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Siteneski A, de la Cruz-Velez M, Montes-Escobar K, Duran-Ospina JP, Fonseca-Restrepo C, Barreiro-Linzán MD, Campos García GA, Gil-Mohapel J. Effects of Transition from Remote to In-Person Learning in University Students: A Longitudinal Study. Eur J Investig Health Psychol Educ 2024; 14:1786-1802. [PMID: 38921084 PMCID: PMC11202480 DOI: 10.3390/ejihpe14060118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
Previous studies have shown that the transition from the University environment to remote learning impacted student mental health. Our study aimed to investigate the effects of university environment on anxiety and depressive symptoms in health sciences students. Students at the Technical University of Manabí, Ecuador, with 6-10 in-person semesters, who shifted to remote learning and then returned to face-to-face learning were selected. Students responded to the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). In addition, questions regarding social interaction, physical exercise, mood and sleep habits were also asked. This longitudinal study tracked 323 students during the return to in-person classes and term end. The results showed similar rates of anxiety (GAD-7, p = 0.011-p = 0.002) and depression (PHQ-9 p = 0.001-p = 0.032) among students at week 1 and week 15. Previous diagnosis of depression (OR, 0.171; CI 0.050-0.579, p < 0.005) was shown to correlate with depression levels in week 1, with no changes seen at follow-up. Anxiety levels were shown to be associated with a previous diagnosis of the disorder at week 1, but not at follow-up (OR 0.233; CI 0.085-0.643, p < 0.005). The return to in-person learning among university students maintained levels of anxiety and depressive symptoms, underscoring ongoing vulnerabilities to mental health disorders in this group.
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Affiliation(s)
- Aline Siteneski
- School of Medicine, Faculty of Health Sciences, Universidad Técnica de Manabí, Portoviejo 130102, Ecuador; (M.d.l.C.-V.)
- Research Institute, Universidad Técnica de Manabí, Portoviejo 130105, Ecuador
| | - Melina de la Cruz-Velez
- School of Medicine, Faculty of Health Sciences, Universidad Técnica de Manabí, Portoviejo 130102, Ecuador; (M.d.l.C.-V.)
| | - Karime Montes-Escobar
- Department of Mathematics and Statistics, Institute of Basic Sciences, Technical University of Manabí, Portoviejo 130105, Ecuador; (K.M.-E.); (M.D.B.-L.)
- Statistics Department, University of Salamanca, 37007 Salamanca, Spain
| | | | - Carolina Fonseca-Restrepo
- Departamento de Medicina Veterinaria, Facultad de Ciencias Veterinarias, Universidad Técnica de Manabí, Portoviejo 130105, Ecuador;
| | - Mónica Daniela Barreiro-Linzán
- Department of Mathematics and Statistics, Institute of Basic Sciences, Technical University of Manabí, Portoviejo 130105, Ecuador; (K.M.-E.); (M.D.B.-L.)
| | - Gusdanis Alberto Campos García
- School of Medicine, Faculty of Health Sciences, Universidad Técnica de Manabí, Portoviejo 130102, Ecuador; (M.d.l.C.-V.)
| | - Joana Gil-Mohapel
- Island Medical Program, Faculty of Medicine, University of British Columbia, Victoria, BC V8P 5C2, Canada;
- Division of Medical Sciences, University of Victoria, Victoria, BC V8P 5C2, Canada
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Brattmyr M, Lindberg MS, Lundqvist J, Solem S, Hjemdal O, Anyan F, Havnen A. Symptoms and prevalence of common mental disorders in a heterogenous outpatient sample: an investigation of clinical characteristics and latent subgroups. BMC Psychiatry 2023; 23:804. [PMID: 37924053 PMCID: PMC10623879 DOI: 10.1186/s12888-023-05314-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROM) provide clinicians with information about patients' perceptions of distress. When linked with treatment and diagnostic registers, new information on common mental health disorders (CMHD) and service use, may be obtained, which might be useful clinically and for policy decision-making. This study reports the prevalence of CMHD and their association with PROM severity. Further, subgroups of self-reported symptoms of depression and anxiety were examined, and their association with clinician-assessed mental disorders, functional impairment, and service use. METHODS In a cohort study of 2473 (63% female) outpatients, CMHD was examined with pre-treatment scores of self-reported depression and anxiety, and the number of assessments and psychotherapy appointments one year after treatment start. Factor mixture modelling (FMM) of anxiety and depression was used to examine latent subgroups. RESULTS Overall, 22% of patients with a CMHD had an additional comorbid mood/anxiety disorder, making the prevalence lower than expected. This comorbid group reported higher symptoms of anxiety and depression compared to patients with non-comorbid disorders. FMM revealed three classes: "anxiety and somatic depression" (33%), "mixed depression and anxiety" (40%), and "cognitive depression" (27%). The anxiety and somatic depression class was associated with older age, being single and on sick leave, higher probability of depressive-, anxiety-, and comorbid disorders, having more appointments and higher functional impairment. Although the cognitive depression class had less somatic distress than the mixed depression and anxiety class, they reported more functional impairment and had higher service use. CONCLUSION The results show that higher levels of somatic symptoms of depression could both indicate higher and lower levels of functional impairment and service use. A group of patients with high somatic depression and anxiety was identified, with severe impairment and high service needs. By gaining insights into CMHD factors' relation with clinical covariates, self-reported risk factors of depression and anxiety could be identified for groups with different levels of aggravating life circumstances, with corresponding service needs. These could be important symptom targets in different groups of patients.
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Affiliation(s)
- Martin Brattmyr
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway.
| | - Martin Schevik Lindberg
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
- Mental Health Care Services, Trondheim Municipality, Norway
| | - Jakob Lundqvist
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
- Division of Psychiatry, Nidaros Community Mental Health Centre, St. Olavs University Hospital, Trondheim, Norway
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Viana HKMMC, da Silva Oliveira GL, Moreno LCGEAI, de Melo-Cavalcante AAC, de Moura do Amaral MP, Arcanjo DDR, Rolim HML. Involvement of the serotoninergic system in the anxiolytic action mechanism of a liposomal formulation containing nimodipine (NMD-Lipo). Pharmacol Biochem Behav 2023; 232:173654. [PMID: 37802395 DOI: 10.1016/j.pbb.2023.173654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
In the search for anxiolytic drugs with fewer adverse effects, calcium blockers were proposed as a benzodiazepines (BZDs) alternative. In this context, the anxiolytic effect of nimodipine has been demonstrated. However, its low bioavailability and solubility could be improved by using nanostructured drug delivery systems such as liposomes. In this way, liposomal formulation containing nimodipine (NMD-Lipo) was developed. The NMD-lipo is a formulation capable of improving the kinetic characteristics of the drug, as well as the anxiolytic effect of nimodipine. In this work, the serotonergic system participation in the anxiolytic mechanism of the liposomal formulation containing nimodipine (NMD-Lipo) was investigated. A possible 5-HT1A receptor mediation on the NMD-Lipo anxiolytic effect was demonstrated by using WAY 100635 (5-HT1A receptor antagonist) since the antagonist reversed the NMD-Lipo anxiolytic effect in the light/dark test and elevated plus maze test. The results demonstrated that the NMD-Lipo administration had anxiolytic activity through 5-HT1A receptors without causing sedation or compromising the motor coordination of the tested animals.
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Affiliation(s)
- Hellen Kelen Maria Medeiros Coimbra Viana
- Laboratory of Pharmaceutical Nanosystems (NANOSFAR), Postgraduate Program in Pharmaceutical Sciences, Federal University of Piaui (UFPI), Teresina, PI 64.049-550,Brazil
| | - George Laylson da Silva Oliveira
- Laboratory of Experimental Neurochemistry (LAPNEX), Postgraduate Program in Pharmaceutical Sciences, Federal University of Piaui (UFPI), Teresina, PI 64.049-550,Brazil
| | | | - Ana Amélia Carvalho de Melo-Cavalcante
- Laboratory of Experimental Neurochemistry (LAPNEX), Postgraduate Program in Pharmaceutical Sciences, Federal University of Piaui (UFPI), Teresina, PI 64.049-550,Brazil
| | - Maurício Pires de Moura do Amaral
- Interdisciplinary Neuroscience and Toxicology Laboratory (LINT), PostgraduateProgram in Pharmaceutical Sciences, Federal University of Piaui (UFPI), Teresina, PI 64.049-550, Brazil
| | - Daniel Dias Rufino Arcanjo
- Interdisciplinary Neuroscience and Toxicology Laboratory (LINT), PostgraduateProgram in Pharmaceutical Sciences, Federal University of Piaui (UFPI), Teresina, PI 64.049-550, Brazil
| | - Hercília Maria Lins Rolim
- Laboratory of Pharmaceutical Nanosystems (NANOSFAR), Postgraduate Program in Pharmaceutical Sciences, Federal University of Piaui (UFPI), Teresina, PI 64.049-550,Brazil.
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Sobański JA, Klasa K, Dembińska E, Mielimąka M, Citkowska-Kisielewska A, Jęda P, Rutkowski K. Central psychological symptoms from a network analysis of patients with anxiety, somatoform or personality disorders before psychotherapy. J Affect Disord 2023; 339:1-21. [PMID: 37399849 DOI: 10.1016/j.jad.2023.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/05/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Cross-sectional network analysis examines the relationships between symptoms to explain how they constitute disorders. Up to now, research focuses mostly on depression, posttraumatic stress disorder, and rarely assesses larger networks of various symptoms measured with instruments independent of classifications. Studies on large groups of psychotherapy patients are also rare. METHODS Analyzing triangulated maximally filtered graph (TMFG) networks of 62 psychological symptoms reported by 4616 consecutive nonpsychotic adults in 1980-2015. RESULTS Case-dropping and nonparametric bootstrap proved the accuracy, stability and reliability of networks in patients' sex-, age-, and time of visit divided subgroups. Feeling that others are prejudiced against the patient was the most central symptom, followed by catastrophic fears, feeling inferior and underestimated. Sadness, panic, and sex-related complaints were less central than we expected. All analysed symptoms were connected, and we found only small sex-related differences between subsamples' networks. No differences were observed for time of visit and age of patients. LIMITATION Analyses were cross-sectional and retrospective, not allowing examination of directionality or causality. Further, data are at the between-person level; thus, it is unknown whether the network remains constant for any person over time. One self-report checklist and building binary network method may bias results. Our results indicate how symptoms co-occured before psychotherapy, not longitudinally. Our sample included public university hospital patients, all White-Europeans, predominantly females and university students. CONCLUSIONS Hostile projection, catastrophic fears, feeling inferior and underestimated were the most important psychological phenomena reported before psychotherapy. Exploring these symptoms would possibly lead to enhancement of treatments.
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Affiliation(s)
- Jerzy A Sobański
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychotherapy, Poland.
| | - Katarzyna Klasa
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychotherapy, Poland
| | - Edyta Dembińska
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychotherapy, Poland
| | - Michał Mielimąka
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychotherapy, Poland
| | | | - Patrycja Jęda
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychotherapy, Poland
| | - Krzysztof Rutkowski
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychotherapy, Poland
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Hyland P, Redican E, Karatzias T, Shevlin M. Assessing the validity and reliability of the International Anxiety Questionnaire and the International Depression Questionnaire in two bereaved national samples. Clin Psychol Psychother 2023. [PMID: 37776046 DOI: 10.1002/cpp.2917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
The International Anxiety Questionnaire (IAQ) and International Depression Questionnaire (IDQ) are self-report measures of ICD-11 Generalized Anxiety Disorder (ICD-11 GAD) and ICD-11 Single Episode Depressive Disorder (ICD-11 DD). This study tested the psychometric properties of these scales in two samples of bereaved adults from the United Kingdom and the Republic of Ireland. Confirmatory factor analysis (CFA) was used to test the combined dimensionality and measurement invariance of the IAQ and IDQ across the United Kingdom (n = 1012) and Irish (n = 1011) samples. Differential item functioning (DIF) was tested using multiple indicator multiple cause (MIMIC) modelling while convergent validity was also assessed. CFA results supported a correlated two-factor model in both samples. The MIMIC model showed that the IDQ item "Had recurrent thoughts of death or suicide" showed DIF and the effect was small. Internal reliability of the scales were high and convergent validity was supported. The prevalence of ICD-11 GAD was 18.6% and 16.1% and ICD-11 DD was 13.8% and 10.5% in the United Kingdom and Irish samples, respectively. Findings of the study provide support for the validity, measurement invariance, and reliability of the IAQ and IDQ among two bereaved national samples.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Enya Redican
- School of Psychology, Ulster University, Ulster, UK
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Ulster, UK
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Wijnen J, Gordon NL, van 't Hullenaar G, Pont ML, Geijselaers MWH, Van Oosterwijck J, de Jong J. An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders. Front Psychiatry 2023; 14:1113356. [PMID: 37426091 PMCID: PMC10326275 DOI: 10.3389/fpsyt.2023.1113356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Although multimodal interventions are recommended in patients with severe depressive and/or anxiety disorders, available evidence is scarce. Therefore, the current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, for patients with (comorbid) depressive and/or anxiety disorders. Methods Participants were 3,900 patients diagnosed with a depressive and/or anxiety disorder. The primary outcome was Health-Related Quality of Life (HRQoL) measured with the Research and Development-36 (RAND-36). Secondary outcomes included: (1) current psychological and physical symptoms measured with the Brief Symptom Inventory (BSI) and (2) symptoms of depression, anxiety, and stress measured with the Depression Anxiety Stress Scale (DASS). The healthcare program consisted of two active treatment phases: main 20-week program and a subsequent continuation-phase intervention (i.e., 12-month relapse prevention program). Mixed linear models were used to examine the effects of the healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of 12-month relapse prevention program (T3). Results Results showed significant improvements from T0 to T2 for the primary variable (i.e., RAND-36) and secondary variables (i.e., BSI/DASS). During the 12-month relapse prevention program, further significant improvements were mainly observed for secondary variables (i.e., BSI/DASS) and to a lesser extent for the primary variable (i.e., RAND-36). At the end of the relapse prevention program (i.e., T3), 63% of patients achieved remission of depressive symptoms (i.e., DASS depression score ≤ 9) and 67% of patients achieved remission of anxiety symptoms (i.e., DASS anxiety score ≤ 7). Conclusion An interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, seems effective for patients suffering from depressive and/or anxiety disorders with regard to HRQoL and symptoms of psychopathology. As reimbursement and funding for interdisciplinary multimodal interventions in this patient group has been under pressure in recent years, this study could add important evidence by reporting on routinely collected outcome data from a large patient group. Future studies should further investigate the long-term stability of treatment outcomes after interdisciplinary multimodal interventions for patients suffering from depressive and/or anxiety disorders.
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Affiliation(s)
- Jaap Wijnen
- Intergrin Academy, Geleen, Netherlands
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
| | | | | | | | | | - Jessica Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Center for InterProfessional Collaboration in Education Research and Practice (IPC-ERP UGent), Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Shevlin M, Hyland P, Butter S, McBride O, Hartman TK, Karatzias T, Bentall RP. The development and initial validation of self-report measures of ICD-11 depressive episode and generalized anxiety disorder: The International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ). J Clin Psychol 2023; 79:854-870. [PMID: 36215152 PMCID: PMC10092474 DOI: 10.1002/jclp.23446] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/11/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The new International Classification of Diseases came into effect in 2022 (ICD-11; World Health Organization, 2022) and included updated descriptions and diagnostic rules for "Depressive Episode" and "Generalized Anxiety Disorder." No self-report measures align with these disorders so this study reports the development and initial validation of the "International Depression Questionnaire" (IDQ) and "International Anxiety Questionnaire" (IAQ). METHODS Items were developed that aligned to the ICD-11 descriptions and their performance was assessed using data from a community sample (N = 2058) that was representative of the United Kingdom adult population. RESULTS Item response theory models indicated that the two scales were unidimensional, and the items performed well in terms of difficulty and discrimination. Estimates of internal reliability were high. Based on ICD-11 derived diagnostic algorithms, 7.4% met requirements for ICD-11 Depressive Episode and 7.1% for Generalized Anxiety Disorder. CONCLUSIONS The IDQ and the IAQ are short, easy to use, self-report measures aligned to the new and updated ICD-11 diagnostic descriptions. This study provides initial evidence that the scales produce scores that are reliable and valid.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, Scotland
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
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Petkari E, Priebe S. Subjective quality of life factorial structure across mental disorders: should we switch to assessing dimensions? Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01536-z. [PMID: 36571599 DOI: 10.1007/s00406-022-01536-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022]
Abstract
A two-factor structure of subjective quality of life (SQoL) was established for patients with schizophrenia with the dimensions being 'Life and Health' and 'Living Environment'. This study investigated whether the same structure applies in patients with mood and anxiety disorders and, if so, whether the dimension scores differ between the three diagnostic groups. SQoL data of 1366 patients with mood and 419 patients with anxiety disorders obtained on the Manchester Short Assessment of Quality of Life (MANSA) were retrieved from 3 multisite studies. We performed Confirmatory Factor Analyses (CFAs) based on the MANSA SQoL items of each diagnostic sample. Next, through a series of Kruskal-Wallis and Mann-Whitney tests, we compared the scores of the two factors across patients with mood disorders, anxiety disorders and schizophrenia. The two CFAs showed adequate fit of the two-factor structure across mood and anxiety disorders. The dimension scores on 'Life and Health' differed significantly between all three diagnostic groups. They were lowest in patients with anxiety disorders, higher in patients with mood disorders and highest in patients with schizophrenia. However, on the 'Living Environment' dimension, patients with mood disorders had significantly higher scores than patients with schizophrenia, whilst patients with anxiety disorders did not differ significantly from either other group. The findings suggest that a two-factor structure of SQoL applies across mental disorders. The two dimensions vary across diagnostic groups in different ways. Assessing two dimensions of SQoL may provide more specific and relevant information than global scores.
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Affiliation(s)
- Eleni Petkari
- School of Health Sciences, Universidad Internacional de la Rioja, Av. de la Paz, 137, 26006, Logroño, Spain.
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organization Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
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