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Lopez AO, Martinez MN, Garcia JM, Kunik ME, Medina LD. Self-report depression screening measures for older Hispanic/Latin American adults: A PRISMA systematic review. J Affect Disord 2021; 294:1-9. [PMID: 34252863 PMCID: PMC8410643 DOI: 10.1016/j.jad.2021.06.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/26/2021] [Accepted: 06/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Assessing depression symptoms in Hispanic/Latin American (H/Ls) older adults, a group at high risk for depression, is nuanced due to the influence of cultural characteristics in symptom expression and manifestation. Little is known about the psychometric properties of available measures when used with this population. METHODS We conducted a two-stage systematic review of available depression assessment tools. We first identified self-report measures designed for use with adults. We then identified studies where at least one of such measures was used with older H/Ls that reported psychometric properties for the measure(s) used. RESULTS Only 3 measures were identified for use with older H/Ls: the BDI, GDS, and CES-D. However, few data were found to support the validity of the BDI, and the CES-D was not consistently valid across cultural groups. The GDS was found appropriate, though its performance varied based on race/ethnicity, nationality, and cutoff scores. The CES-D and GDS also demonstrated varying psychometric properties based on study setting (research versus clinical) and target population (inpatient psychiatric patients versus community-dwelling individuals). LIMITATIONS The number of articles that met criteria for inclusion in our review was small, and there was variation among samples of the few studies included. CONCLUSIONS Currently available self-report depression screening measures have acceptable applicability among older H/Ls, but their utility may vary based on their intended use. Modified cutoff scores may be beneficial in maximizing the utility of these measures when given to diverse older adults.
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Affiliation(s)
- Andrea Ochoa Lopez
- Department of Psychology, University of Houston, Houston, TX, United States
| | | | - Joshua M Garcia
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Mark E Kunik
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Luis D Medina
- Department of Psychology, University of Houston, Houston, TX, United States.
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Brain immune cells characterization in UCMS exposed P2X7 knock-out mouse. Brain Behav Immun 2021; 94:159-174. [PMID: 33609652 DOI: 10.1016/j.bbi.2021.02.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Several lines of evidence suggest that neuroinflammation might be a key neurobiological mechanism of depression. In particular, the P2X7 receptor (P2X7R), an ATP-gated ion channel involved in activation of the pro-inflammatory interleukin IL-1β, has been shown to be a potential new pharmacological target in depression. The aim of this study was to explore the impact of unpredictable chronic mild stress (UCMS) on behavioural changes, hippocampal neurogenesis, and cellular characterisation of brain immune cells, in P2X7R Knock-Out (KO) mice. METHODS P2X7R KO and wild-type (WT) mice were subjected to a 6-week UCMS protocol and received a conventional oral antidepressant (15 mg.kg-1 fluoxetine) or water per os. The mice then underwent behavioural tests consisting of the tail suspension test (TST), the elevated plus maze (EPM) test, the open field test, the splash test and the nest building test (week 7). Doublecortin immunostaining (DCX) of brain slices was used to assess neurogenesis in the dentate gyrus. Iba1 and TMEM119 immunostaining was used to characterise brain immune cells, Iba1 as a macrophage marker (including microglial cells) and TMEM119 as a potential specific resident microglial cells marker. RESULTS After a 6-week UCMS exposure, P2X7R KO mice exhibited less deterioration of their coat state, spent a significantly smaller amount of time immobile in the TST and spent a larger amount of time in the open arms of the EPM. As expected, adult ventral hippocampal neurogenesis was significantly decreased by UCMS in WT mice, while P2X7R KO mice maintained ventral hippocampal neurogenesis at similar levels in both control and UCMS conditions. In stress-related brain regions, P2X7R KO mice also exhibited less recruitment of Iba1+/TMEM119+ and Iba1+/TMEM119- cells in the brain. The ratio between these two staining patterns revealed that brain immune cells were mostly composed of Iba1+/TMEM119+ cells (87 to 99%), and this ratio was affected neither by P2X7R genetic depletion nor by antidepressant treatment. DISCUSSION Behavioural patterns, neurogenesis levels and density of brain immune cells in P2X7R KO mice after exposure to UCMS significantly differed from control conditions. Brain immune cells were mostly increased in brain regions known to be sensitive to UCMS exposure in WT but not in P2X7R KO mice. Considering Iba1+/TMEM119- staining might characterize peripheral immune cells, the ratio between Iba1+/TMEM119+ cells and IBA1+/TMEM119- cells, suggests that the rate of peripheral immune cells recruitment may not be modified neither by P2X7R gene expression nor by antidepressant treatment.
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Kolovos S, Bosmans JE, van Dongen JM, van Esveld B, Magai D, van Straten A, van der Feltz-Cornelis C, van Steenbergen-Weijenburg KM, Huijbregts KM, van Marwijk H, Riper H, van Tulder MW. Utility scores for different health states related to depression: individual participant data analysis. Qual Life Res 2017; 26:1649-1658. [PMID: 28260149 PMCID: PMC5486895 DOI: 10.1007/s11136-017-1536-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Depression is associated with considerable impairments in health-related quality-of-life. However, the relationship between different health states related to depression severity and utility scores is unclear. The aim of this study was to evaluate whether utility scores are different for various health states related to depression severity. METHODS We gathered individual participant data from ten randomized controlled trials evaluating depression treatments. The UK EQ-5D and SF-6D tariffs were used to generate utility scores. We defined five health states that were proposed from American Psychiatric Association and National Institute for Clinical Excellence guidelines: remission, minor depression, mild depression, moderate depression, and severe depression. We performed multilevel linear regression analysis. RESULTS We included 1629 participants in the analyses. The average EQ-5D utility scores for the five health states were 0.70 (95% CI 0.67-0.73) for remission, 0.62 (95% CI 0.58-0.65) for minor depression, 0.57 (95% CI 0.54-0.61) for mild depression, 0.52 (95%CI 0.49-0.56) for moderate depression, and 0.39 (95% CI 0.35-0.43) for severe depression. In comparison with the EQ-5D, the utility scores based on the SF-6D were similar for remission (EQ-5D = 0.70 vs. SF-6D = 0.69), but higher for severe depression (EQ-5D = 0.39 vs. SF-6D = 0.55). CONCLUSIONS We observed statistically significant differences in utility scores between depression health states. Individuals with less severe depressive symptoms had on average statistically significant higher utility scores than individuals suffering from more severe depressive symptomatology. In the present study, EQ-5D had a larger range of values as compared to SF-6D.
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Affiliation(s)
- Spyros Kolovos
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - Judith E Bosmans
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Birre van Esveld
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Dorcas Magai
- Department of Clinical, Neuro and Developmental Psychology, and the EMGO Institute for Health and Care Research, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro and Developmental Psychology, and the EMGO Institute for Health and Care Research, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Christina van der Feltz-Cornelis
- Department of Social Psychiatry Tranzo, Tilburg University, Tilburg, The Netherlands
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands
| | | | | | - Harm van Marwijk
- Centre for Primary Care, Institute for Population Health, University of Manchester, Manchester, UK
- Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, and the EMGO Institute for Health and Care Research, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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Kolovos S, Kleiboer A, Cuijpers P. Effect of psychotherapy for depression on quality of life: meta-analysis. Br J Psychiatry 2016; 209:460-468. [PMID: 27539296 DOI: 10.1192/bjp.bp.115.175059] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/14/2016] [Accepted: 04/27/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several meta-analyses have shown that psychotherapy is effective for reducing depressive symptom severity. However, the impact on quality of life (QoL) is as yet unknown. AIMS To investigate the effectiveness of psychotherapy for depression on global QoL and on the mental health and physical health components of QoL. METHOD We conducted a meta-analysis of 44 randomised clinical trials comparing psychotherapy for adults experiencing clinical depression or elevated depressive symptoms with a control group. We used subgroup analyses to explore the influence of various study characteristics on the effectiveness of treatment. RESULTS We detected a small to moderate effect size (Hedges' g = 0.33, 95% CI 0.24-0.42) for global QoL, a moderate effect size for the mental health component (g = 0.42, 95% CI 0.33-0.51) and, after removing an outlier, a small but statistically significant effect size for the physical health component (g = 0.16, 95% CI 0.05-0.27). Multivariate meta-regression analyses showed that the effect size of depressive symptoms was significantly related to the effect size of the mental health component of QoL. The effect size of depressive symptoms was not related to global QoL or the physical health component. CONCLUSIONS Psychotherapy for depression has a positive impact on the QoL of patients with depression. Improvements in QoL are not fully explained by improvements in depressive symptom severity.
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Affiliation(s)
- Spyros Kolovos
- Spyros Kolovos, MSc, Department of Health Sciences, VU University Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Annet Kleiboer, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University, Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lunebrug, Germany
| | - Annet Kleiboer
- Spyros Kolovos, MSc, Department of Health Sciences, VU University Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Annet Kleiboer, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University, Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lunebrug, Germany
| | - Pim Cuijpers
- Spyros Kolovos, MSc, Department of Health Sciences, VU University Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Annet Kleiboer, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University, Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lunebrug, Germany
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Huibers MJH, de Graaf LE, Peeters FPML, Arntz A. Does the weather make us sad? Meteorological determinants of mood and depression in the general population. Psychiatry Res 2010; 180:143-6. [PMID: 20494449 DOI: 10.1016/j.psychres.2009.09.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 09/24/2009] [Accepted: 09/29/2009] [Indexed: 11/15/2022]
Abstract
It is a common and well-spread belief that people feel more depressed when the weather is bad. However, whether meteorological factors such as temperature, sunshine and rainfall can actually account for variations in the prevalence of depression in the general population has yet to be investigated. We aimed to assess the influence of weather conditions on the seasonal variation of depression observed in the general population. We used data from a large-scale depression-screening programme in the south of the Netherlands. Seasonal prevalence of DSM-IV classified major depression and sad mood in a sample of 14,478 participants from the general population was calculated, and linked to mean daily temperature, duration of sunshine and duration of rainfall in logistic regression analyses. The prevalence of major depression and sad mood showed seasonal variation, with peaks in the summer and fall. Weather conditions were not associated with mood, and did not explain the seasonal variation we found. We conclude that, contrary to popular belief, weather conditions and sad mood or depression do not seem to be associated. Future studies might use daily measures of well-being as outcome.
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Affiliation(s)
- Marcus J H Huibers
- Department of Clinical Psychological Science, Maastricht University, The Netherlands.
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de Graaf LE, Huibers MJH, Cuijpers P, Arntz A. Minor and major depression in the general population: does dysfunctional thinking play a role? Compr Psychiatry 2010; 51:266-74. [PMID: 20399336 DOI: 10.1016/j.comppsych.2009.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2009] [Revised: 07/08/2009] [Accepted: 08/05/2009] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although most research suggests that minor depression is part of a depression continuum, conflicting results have also been found. Moreover, little is known about dysfunctional thinking in minor depression and how this varies along the continuum. Especially, research on the form of dysfunctional thinking (ie, extreme responding) is lacking. We have addressed these issues by reporting results from a large community sample. METHODS Demographic, clinical, and cognitive factors (ie, content and form of dysfunctional thinking) were compared between minor depression (ie, 2-4 symptoms), major depression with 5 to 6 symptoms, and major depression with 7 to 9 symptoms. A large community sample (N = 1129) was used. Differences between the 3 subgroups were examined as well as linear relations between number of symptoms and factors marking the severity. RESULTS Most demographic variables did not distinguish the 3 depression status categories from each other. Clinical and cognitive factors acted in synchrony with the depression continuum. CONCLUSIONS Minor depression should be considered as part of continuum together with major depression. Not only the content but also the form of dysfunctional thinking seems to play a major role in depression. Extreme positive responding is more prominent in mild depression, whereas more severely depressed individuals have a general tendency toward extreme negative responding. This finding, if replicated, may have important implications for the cognitive theory of depression.
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Affiliation(s)
- L Esther de Graaf
- Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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McKnight PE, Kashdan TB. The importance of functional impairment to mental health outcomes: a case for reassessing our goals in depression treatment research. Clin Psychol Rev 2009; 29:243-59. [PMID: 19269076 PMCID: PMC2814224 DOI: 10.1016/j.cpr.2009.01.005] [Citation(s) in RCA: 243] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 12/12/2008] [Accepted: 01/21/2009] [Indexed: 11/22/2022]
Abstract
Outcomes in depression treatment research include both changes in symptom severity and functional impairment. Symptom measures tend to be the standard outcome but we argue that there are benefits to considering functional outcomes. An exhaustive literature review shows that the relationship between symptoms and functioning remains unexpectedly weak and often bidirectional. Changes in functioning often lag symptom changes. As a result, functional outcomes might offer depression researchers more critical feedback and better guidance when studying depression treatment outcomes. The paper presents a case for the necessity of both functional and symptom outcomes in depression treatment research by addressing three aims-1) review the research relating symptoms and functioning, 2) provide a rationale for measuring both outcomes, and 3) discuss potential artifacts in measuring functional outcomes. The three aims are supported by an empirical review of the treatment outcome and epidemiological literatures.
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Affiliation(s)
- Patrick E McKnight
- Department of Psychology, George Mason University, MSN 3F5, 4400 University Drive, Fairfax, VA 22030-4400, United States.
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de Graaf LE, Roelofs J, Huibers MJH. Measuring Dysfunctional Attitudes in the General Population: The Dysfunctional Attitude Scale (form A) Revised. COGNITIVE THERAPY AND RESEARCH 2009; 33:345-355. [PMID: 19623267 PMCID: PMC2712063 DOI: 10.1007/s10608-009-9229-y] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Accepted: 01/06/2009] [Indexed: 11/18/2022]
Abstract
The Dysfunctional Attitude Scale (DAS) was designed to measure the intensity of dysfunctional attitudes, a hallmark feature of depression. Various exploratory factor analytic studies of the DAS form A (DAS-A) yielded mixed results. The current study was set up to compare the fit of various factor models. We used a large community sample (N = 8,960) to test the previously proposed factor models of the DAS-A using confirmatory factor analysis. The retained model of the DAS-A was subjected to reliability and validity analyses. All models showed good fit to the data. Finally, a two-factor solution of the DAS-A was retained, consisting of 17 items. The factors demonstrated good reliability and convergent construct validity. Significant associations were found with depression. Norm-scores were presented. We advocate the use of a 17-item DAS-A, which proved to be useful in measuring dysfunctional beliefs. On the basis of previous psychometric studies, our study provides solid evidence for a two-factor model of the DAS-A, consisting of ‘dependency’ and ‘perfectionism/performance evaluation’.
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Affiliation(s)
- L. Esther de Graaf
- Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Jeffrey Roelofs
- Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Marcus J. H. Huibers
- Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Kalpakjian CZ, Bombardier CH, Schomer K, Brown PA, Johnson KL. Measuring depression in persons with spinal cord injury: a systematic review. J Spinal Cord Med 2009; 32:6-24. [PMID: 19264045 PMCID: PMC2647502 DOI: 10.1080/10790268.2009.11760748] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 06/30/2008] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/OBJECTIVE Depression has been studied extensively among people with spinal cord injury (SCI). However, basic questions persist regarding the reliability and validity of depression measurement in the context of SCI. The objective of this study was to evaluate the state of knowledge of depression measurement in persons with SCI. METHODS English-language peer-reviewed citations from MEDLINE, CINAHL, PsycINFO, ProQuest, Google Scholar, and Web of Science from 1980 to present. Two reviewers screened 377 abstracts on SCI and depression topics to identify 144 containing classifiable psychometric data. All 144 were reviewed by 6 reviewers. Twenty-four studies reporting psychometric data on 7 depression measures in SCI samples were identified, including 7 validity studies. RESULTS Reliability data were limited to internal consistency and were consistently good to excellent across 19 studies. Validity data were limited to concurrent validity, construct validity, and/or clinical utility in 10 studies. Measures were comparable with respect to internal consistency, factor structure, and clinical utility. Results are limited to peer-reviewed, English literature, and studies were not judged for quality. CONCLUSIONS Greater attention should be paid to the psychometric evaluation of established measures. Although existing evidence may not justify universal screening, we recommend depression screening in clinical practice when patients may be seen by nonpsychology personnel. There is insufficient evidence to recommend one screening measure over another. Therefore, selection of measures will depend on clinician preferences. Psychometric studies are needed to show test-retest reliability, criterion validity, and sensitivity to change to improve depression recognition and treatment.
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Affiliation(s)
- Claire Z Kalpakjian
- Model SCI System, University of Michigan, Department of Physical Medicine and Rehabilitation, 300 N. Ingalls, Room NI 2A09, Ann Arbor, MI 48109, USA.
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Lieberman DZ, Peele R, Razavi M. Combinations of DSM-IV-TR criteria sets for bipolar disorders. Psychopathology 2008; 41:35-8. [PMID: 17952019 DOI: 10.1159/000109953] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 08/27/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND DSM-IV-TR is the standard for making psychiatric diagnoses in many countries. The diagnostic categorization of DSM-IV-TR is valued for its reliability, however it is well accepted that patients with the same diagnosis demonstrate substantial heterogeneity. In order to quantitatively characterize the degree of possible heterogeneity that can exist, combinatorial mathematics was used to calculate the number of possible ways to satisfy symptom criteria for the diagnosis of bipolar disorder as an example of this problem. SAMPLING AND METHODS The formula n!/(r!(n - r)!), which calculates the number of different ways of choosing an unordered number of items without repetition from a larger set, was used to calculate the number of combinations which meet the criteria for the core episodes of bipolar disorder and the specifiers. RESULTS The number of possible combinations for the core episodes ranged from 163 for a manic episode to 37,001 for a mixed episode. When the full collection of specifiers that DSM-IV-TR applies to bipolar disorder was used, the number of combinations was over 5 billion. CONCLUSIONS The precision of medical communication about bipolar disorder is called into question by the billions of different ways that the criteria for this diagnosis can be met. As DSM-V is developed, the possible combinations for each diagnostic criterion should be calculated, and the effect this number has on clinical communication should be considered.
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Affiliation(s)
- Daniel Z Lieberman
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC 20037, USA.
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Cornaggia CM, Beghi M, Beghi E. Psychiatric events in epilepsy. Seizure 2007; 16:586-92. [PMID: 17544705 DOI: 10.1016/j.seizure.2007.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 04/13/2007] [Accepted: 04/26/2007] [Indexed: 10/23/2022] Open
Abstract
Psychiatric events are thought to be more frequent in people with epileptic seizures than in the general population. However, inter-ictal psychiatric events attributable to epilepsy remain controversial. The aim of the present study was to evaluate the occurrence of psychiatric events in a population of fairly unselected patients with epilepsy and in the general population, and the correlation between psychiatric complaints and selected demographic and disease characteristics. The survey was part of a multicentre prospective cohort study of everyday life risks conducted in eight European countries and comparing referral children and adults with epilepsy referred to secondary/tertiary centers to age- and sex-matched non-epileptic controls. Nine hundred and fifty-one patients with epilepsy and 909 controls were studied. Each patient and his/her control received a diary to record any accident or illness, with severity, circumstances, causes, consequences, and (for the cases) the possible relation to a seizure. The follow-up period ranged between 1 and 2 years. Fifty-eight psychiatric events occurred in 25 patients (2.6%) and 88 in 19 controls (2.1%). Housewives (9.3%) and unemployed persons (4.1%) were mostly affected. No correlation was found between psychiatric events, demographic and disease characteristics. Our results suggest that people with epilepsy if unselected are not at higher risk for psychiatric disorders than the general population.
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Affiliation(s)
- Cesare Maria Cornaggia
- Clinical Psychiatry, University of Milano Bicocca, V. Cadore 48, 20052 Monza, Milan, Italy
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