Psychometric Properties of the Slovenian Version of the Cardiac Depression Scale.

Introduction: The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease. Methods: A total of 272 patients with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed. Results: Cronbach's alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations. Conclusions: The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.

Evaluating anxiety in elective coronary angiography study: rationale, design, and study methodology.

AIMS: Prevalence of anxiety disorder in coronary artery disease reaches up to 15% and about half of patients with coronary artery disease have anxiety or depression comorbidity. Prevalence of anxiety in patients undergoing percutaneous coronary intervention ranges 24-72%. Depression can often overlap with anxiety symptoms and the evaluation of anxiety in elective coronary angiography study (ANGST) aims to determine the prevalence of anxiety by excluding patients with comorbid depressive symptoms. ANGST also aims to determine how anxiety correlates with psychological parameters (personality traits, coping strategies) and with outcome of elective coronary angiography (ECA). METHODS: We will conduct a prospective single-center cross-section study in patients undergoing ECA. Anxiety will be evaluated at four time points using self-rating questionnaires: 14 days prior to ECA; 2-4 h before ECA; 24 h after ECA, but prior to discharge; and 4-6 weeks after discharge. The primary outcome of ANGST is the burden of anxiety experienced by patients without depressive symptoms and a correlation of anxiety with ECA outcome. CONCLUSION: Our study aims to provide evidence on which personality traits and coping strategies affect the levels of anxiety. We will also determine psychometric properties of the two questionnaires used in our study. The results will have implications for improvement of interventions designed to recognize anxiety and will offer future research of psychological and/or pharmacological interventions to reduce the burden of anxiety.

The present global financial and economic crisis poses an additional risk factor for mental health problems on the employees.

BACKGROUND: The global financial and economic crisis starting in 2007 led to a deterioration of several socio-economic determinants of mental health. The aim of this cross-sectional study was to examine the impact of the present economic crisis on the depression and anxiety levels of the employed in the private and public sector in Slovenia. SUBJECTS AND METHODS: Altogether 1592 employees completed an internet based self-reported questionnaire. Data about perceived impact of the economic crisis, several socio-demographic, socioeconomic, and health parameters were collected. Depression symptoms were assessed by the Center for Epidemiological Studies-Depression Scale and anxiety symptoms by the Spielberger State-Inventory. Regression models were used 1) to explore the associations of the economic crisis with the level of depression and anxiety symptoms while controlling for some sociodemographic and work characteristic variables, and 2) to understand the relationship between some potentially important socioeconomic variables and the perception of the economic crisis. RESULTS: Depressive and anxiety scores were significantly increased among 590 (46.6%) employees being affected by the economic crisis. The level of depressive symptoms was significantly associated with perceived impact by the crisis, recent sick leave, reported injuries sustained at work, benzodiazepine and analgesic use, the lack of emotional support, and trust in crisis telephone lines. The level of anxiety symptoms yielded the robust association with the level of depression symptoms, reported injuries sustained on the way to work and education. CONCLUSIONS: The economic crisis poses an additional risk factor for mental health problems which clinicians should internalize and become more aware of them. Symptoms of depression and anxiety can be masked in high-utilizers of medical care with physical complaints or psychoactive drug use.

Duration of untreated psychosis and it's effect on the functional outcome in schizophrenia - preliminary results.

OBJECTIVES: A long duration of untreated psychosis (DUP) is associated with a poorer prognosis and with worse functional outcome. The aim of the study was to show that early treatment with antipsychotics in the prodromal phase improves the outcome; to compare outcome in patients with DUP longer than 1 year (group 1) with patients who had received treatment with antipsychotic medication in the prodromal phase of the disease (group 0). SUBJECTS AND METHODS: 87 patients with schizophrenia were included in the retrospective study, 37 patients in group 0 and 50 patients in group 1. Sociodemographic parameters were evaluated, including employment, marital status and educational level. Groups were compared during the acute psychosis of first episode (t1) and at the conclusion of the study (t2). RESULTS: Vocational status was worse in group 1 with a higher degree of unemployment and disability than in group 0 (chi(2)=17.47, df=4, p=0.002) at t2. More than half of the patients in group 1 were on disability benefit as compared to 19% of patients in group 0. At t1 differences were not statistically significant (chi(2)=4.15, df=3, p=0.245). There were more single patients in group 1 during both evaluations. At t1 almost half of the patients in group 0 were married; in group 1 only 18% were married (chi(2)=11.47, df=3, p=0.003). Also at t2 more patients in group 0 were married than in group 1 (chi(2)=8.01, df=3, p=0.046). Significant differences between the groups in achieved educational level were noted only at t1 (chi(2)=9.65, df=3, p=0.022). CONCLUSIONS: Better outcome can be achieved with early antipsychotic treatment in the prodromal phase.

A blind spot on the global mental health map: a scoping review of 25 years' development of mental health care for people with severe mental illnesses in central and eastern Europe.

Just over 25 years have passed since the major sociopolitical changes in central and eastern Europe; our aim was to map and analyse the development of mental health-care practice for people with severe mental illnesses in this region since then. A scoping review was complemented by an expert survey in 24 countries. Mental health-care practice in the region differs greatly across as well as within individual countries. National policies often exist but reforms remain mostly in the realm of aspiration. Services are predominantly based in psychiatric hospitals. Decision making on resource allocation is not transparent, and full economic evaluations of complex interventions and rigorous epidemiological studies are lacking. Stigma seems to be higher than in other European countries, but consideration of human rights and user involvement are increasing. The region has seen respectable development, which happened because of grassroots initiatives supported by international organisations, rather than by systematic implementation of government policies.