Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 29.047
Filtrar
1.
Lancet Psychiatry ; 7(1): 52-63, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31787585

RESUMO

BACKGROUND: Since people with mental illness are more likely to die from cancer, we assessed whether people with mental illness undergo less cancer screening compared with the general population. METHODS: In this systematic review and meta-analysis, we searched PubMed and PsycINFO, without a language restriction, and hand-searched the reference lists of included studies and previous reviews for observational studies from database inception until May 5, 2019. We included all published studies focusing on any type of cancer screening in patients with mental illness; and studies that reported prevalence of cancer screening in patients, or comparative measures between patients and the general population. The primary outcome was odds ratio (OR) of cancer screening in people with mental illness versus the general population. The Newcastle-Ottawa Scale was used to assess study quality and I2 to assess study heterogeneity. This study is registered with PROSPERO, CRD42018114781. FINDINGS: 47 publications provided data from 46 samples including 4 717 839 individuals (501 559 patients with mental illness, and 4 216 280 controls), of whom 69·85% were women, for screening for breast cancer (k=35; 296 699 individuals with mental illness, 1 023 288 in the general population), cervical cancer (k=29; 295 688 with mental illness, 3 540 408 in general population), colorectal cancer (k=12; 153 283 with mental illness, 2 228 966 in general population), lung and gastric cancer (both k=1; 420 with mental illness, none in general population), ovarian cancer (k=1; 37 with mental illness, none in general population), and prostate cancer (k=6; 52 803 with mental illness, 2 038 916 in general population). Median quality of the included studies was high at 7 (IQR 6-8). Screening was significantly less frequent in people with any mental disease compared with the general population for any cancer (k=37; OR 0·76 [95% CI 0·72-0·79]; I2=98·53% with publication bias of Egger's p value=0·025), breast cancer (k=27; 0·65 [0·60-0·71]; I2=97·58% and no publication bias), cervical cancer (k=23; 0·89 [0·84-0·95]; I2=98·47% and no publication bias), and prostate cancer (k=4; 0·78 [0·70-0·86]; I2=79·68% and no publication bias), but not for colorectal cancer (k=8; 1·02 [0·90-1·15]; I2=97·84% and no publication bias). INTERPRETATION: Despite the increased mortality from cancer in people with mental illness, this population receives less cancer screening compared with that of the general population. Specific approaches should be developed to assist people with mental illness to undergo appropriate cancer screening, especially women with schizophrenia. FUNDING: None.


Assuntos
Neoplasias da Mama , Neoplasias Colorretais , Detecção Precoce de Câncer/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Neoplasias do Colo do Útero , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Feminino , Humanos , Transtornos Mentais/fisiopatologia , Prevalência , Qualidade de Vida , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle
3.
Lancet Psychiatry ; 7(1): 78-92, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31474568

RESUMO

Integration of services into primary health care for people with common mental disorders is considered a key strategy to improve access to mental health care in low-income and middle-income countries, yet services at the primary care level are largely unavailable. We did a systematic review to understand the barriers and facilitators in the implementation of mental health programmes. We searched five databases and included studies published between Jan 1, 1990, and Sept 1, 2017, that used qualitative methods to assess the implementation of programmes for adults with common mental disorders at primary health-care settings in low-income and middle-income countries. The Critical Appraisal Skills Programme Qualitative Checklist was used to assess the quality of eligible papers. We used the so-called best fit framework approach to synthesise findings according to the Consolidated Framework for Implementation Research. We identified 24 papers for inclusion. These papers described the implementation of nine programmes in 11 countries. Key factors included: the extent to which an organisation is ready for implementation; the attributes, knowledge, and beliefs of providers; complex service user needs; adaptability and perceived advantage of interventions; and the processes of planning and evaluating the implementation. Evidence on implementation of mental health programmes in low-income and middle-income countries is scarce. Synthesising results according to the Consolidated Framework for Implementation Research helped to identify key areas for future action, including investment in primary health-care strengthening, capacity building for health providers, and increased support to address the social needs of service users.


Assuntos
Prestação Integrada de Cuidados de Saúde , Planejamento em Saúde , Transtornos Mentais , Serviços de Saúde Mental , Atenção Primária à Saúde , Adulto , Países em Desenvolvimento , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/organização & administração , Pobreza
4.
Anaesthesia ; 75(1): 96-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729019

RESUMO

Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.


Assuntos
Anestesistas/psicologia , Anestesistas/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Estresse Psicológico/diagnóstico , Suicídio/prevenção & controle , Suicídio/psicologia , Guias como Assunto , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Fatores de Risco , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Suicídio/estatística & dados numéricos , Reino Unido
5.
Psychiatr Hung ; 35(1): 20-29, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31854319

RESUMO

BACKGROUND: The measure of health-related quality of life (HRQoL) among children with mental disorders is still in early ages, even though the worldwide-pooled prevalence of psychiatric diagnoses among children and adolescents is around 13%. Several studies confirmed that these children have impaired social and school functioning and low HRQoL. Mental disorders among children often remain undiagnosed or diagnosed too late, in that case additional negative effects could be expected. The aim of the current study was to identify psychiatric disorders in children who participated in a clinical study as a "healthy" control group and measure its effects on HRQoL. METHODS: The inclusion criteria for control participated children were not having ongoing or previous psychiatric or psychological treatment. In the second step control children (n=79, age range 6-15) were divided into two subgroups according to achieved diagnostic criteria. Measures were Mini International Neuropsychiatric Interview Kid and Inventory for the Assessment of the Quality of Life in Children and Adolescents. For data analyzing due to unequal sample sizes robust Welch t-test with omega squared, Spearman's rank correlation coefficients and logistic regression were applied. RESULTS: According to the children and parents control group with diagnoses have lower HRQoL in school, peer relationships and mental health dimensions than control group without diagnoses. Furthermore, by the children's report this difference exists in the domain of time spent alone, by the parent proxy report exist in the somatic health and general dimensions. An increasing number of diagnoses decreased HRQoL in most areas. The presence of psychiatric diagnoses by children increase 8 times more likely to have low HRQoL in the domain of school and 4 times in the domain of time spent alone. CONCLUSIONS: These results draw attention to the relative high ratio of undiagnosed mental disorders in the control group and for the low HRQoL of these children. Screening of psychiatric disorders in schools should be crucial and the earliest recourse of treatment in the identified children. The findings of this study also underline the importance of assessing HRQoL from different perspectives.


Assuntos
Grupos Controle , Nível de Saúde , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Qualidade de Vida/psicologia , Adolescente , Criança , Humanos , Pais
7.
Psychiatr Hung ; 34(4): 443-450, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31767805

RESUMO

Professor László Tringer, on the occasion of his 80th birthday, will revive his almost half a century experience in the field of Hungarian forensic psychiatry (since 1970) as an expert witness, as well as the memorable events of his work in this field. The activities of Medical Research Council Justice Committee (MRC JC), the inflation of psychiatric diagnoses and the question of expert objectivity are also discussed.


Assuntos
Psiquiatria Legal/história , Prova Pericial , História do Século XX , Humanos , Hungria , Transtornos Mentais/diagnóstico
9.
Adv Exp Med Biol ; 1192: 341-352, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705504

RESUMO

Early detection and early intervention approach targets people at-risk stages who are very close to conversion to illness, or patients who have just transited the illness stage and have not, yet, become chronic. Rigorous efforts have been put in for early detection and early intervention in psychiatry. A high-risk population is identified by clinical manifestations that, as per their severity and suffering, do not yet meet the diagnostic criteria of psychiatric disorders. There have been attempts to break through the existing phenotype-based diagnostic system using biomarkers, but researchers have yet to overcome the heterogeneity of the disease. Nowadays, the clinical staging models in psychosis, bipolar, and depressive disorders have been proposed as a heuristic and a practical alternative to this. This model is evolving to integrate various demographic factors, clinical symptoms, cognitive functions, and biomarkers.


Assuntos
Transtornos Mentais/diagnóstico , Diagnóstico Precoce , Humanos , Fenótipo , Fatores de Risco
10.
Adv Exp Med Biol ; 1192: 399-428, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705506

RESUMO

Theoretical psychiatry considers theoretical problems in psychiatry as well as the quality and effectiveness of mental health care. This chapter addresses the idea of predictive, preventive, precision, personalized, and participatory medicine in psychiatry from a theoretical transdisciplinary integrative perspective and systems networking. The aim of the chapter is to bring together some current ideas and concepts such as computational neuroscience, network theory, multi-omics profile, precision medicine, and person-centered psychiatry as a coherent system of theory and practice.


Assuntos
Transtornos Mentais/terapia , Assistência Centrada no Paciente/métodos , Medicina de Precisão , Psiquiatria/métodos , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Modelos Psicológicos
11.
Adv Exp Med Biol ; 1192: 479-489, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705509

RESUMO

Understanding of the psychopathology of various psychiatric disorders is evolving, with newer avenues of research enlightening us from genetics, epigenetics, functional neurobiology, neural circuits, hormones and social/environmental determinants. We are now aware that neurobiological factors are contributing to the development of psychiatric illnesses coupled with their interaction with psychosocial factors. Resilience is defined as the ability to bounce back after an adversity or life event that was traumatic and life-changing. It is a factor that is a unique psychopathological construct as it is a biopsychosocial factor which determines an individual's response to an illness and recovery from the same. Resilience is a human capacity to adapt swiftly and successfully to stress and to revert to a positive state. There has been now a paradigm shift in the understanding of resilience with respect to stress risk vulnerability and such dimensions of psychopathology. Resilience is a factor that must be evaluated in every patient and that shall help us determine the outcome of psychiatric disorders and will also be a determinant in the occurrence of relapses. Early identification of vulnerable patients shall lead to the implementation of resilience-based interventions in these populations and shall prevent against future occurrence of these disorders. In this chapter, we posit the construct of resilience as a psychopathological construct for mental disorders.


Assuntos
Transtornos Mentais/psicologia , Psicopatologia , Resiliência Psicológica , Humanos , Transtornos Mentais/diagnóstico , Neurobiologia
12.
Adv Exp Med Biol ; 1192: 521-544, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705512

RESUMO

Major psychiatric disorders are linked to early mortality and patients afflicted with these ailments demonstrate an increased risk of developing physical diseases that are characteristically seen in the elderly. Psychiatric conditions like major depressive disorder, bipolar disorder, and schizophrenia may be associated with accelerated cellular aging, indicated by shortened leukocyte telomere length (LTL), which could underlie this connection. Telomere shortening occurs with repeated cell division and is reflective of a cell's mitotic history. It is also influenced by cumulative exposure to inflammation and oxidative stress as well as the availability of telomerase, the telomere-lengthening enzyme. Precariously short telomeres can cause cells to undergo senescence, apoptosis, or genomic instability; shorter LTL correlates with compromised general health and foretells mortality. Important data specify that LTL may be reduced in principal psychiatric illnesses, possibly in proportion to exposure to the ailment. Telomerase, as measured in peripheral blood monocytes, has been less well characterized in psychiatric illnesses, but a role in mood disorder has been suggested by preclinical and clinical studies. In this manuscript, the most recent studies on LTL and telomerase activity in mood disorders are comprehensively reviewed, potential mediators are discussed, and future directions are suggested. An enhanced comprehension of cellular aging in psychiatric illnesses could lead to their re-conceptualizing as systemic ailments with manifestations both inside and outside the brain. At the same time, this paradigm shift could identify new treatment targets, helpful in bringing about lasting cures to innumerable sufferers across the globe.


Assuntos
Senescência Celular/genética , Leucócitos/metabolismo , Transtornos Mentais/genética , Telomerase , Telômero/metabolismo , Idoso , Humanos , Transtornos Mentais/diagnóstico , Homeostase do Telômero , Encurtamento do Telômero
13.
Health Qual Life Outcomes ; 17(1): 157, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640806

RESUMO

BACKGROUND: Mental health is increasingly viewed as the presence of various aspects of well-being rather than just the absence of mental illness. The Mental Health Continuum-Short Form (MHC-SF) is a 14-item instrument that assesses mental health, focusing on emotional, psychological, and social well-being. The present study examined for the first time the psychometric properties of the Dutch version of the MHC-SF among adolescents, focusing on its factor structure, internal consistency, construct validity, and gender and age factorial invariance. METHODS: Data were collected from a school-based sample of 1175 adolescents (53.4% girls) aged 11-17 years (M = 13.7; SD = 1.1). Participants completed an online questionnaire in the classroom during regular school hours. Statistical analyses to evaluate the factor structure, internal consistency, construct validity, and gender and age factorial invariance were performed in SPSS and R. RESULTS: Using confirmatory factor analyses, a satisfactory-to-good fit was obtained for the three-factor model (emotional, psychological, and social well-being). The MHC-SF scores showed good internal consistency (Cronbach's alpha = .91) and results supported convergent and divergent validity. Finally, the MHC-SF showed gender and age factorial invariance. CONCLUSION: The current psychometric evaluation indicates the MHC-SF is a reliable and valid instrument to assess multiple dimensions of well-being among Dutch adolescents. The instrument can be applied for research purposes and in clinical practice.


Assuntos
Escalas de Graduação Psiquiátrica/normas , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adolescente , Criança , Análise Fatorial , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Saúde Mental , Países Baixos , Reprodutibilidade dos Testes , Traduções
14.
Nervenarzt ; 90(12): 1207-1214, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31641793

RESUMO

The breathtaking technological progress in the field of mobile computing, smartphones and wearables offers new opportunities for psychiatric research and therapy. Wearables enable not only the objective assessment of psychiatric symptoms in real time and everyday life but using continuous monitoring and analysis of relevant parameters can also define important situations, contexts and timing during which extended assessment strategies and real-life interventions can be implemented. The momentary effect of inner city green space exposure on well-being, motivational behavior feedback and geofencing for the detection of drinking episodes are used as examples to illustrate the core benefits of real-time analyses and feedback from wearables for psychiatric research and therapy.


Assuntos
Psiquiatria , Dispositivos Eletrônicos Vestíveis , Humanos , Transtornos Mentais/diagnóstico , Psiquiatria/instrumentação , Psiquiatria/tendências
15.
BMC Psychol ; 7(1): 67, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651367

RESUMO

BACKGROUND: To bridge the gap between symptoms and treatment, constructing case formulations is essential for clinicians. Limited scientific value has been attributed to case formulations because of problems with quality, reliability, and validity. For understanding, communication, and treatment planning beyond each specific clinician-patient dyad, a case formulation must convey valid information concerning the patient, as well as being a reliable source of information regardless of the clinician's theoretical orientation. The first aim of the present study is to explore the completeness of unstructured psychodynamic formulations, according to four components outlined in the Case Formulation Content Coding Method (CFCCM). The second aim is to estimate the reliability of independent formulations and their components, using similarity ratings of matched versus mismatched cases. METHODS: This study explores psychodynamic case formulations as made by two or more experienced clinicians after listening to an evaluation interview. The clinicians structured the formulations freely, with the sole constraint that technical, theory-laden terminology should be avoided. The formulations were decomposed into components after all formulations had been written. RESULTS: The results indicated that most formulations were adequately comprehensive, and that overall reliability of the formulations was high (> 0.70) for both experienced and inexperienced clinician raters, although the lower bound reliability estimate of the formulation component deemed most difficult to rate - inferred mechanisms - was marginal, 0.61. CONCLUSIONS: These results were achieved on case formulations made by experienced clinicians using simple experience-near language and minimizing technical concepts, which indicate a communicative quality in the formulations that make them clinically sound. TRIAL REGISTRATION: linicalTrials.gov Identifier: NCT00423462 . https://doi.org/10.1007/s00432-018-2781-7 ., January 18, 2007.


Assuntos
Entrevista Psicológica , Transtornos Mentais/terapia , Psicoterapia , Humanos , Linguagem , Transtornos Mentais/diagnóstico , Reprodutibilidade dos Testes
16.
Rev Prat ; 69(5): 550-554, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-31626466

RESUMO

The intensification of international migrations questions the national health system: do people who come from elsewhere have specific health needs? Answering this question is difficult on the one hand because of the very great heterogeneity of situations that can cover this "coming from elsewhere", and on the other hand because of the scarcity of available health data depending on the origin. This article brings some elements to answer these questions, starting by defining who are the populations concerned and what is their weight in the French population. From the available scientific literature, it shows that if immigrants are sometimes healthier than natives when they arrive in France, because good health is one of the conditions to "try the adventure elsewhere", this initial robustness can be undermined by the difficult living conditions on arrival in France. In addition, people from countries with limited resources know during their lives in France an "accelerated health transition", chronic diseases and mental disorders taking precedence over infectious diseases.


Assuntos
Emigrantes e Imigrantes , Necessidades e Demandas de Serviços de Saúde , Nível de Saúde , Doenças Transmissíveis/diagnóstico , Emigração e Imigração , França , Humanos , Transtornos Mentais/diagnóstico
18.
Z Evid Fortbild Qual Gesundhwes ; 147-148: 20-27, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31623979

RESUMO

INTRODUCTION: The aim of this pilot study was to evaluate the effectiveness of a complex educational intervention to improve the diagnostic competencies of general practitioners (GPs) regarding the detection of depression, anxiety and somatization. METHODS: Cluster-randomized controlled pilot study with six practices each in the intervention group and in the control group. Psychological morbidity was determined by patient self-report using the Patient Health Questionnaire (PHQ-D). GPs rated the extent of psychological morbidity on a numerical rating scale from 0 (no co-morbidity) to 10 (maximum) of the individual patient after the consultation, independent of the reason for encounter. RESULTS: 364 patients participated. There were moderate correlations between GP rating and the PHQ scales (Spearman correlation between 0.27 and 0.42). There was no significant difference between intervention and control group. Diagnostic accuracy of the GPs, as determined with areas under the curves (AUCs), ranged between 0.52 (95%KI 0.30-0.73) and 0.84 (95%KI 0.67-1.00). The AUCs showed significant heterogeneity (Cochran Q=25.0; p<0.01). The regression analysis with 'presence of psychological disorder' (in PHQ) as the dependent variable showed that longer duration of doctor-patient-relationship was negatively associated with psychological morbidity (OR 0.96; 95%KI 0.92-0.99; p=0.01). There was a significant interaction between the factors 'time of doctor-patient relationship' and 'GP rating' (ß=0.02; OR 1.02, 95%KI 1.01-1.03; p<0.001), pointing towards increasing diagnostic accuracy when patients are known for a longer time. DISCUSSION: We found no significant effect regarding the educational intervention. The GPs' estimation regarding psychological morbidity correlated significantly with the self-rating of the patients on PHQ scales. However, there was a considerable inter-individual variation between the GPs' diagnostic accuracy. The diagnostic estimation improved with increasing duration of doctor-physician relationship. CONCLUSION: A one-time educational intervention seems not to be sufficient to improve diagnostic competencies in the detection of psychological morbidity. The considerable variation of the diagnostic accuracy might explain why 'one-size-fits-all' educational interventions will not help improve diagnostic competencies.


Assuntos
Competência Clínica , Medicina Geral , Clínicos Gerais/educação , Transtornos Mentais/diagnóstico , Relações Médico-Paciente , Educação Médica Continuada , Medicina de Família e Comunidade , Medicina Geral/educação , Medicina Geral/normas , Alemanha , Humanos , Projetos Piloto , Encaminhamento e Consulta
19.
Psychopathology ; 52(4): 248-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31578018

RESUMO

BACKGROUND: Physicians and therapists are also consulted to give judgments on working ability. Ability to work cannot simply be derived from the patient's symptom status but from the illness-related capacity impairments in relation to the work demands. A structured assessment of capacity impairments has been evaluated and applied internationally: the Mini-ICF-APP Social Functioning Scale. It is currently unclear whether a free-text clinical report (i.e., usual clinical practice: clinical exploration according to clinical standards, but without a standardized documentation form, instead a text is written) and a structured capacity assessment correspond to the overall work ability judgment, i.e., the decision whether a patient is "fit for work" or "unfit for work." OBJECTIVES: This investigation assessed, for the first time, whether usual clinical judgment and the additional structured capacity rating support the work ability decision. METHODS: A total of 100 medical reports from patients in a psychotherapy hospital were excerpted for psychopathological symptoms and capacity disorders using a checklist. Additionally, a structured assessment of capacity disorders was documented on the Mini-ICF-APP rating for all patients. RESULTS: In the free-text clinical medical report, endurance, flexibility, and contacts to others were the things mainly reported as impaired. This was similar to the structured Mini-ICF-APP rating. However, other capacity impairments were also reported in the Mini-ICF-APP, i.e., adherence to rules and regulations, planning and structuring, assertiveness, and group integration. When the free-text clinical report and the structured Mini-ICF-APP rating were compared, there was a higher rate of stated impairments covering all capacity dimensions in the Mini-ICF-APP rating. CONCLUSIONS: The free-text report in the medical report shows the differences between patients who are fit for work and those who are not, and thus speak for the validity of work ability decisions. However, optimization is possible in terms of depth and differentiation of capacity impairment description by adhering to the standard set by the Mini-ICF-APP.


Assuntos
Transtornos Mentais/diagnóstico , Saúde do Trabalhador/tendências , Avaliação da Capacidade de Trabalho , Local de Trabalho/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
BMC Psychol ; 7(1): 66, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31639054

RESUMO

BACKGROUND: Recent Life Changes Questionnaire (RLCQ) developed by Richard Rahe has enabled quantification of stress by analyzing life events. The overall aim of the study was to create a reliable version of the Rahe's RLCQ for measuring stress in individuals living in developing countries and assess its validity. This paper discusses criterion validation of the adapted RLCQ in urban communities in Pakistan. METHODS: This is a criterion validation study. Four urban communities of Karachi, Pakistan were selected for the study in which households were randomly chosen. Two data collectors were assigned to administer the adapted RLCQ to eligible participants after obtaining written informed consent. Following this interaction, two psychologists interviewed the same participants with a diagnostic gold standard of Mini International Neuropsychiatric Interview (MINI) which is utilized in usual practice within Pakistan to confirm the presence of stress related mental disorders such as Depression, Anxiety, Dysthymia, Suicide, Phobia, OCD, Panic Disorder, PTSD, Drug abuse and dependence, Alcohol abuse and dependence, Eating Disorders and Antisocial Personality Disorder to validate the accuracy of the adapted RLCQ. We generated the ROC curves for the adapted RLCQ with suggested cut-offs, and analyzed the sensitivity and specificity of the adapted RLCQ. RESULTS: The area under the receiver operating characteristic curve (ROC) of common mental disorders such as depression and anxiety was 0.64, where sensitivity was 66%, specificity was 56% and the corresponding cut off from the adapted RLCQ was 750. Individuals scoring ≥750 were classified as high stress and vice versa. In contrast, the area under the ROC curve for serious mental disorder and adverse outcomes such as suicide, bipolar and dysthymia was 0.75, where sensitivity was 72% and specificity was 60% at the cut off of 800 on the adapted RLCQ. Individuals scoring ≥800 were classified as high stress and vice versa. The rate of agreement between the two psychologists was 94.32% (Kappa = 0.84). CONCLUSION: The adapted and validated RLCQ characterizes common mental disorders such as depression and anxiety with moderate accuracy and severe mental disorders such as suicide, bipolar and dysthymia with high accuracy. TRIAL REGISTRATION: Clinicaltrials.gov NCT02356263 . Registered January 28, 2015. (Observational Study Only).


Assuntos
Climatério/psicologia , Transtornos Mentais/diagnóstico , Estresse Psicológico , Inquéritos e Questionários , Adulto , Ansiedade , Depressão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , População Urbana
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA