Relationship between diagnosis and disposition of patients admitted to a state psychiatric hospital

Correlates of Near-Infrared Spectroscopy Brain-Computer Interface Accuracy in a Multi-Class Personalization Framework

Brain–computer interfaces (BCIs) provide individuals with a means of interacting with a computer using only neural activity. To date, the majority of near-infrared spectroscopy (NIRS) BCIs have used prescribed tasks to achieve binary control. The goals of this study were to evaluate the possibility of using a personalized approach to establish control of a two-, three-, four-, and five-class NIRS–BCI, and to explore how various user characteristics correlate to accuracy. Ten able-bodied participants were recruited for five data collection sessions. Participants performed six mental tasks and a personalized approach was used to select each individual’s best discriminating subset of tasks. The average offline cross-validation accuracies achieved were 78, 61, 47, and 37% for the two-, three-, four-, and five-class problems, respectively. Most notably, all participants exceeded an accuracy of 70% for the two-class problem, and two participants exceeded an accuracy of 70% for the three-class problem. Additionally, accuracy was found to be strongly positively correlated (Pearson’s) with perceived ease of session (ρ = 0.653), ease of concentration (ρ = 0.634), and enjoyment (ρ = 0.550), but strongly negatively correlated with verbal IQ (ρ = −0.749).

Finding workers, offenders, or students most at-risk for violence: actuarial tests save lives and resources

147 adults (107 men, 40 women) and 89 adolescents (61 boys, 28 girls), selected randomly from referrals and volunteers, were given the Ammons Quick Test (QT), the Beck Suicide Scale (BSS), the Minnesota Multiphasic Personality Inventory Second (MMPI-2) or Adolescent Versions (MMPI-A), the Raven's Advanced Progressive Matrices, and the Standard Predictor (SP) of Violence Potential Adult or Adolescent Versions. The goals were to: (a) demonstrate computer and paper-and-pencil tests correlated; (b) validate tests to identify at-risk for violence; (c) show that identifying at-risk saves lives and resources; and (d) find which industries benefited from testing at-risk. Paper-and-pencil vs. computer test correlations (.83-.99), sensitivity (.97-.98), and specificity (.50-.97) were computed. Testing at-risk saves lives and resources. Critical industries for testing at-risk individuals may include airlines, energy generating industries, insurance, military, nonprofit-religious, prisoners, trucking or port workers, and veterans.

Schizoaffective disorder diagnosed according to different diagnostic criteria--systematic literature search and meta-analysis of key clinical characteristics and heterogeneity

BACKGROUND

Schizoaffective disorder is viewed as a heterogeneous diagnosis among psychotic illnesses. Different diagnostic systems differ in their definition with DSM (-IIIR, -IV, and -V) providing a narrower definition than RDC and ICD-10. It is unclear whether this difference is reflected in patient samples diagnosed according to different diagnostic systems.

METHODS

Exploratory study based on a systematic review of studies of schizoaffective disorder samples diagnosed by either RDC and ICD-10 (group of "broad criteria") or DSM-IIIR and -IV ("narrow criteria"); comparison (by Mann-Whitney-U-tests) of key characteristics, such as age, number of hospitalizations, or scores in psychometric tests, between more broadly and more narrowly defined schizoaffective disorder samples using standard deviations as a measurement of heterogeneity as well as weighted means and percentages. To reduce selection bias only studies including schizoaffective patient samples together with affective disorder and schizophrenia samples were selected.

RESULTS

55 studies were included, 14 employing RDC, 4 ICD-10, 20 DSM-IIIR, and 17 DSM-IV. Thirteen characteristics were compared: patients diagnosed according to broader criteria had fewer previous hospitalizations (2.2 vs. 5.4) and were both less often male (42 vs. 51%) and married (21 vs. 40%). Heterogeneity was similar in both groups but slightly higher in RDC and ICD-10 samples than in DSM-IIIR and -IV-samples: +4% regarding demographic and clinical course data and +13% regarding psychometric tests (pooled SD).

LIMITATIONS

Secular trends and different designs may have confounded the results and limit generalizability. Some comparisons were underpowered.

CONCLUSIONS

Differences in diagnostic criteria are reflected in key characteristics of samples. The association of larger heterogeneity with wider diagnostic criteria supports employing standard deviations as a measurement of heterogeneity.

Ammons Quick Test Validity among Randomly Selected Referrals

After selection using a random number table, from volunteer referrals, 89 Youth (61 boys, 28 girls; 48 African Americans, 2 Asian Americans, 27 Euro-Americans, 12 Hispanic Americans), and 147 Adults (107 men, 40 women; 11 African Americans, 6 Asian Americans, 124 Euro-Americans, 6 Hispanic Americans) were administered the Amnions Quick Test (QT). Means, confidence intervals, standard deviations, and Pearson product-moment correlations among tests were computed. The Amnions QT was moderately to strongly and significantly correlated statistically with: the Peabody Picture Vocabulary Test-3b (PPVT-3b); the Vineland Adaptive Behavior Scales-2 Parent/Teacher Form; the Wechsler Intelligence Scale for Children (WISC-4) or the Wechsler Adult Intelligence Scale (WAIS-4); and the Wide Range Achievement Test-Fourth Edition (WRAT-4) Blue and Green Forms. After 51 years, the original norms for the Amnions QT remain valid measures of receptive vocabulary, verbal intelligence, and auditory information processing useful to clinicians.

Patterns of care in patients discharged from acute psychiatric inpatient facilities: a national survey in Italy

OBJECTIVE

To analyze the characteristics of patients scheduled for discharge from acute psychiatric inpatient facilities in Italy, and their pattern of care.

METHODS

Socio-demographic and clinical characteristics, and patterns of care of 1,330 patients discharged from public and private inpatient facilities in Italy were assessed with a standardized methodology during an index period in the year 2004.

RESULTS

About one half of the sample had schizophrenia or bipolar disorder. However, the case-mix differed between public and private facilities, where in-patients had more frequently mood and anxiety disorders. The use of two or more drugs was very common, involving more than 90% of patients and including typically benzodiazepines and antipsychotics. Structured psychosocial treatments were rarely initiated during the hospital stay. Increasing age, male gender, long stay in the facility (>60 days), personality disorder and type of facility were associated with a higher likelihood of being discharged to a community residential facility. Predictors of discharge to another psychiatric facility were increasing age, being single, schizophrenia, personality disorder and organic mental disorder. Families were not involved in decisions about patients' discharge in a significant proportion of cases. University psychiatric clinics and private facilities were less coordinated with the community system of care than General Hospital Psychiatric Units. Referral of patients with substance use disorder to drug addiction services occurred in just 30% of subjects.

CONCLUSIONS

This study provides information on the characteristics and the pattern of care of patients discharged from inpatient facilities in a country that has closed down all its mental hospitals. This information may be relevant for those countries that are affording now the downsizing of MHs, and the expansion of community-based models of care.

Does schizoaffective disorder really exist? A systematic review of the studies that compared schizoaffective disorder with schizophrenia or mood disorders

BACKGROUND

Since its first definition in the literature, schizoaffective disorder (SAD) has raised a considerable controversy regarding its clinical distinction from schizophrenia (SCH) and mood disorders (MD) as well as its validity as an independent nosological category.

OBJECTIVE

Investigate the validity of SAD as a discrete nosological category and its relationship with SCH and MD.

METHOD

A systematic literature review of clinical trial that compared SAD with SCH and/or MD patients was carried out throughout MEDLINE, psycINFO, Cochrane Library, SCIELO and LILACS databases.

RESULTS

Evaluation of demographic characteristics, symptomatology, other clinical data, dexamethasone suppression test, neuroimage exams, response to treatment, evolution and family morbidity indicated that SAD occupies an intermediate position between SCH and MD. Literature review also failed to indicate a clear cut distinction between SAD and SCH or MD.

DISCUSSION

Present analysis indicated that SAD cannot be interpreted as atypical forms of SCH or MD. SAD also does not appear to represent a SCH and MD comorbidity or yet an independent mental disorder. It is argued that SAD might constitute a heterogeneous group composed by both SCH and MD patients or a middle point of a continuum between SCH and MD.