Tempo Real , Valores de Referência , Estatísticas não Paramétricas , Fator de Necrose Tumoral alfa/sangue
11.
J Clin Psychiatry ; 80(1)2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865786

RESUMO

At least half of the cases of bipolar disorder begin in childhood or adolescence. How do you decide whether a young patient's symptoms indicate bipolar disorder? Read this CME Brief Report to learn about reliable tools and methods to identify bipolar disorder in pediatric patients.


Assuntos
Transtorno Bipolar , Programas de Rastreamento/métodos , Adolescente , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Escalas de Graduação Psiquiátrica
12.
J Affect Disord ; 250: 226-230, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30870772

RESUMO

BACKGROUND: Sleep disturbances are common in bipolar disorder (BD) and are often assessed by self-report at clinic visits over the course of BD treatment. Self-report may be subject to recall bias based upon current mood/affect states. This study sought to identify the degree of inaccuracy between subjective and objective measures of sleep duration in those with and without BD, and to assess the demographic and clinical correlates of this inaccuracy. METHODS: Thirty-one individuals with BD and 54 healthy control (HC) participants reported on the number of hours slept a night over the past month and subsequently completed up to 14 days/nights of wrist actigraphy which provided an objective measure of sleep duration. We compared the subjective rating to the average of all nights of objective sleep duration, and correlated the magnitude of inaccuracy with demographic and clinical characteristics in the BD and HC groups. RESULTS: On average, both BD and HC groups overestimated their sleep, and there were no differences in inaccuracy between groups. In the BD group, greater inaccuracy was associated with lower functioning, even after controlling individually for objective and subjective sleep measures. LIMITATIONS: Cross-sectional study, only focus on sleep duration, and less severe bipolar symptoms of sample. CONCLUSIONS: Inaccuracy in reports of sleep duration was associated with lower functioning among BD patients. Better identifying discrepancies in reports of sleep duration in clinical practice could help in more efficient monitoring and management of BD symptoms.


Assuntos
Transtorno Bipolar/diagnóstico , Transtornos do Sono-Vigília/diagnóstico , Actigrafia , Adulto , Afeto , Transtorno Bipolar/fisiopatologia , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Transtornos do Sono-Vigília/fisiopatologia , Fatores de Tempo , Adulto Jovem
13.
J Affect Disord ; 251: 100-106, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-30921592

RESUMO

INTRODUCTION: Exercise is an adjuvant therapy indicated for various psychiatric disorders. However, prospective studies in patients with bipolar disorder (BD) are scarce and with uncertain conclusions. This study aims to evaluate physical activity as a prognostic factor for BD, analyzing relationship with levels of anxiety, functionality, sleep, mood episodes and hospitalizations. METHODS: Three psychiatrists interviewed 80 BD outpatients in euthymia, referred from four different institutions in Brazil. In this moment, they evaluated the intensity of physical activities using the International Physical Activity Questionnaire (IPAQ) - short form. They reevaluated patients and reviewed medical records monthly for 18 months to identify mood episodes and psychiatric hospitalizations. RESULTS: Thirty-eight patients (47.5%) were physically inactive (or sedentary) and 42 (52.5%) active. Physically active patients had lower Body Mass Index (p = 0.006), waist circumference (p = 0.002), lower levels of anxiety (p = 0.032) and less insomnia (p = 0.001). Sedentary individuals revealed poorer global functioning (p < 0.001) and in all domains: autonomy (p < 0.001), occupational functioning (p = 0.008), cognitive functioning (p = 0.013), capacity of managing the finances (p = 0.012), interpersonal relationships (p = 0.011) and leisure time (p = 0.001). Less activity was associated with more mood episodes (p = 0.042) and psychiatric hospitalizations (p = 0.043) over 18 months. CONCLUSION: This study suggested physical activity as a good prognostic factor for BD during euthymia. This reinforces the need to encourage this practice in clinical settings. Future prospective surveys with longer duration using objective instruments are proposed.


Assuntos
Transtorno Bipolar/psicologia , Exercício/psicologia , Adulto , Idoso , Transtornos de Ansiedade/psicologia , Transtorno Bipolar/diagnóstico , Índice de Massa Corporal , Brasil , Transtorno Ciclotímico/complicações , Feminino , Humanos , Relações Interpessoais , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Tempo , Adulto Jovem
14.
Eur Psychiatry ; 58: 45-53, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30818134

RESUMO

BACKGROUND: Sleep alterations are frequent occurrence in Bipolar Disorder (BD), both in acute and interepisodic phases. Sleep alterations have been also described both long before BD onset, as aspecific risk syndromes, or as immediate prodromes of BD onset. The aim of the present study is to systematically review the relationship between sleep alterations anticipating for the full-blown onset of BD, both in general and according to specific polarities of onset. METHODS: A systematic literature research according to PRISMA statement and considering: 1. prospective studies about BD patients' offspring with sleep alterations who later developed BD. 2. prospective studies assessing patients with sleep disorders who later developed BD. 3. retrospective studies on BD patients where sleep alterations before BD onset of the disease were reported. RESULTS: A total of 16 studies were included in this review. Sleep disturbances may frequently appear 1 year before the onset of BD or more, often during childhood or adolescence. A decreased need for sleep may precede the onset of the illness, specially a manic episode, while insomnia appears to anticipate either a manic or a depressive episode. Hypersomnia seems to precede bipolar depressive episodes. CONCLUSIONS: Sleep alterations frequently appear long before the onset of BD, and appear to be related specifically to the polarity of the index episode. The detection and treatment of sleep alterations in special high risk populations may help achieving an earlier detection of the illness.


Assuntos
Transtorno Bipolar/epidemiologia , Diagnóstico Precoce , Transtornos do Sono-Vigília/epidemiologia , Adolescente , Adulto , Transtorno Bipolar/diagnóstico , Causalidade , Criança , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Transtornos do Sono-Vigília/diagnóstico
15.
J Affect Disord ; 250: 43-50, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30826493

RESUMO

BACKGROUND: The concept of predominant polarity (PP) is defined as presenting more symptoms of one polarity. Previous studies have defined PP as one polarity (either a depression or mania episode) occurring during at least two-thirds of the lifetime. METHODS: We conducted an observational study with the COPE-BD (Clinical Outcome and Psycho-Education for Bipolar Disorder, Clinical Outcome Measures Section) dataset to identify the diagnostic and treatment differences between bipolar disorder (BD) patients with and without PP. RESULTS: The final sample included 210 BD-I (59.0%) and 146 BD-II (41.0%) patients. Of these, 28.9% patients presented predominant polarity (PP): 62 (17.4%) of those patients were depressed polarity predominant (DPP), 41 (11.5%) were manic polarity predominant (MPP), and 253 (71.1%) met criteria for bipolar disorders but did not present with PP. In comparison to this group of BD patients with undetermined polarity, the group of BD patients with PP presented more rapid cycling. Furthermore, in the undetermined polarity group, the onset of illness occurred earlier, and the duration of the illness was longer, with more hypomanic/manic and depressive episodes than patients who met the PP criteria. LIMITATIONS: This study has a naturalistic and retrospective design and does not allow a specific follow-up of polarity over time. CONCLUSIONS: These different clinical characteristics underline the importance of considering PP in patients with BD, and justify the need for differential treatment approach which could have an impact on patients' prognosis. Yet, more independent and prospective research is needed to confirm these findings, especially with the new classification of DSM-5 concerning mixed states.


Assuntos
Transtorno Bipolar/diagnóstico , Adulto , Idade de Início , Transtorno Bipolar/classificação , Transtorno Bipolar/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
16.
Tijdschr Psychiatr ; 61(2): 104-111, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-30793271

RESUMO

BACKGROUND: Studies have indicated an association between treatment refractoriness in unipolar depression and unrecognised bipolar spectrum disorder (bsd). If confirmed, this may have implications for diagnosis and treatment.
AIM: To provide an overview on the prevalence and recognition of bsd in treatment resistant depression (trd).
METHOD: A search was made in PubMed concerning the prevalence of bsd in trd and clinical features that may be suggestive of bipolar depression.
RESULTS: Three articles were found that examined the prevalence of bsd in trd; they reported that 26-47% of patients with trd had an underlying bsd. Five cross-sectional studies described the predictors of clinical features in patients with a major depression. The following features occurred significantly more often: positive family history of bsd, young age of onset, higher number of recurrences, and atypical features.
CONCLUSION: There seems to be an association between trd and having an underlying bsd. A few clinical features may help to detect bsd in trd.


Assuntos
Transtorno Bipolar/epidemiologia , Transtorno Depressivo Resistente a Tratamento/epidemiologia , Transtorno Bipolar/diagnóstico , Transtorno Depressivo Resistente a Tratamento/diagnóstico , Humanos , Prevalência , Fatores de Risco
17.
Adv Exp Med Biol ; 1118: 271-293, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30747428

RESUMO

Psychiatric disorders are some of the most impairing human diseases. Among them, bipolar disorder and schizophrenia are the most common. Both have complicated diagnostics due to their phenotypic, biological, and genetic heterogeneity, unknown etiology, and the underlying biological pathways, and molecular mechanisms are still not completely understood. Given the multifactorial complexity of these disorders, identification and implementation of metabolic biomarkers would assist in their early detection and diagnosis and facilitate disease monitoring and treatment responses. To date, numerous studies have utilized metabolomics to better understand psychiatric disorders, and findings from these studies have begun to converge. In this chapter, we briefly describe some of the metabolomic biomarkers found in these two disorders.


Assuntos
Biomarcadores , Transtorno Bipolar/diagnóstico , Metabolômica , Esquizofrenia/diagnóstico , Humanos
18.
Med Hypotheses ; 124: 37-39, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30798913

RESUMO

We previously hypothesized that depressive and manic states may be consecutive presentations of the same underlying neuronal plasticity, and that moderate impairments in neuronal plasticity cause depressive states while further impairment to neuronal plasticity causes manic states. Psychopathological or biological relationships between bipolar disorder and schizophrenia have also been revealed. Therefore, in addition to depressive and manic states, psychosis may also be considered a manifestation resulting from additional impairments to neuronal plasticity. In the present manuscript, we hypothesize that moderate and more severe impairments to neuronal plasticity cause depressive and manic states, respectively, and that more serious impairments to neuronal plasticity cause psychosis. Many studies have suggested that impairments in neuronal plasticity contribute to schizophrenia and other mental disorders with psychotic features, and that the impairment of neuronal plasticity in schizophrenia is more severe than that in bipolar disorder. Therefore, we hypothesize more specifically that impairments in neuronal plasticity may be more severe in the order of the cases featuring psychosis, mania, and depression. This progression notably overlaps with the arrangement of schizophrenia, bipolar disorder, and depressive disorder in the DSM-5. Psychotic symptoms are thought to appear further towards the base of the psychopathological hierarchy than are manic or depressive symptoms. If impairments to neuronal plasticity contribute to this psychopathological hierarchy, as we contest that they do, our hypothesis may serve as a bridge between clinical psychopathology, diagnosis, and biological psychiatry.


Assuntos
Transtorno Bipolar/diagnóstico , Plasticidade Neuronal , Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico , Sintomas Afetivos , Psiquiatria Biológica , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Depressão/diagnóstico , Progressão da Doença , Humanos , Modelos Psicológicos
19.
Schizophr Bull ; 45(45 Suppl 1): S78-S87, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30715541

RESUMO

Psychotic experiences are prevalent across a wide variety of psychiatric, neurological, and medical conditions. Yet current assessments are often designed for one disorder, or are limited in their examination of phenomenological features; this has hindered transdiagnostic research. This article describes an examination of the validity and reliability of the English version of a new assessment, the Questionnaire for Psychotic Experiences (QPE). This study aimed to use the QPE to examine hallucinations and delusions across a number of different conditions, and to ensure that the QPE had acceptable psychometric properties. An International Consortium on Hallucination Research working group, along with consumer groups, developed the 50-item QPE to assess the presence, severity, and phenomenology of hallucinations and delusions. Participants in the study who reported psychotic experiences included those with schizophrenia, schizoaffective disorder, bipolar affective disorder, and major depressive disorder, and those without a need for care (ie, nonclinical participants). There were 173 participants in total. Convergent and discriminant validity were assessed. Reliability was examined in terms of stability, equivalence, and internal consistency. The data confirmed that the QPE had good psychometric properties and could be put forward as an accepted measure of the transdiagnostic evaluation of psychotic experiences. Further validation is recommended with neurological and medical populations. Given its validity and reliability, comprehensive evaluation of psychotic phenomena, and relatively quick administration time, we propose that the QPE is a valuable instrument for both clinical and research settings.


Assuntos
Transtorno Bipolar/diagnóstico , Delusões/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Alucinações/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico , Adulto , Transtorno Bipolar/complicações , Delusões/etiologia , Transtorno Depressivo Maior/complicações , Feminino , Alucinações/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/complicações , Reprodutibilidade dos Testes , Esquizofrenia/complicações , Adulto Jovem
20.
Psychol Assess ; 31(3): 329-339, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30802118

RESUMO

Electronic diary data, such as that acquired through Ecological Momentary Assessments (EMA), has historically provided novel insights into diverse psychological processes. Analyses of these data typically focus on modeling participant-specific means, variability, and stability. We propose a novel statistical framework to determine participant stability by quantifying fragmentation of standardized trajectories using the following 2-step approach: (1) participant-level EMA scores are normalized, and (2) normalized scores are dichotomized into 2 states, inside and outside a range of 1 standard deviation. Within-participant fragmentation measures were calculated from dichotomized scores and modeled with various covariates. We used this method to study patterns of emotional states and showed that the proposed fragmentation measures differentiate mood disorder subtypes, including Bipolar I (BPI), Bipolar II, and major depressive disorder (MDD) compared with unaffected controls. Fragmentation measures were regressed on the mood disorder subtype, adjusting for age, sex, body mass index, and mean squared successive difference. The analyses revealed decreased stability (more fragmentation) among those with BPI when inside the participant-specific standard range of attention (ß = 0.09, p = .004) and decreased stability among those with MDD inside the standard range of mood (ß = 0.04, p = .039) and attention (ß = 0.05, p = .017). This work provides an illustration of the clinical significance of EMA in characterizing the stability of mood, attention, or other psychological states that may underlie psychological disorders and phenomena. The application of fragmentation provides a novel statistical approach that can characterize within-participant stability beyond currently available traditional approaches. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Afeto/fisiologia , Atenção/fisiologia , Transtorno Bipolar/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Avaliação Momentânea Ecológica , Monitorização Ambulatorial/métodos , Psicometria/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Ambulatorial/instrumentação
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