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Colledani D, González Pizzio AP, Devita M, Anselmi P. Investigating the Functioning of Rating Scales With Rasch Models. Assessment 2024:10731911241245792. [PMID: 38655743 DOI: 10.1177/10731911241245792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The hypothesis implicit in the rating scale design is that the categories reflect increasing levels of the latent variable. Rasch models for ordered polytomous items include parameters, called thresholds, that allow for empirically testing this hypothesis. Failure of the thresholds to advance monotonically with the categories (a condition that is referred to as "threshold disordering") provides evidence that the rating scale is not functioning as intended. This work focuses on scales consisting of rather large numbers of categories, whose use is often recommended in the literature. Threshold disordering is observed in both an extended 8-point scale specially developed for the Patient Health Questionnaire-9 and the original 10-point scale of the Behavioral Religiosity Scale. The results of this work prompt practitioners not to take the functioning of the rating scale for granted, but to verify it empirically.
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Ayers S, Coates R, Sinesi A, Cheyne H, Maxwell M, Best C, McNicol S, Williams LR, Uddin N, Hutton U, Howard G, Shakespeare J, Walker JJ, Alderdice F, Jomeen J. Assessment of perinatal anxiety: diagnostic accuracy of five measures. Br J Psychiatry 2024; 224:132-138. [PMID: 38270148 PMCID: PMC10933560 DOI: 10.1192/bjp.2023.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately. AIMS To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective). METHOD We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI). RESULTS The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure. CONCLUSIONS This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City University of London, UK
| | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City University of London, UK
| | - Andrea Sinesi
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, UK
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, UK
| | - Catherine Best
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, UK
| | - Stacey McNicol
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, UK
| | - Louise R. Williams
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City University of London, UK
| | - Nazihah Uddin
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City University of London, UK
| | - Una Hutton
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City University of London, UK
| | | | | | - James J. Walker
- Faculty of Medicine and Health, St James's University Hospital, University of Leeds, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK; and School of Nursing and Midwifery, Queen's University Belfast, UK
| | - Julie Jomeen
- Faculty of Health, Southern Cross University, Australia
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Bernstein GA, Khan MH, Freese RL, Manko C, Silverman M, Ahmed S, Farhadian B, Ma M, Thienemann M, Murphy TK, Frankovich J. Psychometric Properties of the PANS 31-Item Symptom Rating Scale. J Child Adolesc Psychopharmacol 2024; 34:157-162. [PMID: 38536004 DOI: 10.1089/cap.2023.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by sudden onset of obsessive-compulsive disorder and/or eating restriction with associated neuropsychiatric symptoms from at least two of seven categories. The PANS 31-Item Symptom Rating Scale (PANS Rating Scale) was developed to identify and measure the severity of PANS symptoms. The objective of this study was to define the psychometric properties of the PANS Rating Scale. Methods: Children with PANS (N = 135) and their parents participated. Parents completed the PANS Rating Scale and other scales on Research Electronic Data Capture. The PANS Rating Scale includes 31 items that are rated on a Likert scale from 0 = none to 4 = extreme. Pearson's correlations were run between the PANS Total score and scores on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Yale Global Tic Severity Scale (YGTSS), Modified Overt Aggression Scale (MOAS), Columbia Impairment Scale (CIS), PANS Global Impairment Score (GIS), and Children's Global Assessment Scale (CGAS). Results: Convergent validity was supported by significant correlations between the PANS Total and scores on the CY-BOCS, YGTSS, MOAS, CIS, GIS, and CGAS. The largest correlations were with measures of functional impairment: PANS Total and CIS (r = 0.81) and PANS Total and GIS (r = 0.74). Cronbach's alpha was 0.89 which demonstrates strong internal consistency of the 31 items. PANS Total score was significantly higher in children in a flare of their neuropsychiatric symptoms compared to children who were not in a flare. Conclusions: This study provides preliminary support for the PANS Rating Scale as a valid research instrument with good internal consistency. The PANS Rating Scale appears to be a useful measure for assessing children with PANS.
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Affiliation(s)
- Gail A Bernstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Masonic Institute for the Developing Brain, Minneapolis, Minnesota, USA
| | - Maroof H Khan
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rebecca L Freese
- Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cindy Manko
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Melissa Silverman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sana Ahmed
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Bahare Farhadian
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Meiqian Ma
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Margo Thienemann
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Tanya K Murphy
- Department of Pediatrics, University of South Florida, St Petersburg, Florida, USA
| | - Jennifer Frankovich
- Department of Pediatrics, Immune Behavioral Health Program, Stanford University School of Medicine, Palo Alto, California, USA
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Vallejo-Valdivielso M, de Castro-Manglano P, Vidal-Adroher C, Díez-Suárez A, Soutullo CA. Development of a Short Version of the ADHD Rating Scale-IV.es (sADHD-RS-IV.es). J Atten Disord 2024; 28:600-607. [PMID: 38353419 DOI: 10.1177/10870547241232314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To develop a short version of the Spanish 18-item ADHD-Rating Scale IV.es (sADHD-RS-IV.es) to be used as a potential screening tool in pediatric population. METHODS We recruited 652 subjects, ages 6 to 18 (mean ± SD = 11.14 ± 3.27): 518 patients with ADHD (per DSM-IV criteria); and 134 healthy controls. We performed a stepwise logistic regression to select the best subset of ADHD-RS-IV.es items to create a short-form. We calculated internal consistency reliability (Cronbach's and ordinal alphas) and diagnostic accuracy using receiver operating characteristic (ROC) curve. RESULTS Six items were found to enter the stepwise analysis significantly. Internal consistency was high (Cronbach's alpha = 0.86; ordinal alpha = 0.90) and offered a good concordance with clinician diagnosis and a high discriminatory power (AUC = 0.98) with an optimal cut-off at a score of six points. CONCLUSIONS This shorter questionnaire (six items) was able to discriminate ADHD cases from healthy controls.
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Affiliation(s)
- María Vallejo-Valdivielso
- Clínica Universidad de Navarra, Pamplona, Navarra, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
| | - Pilar de Castro-Manglano
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
- Clínica Universidad de Navarra, Madrid, Spain
| | - Cristina Vidal-Adroher
- Clínica Universidad de Navarra, Pamplona, Navarra, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
| | - Azucena Díez-Suárez
- Clínica Universidad de Navarra, Pamplona, Navarra, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
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Ishibashi S, Nishiyama T, Makino T, Suzuki F, Shimada S, Tomari S, Imanari E, Higashi T, Fukumoto S, Kurata S, Mizuno Y, Morimoto T, Nakamichi H, Iida T, Ohashi K, Yamada A, Kimura T, Kuru Y, Sumi S, Tanaka Y, Ono K, Ichikawa H, DuPaul GJ, Kosaka H. Psychometrics of rating scales for externalizing disorders in Japanese outpatients: The ADHD-Rating Scale-5 and the Disruptive Behavior Disorders Rating Scale. Int J Methods Psychiatr Res 2024; 33:e2015. [PMID: 38363207 PMCID: PMC10870953 DOI: 10.1002/mpr.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES This study validated the Japanese version of the Attention-Deficit/Hyperactivity Disorder-Rating Scale-5 (ADHD-RS-5) and the Disruptive Behavior Disorders Rating Scale. We extended the ADHD-RS-5 by adding the oppositional defiant disorder and conduct disorder subscales to compare the two rating scales psychometrically. METHODS We examined the internal consistency, test-retest reliability, construct validity and criterion validity of the two rating scales in 135 Japanese outpatients aged 6-18 years. RESULTS The internal consistency and test-retest reliability were good for all the subscales of the two rating scales except for the conduct disorder subscale of the ADHD-RS-5 extended. Good construct validity was revealed by expected correlational patterns between subscales from the two rating scales and the Children Behavior Checklist. The criterion validity was good for all the subscales of the two rating scales rated by parents, while teacher-ratings revealed substantially lower predictive ability for all the subscales. Agreement between parent- and teacher-ratings of the two rating scales was generally moderate and using predictive ratings alone of both ratings showed the best predictive ability among the integration methods examined. CONCLUSION The two rating scales have sound psychometric properties and will aid in screening and severity assessment of externalizing disorders in Japanese clinical settings.
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Reid G, Vassilev P, Irving J, Ojakäär T, Jacobson L, Lawrence EG, Barnett J, Tapparel M, Koychev I. The usability and reliability of a smartphone application for monitoring future dementia risk in ageing UK adults. Br J Psychiatry 2024:1-7. [PMID: 38356396 DOI: 10.1192/bjp.2024.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND The rising number of dementia diagnoses and imminent adoption of disease-modifying treatments necessitate innovative approaches to identify individuals at risk, monitor disease course and intervene non-pharmacologically earlier in the disease course. Digital assessments of dementia risk and cognitive function have the potential to outperform traditional in-person assessments in terms of their affordability, accuracy and longitudinal tracking abilities. However, their accessibility and reliability in older adults is unclear. AIMS To evaluate the usability and reliability of a smartphone assessment of lifestyle and cognitive factors relevant to dementia risk in a group of UK-based older adults. METHOD Cognitively healthy adults (n = 756) recruited through the Dementias Platform UK Great Minds volunteer register completed three assessments of cognitive function and dementia risk over a 3-month period and provided usability feedback on the Five Lives smartphone application (app). We evaluated cognitive test scores for age, gender and higher education effects, normality distributions, test-retest reliability and their relationship with participants' lifestyle dementia risk factors. RESULTS Participants found the app 'easy to use', 'quick to complete' and 'enjoyable'. The cognitive tests showed normal or near-to-normal distributions, variable test-retest reliabilities and age-related effects. Only tests of verbal ability showed gender and education effects. The cognitive tests did not correlate with lifestyle dementia risk scores. CONCLUSIONS The Five Lives assessment demonstrates high usability and reliability among older adults. These findings highlight the potential of digital assessments in dementia research and clinical practice, enabling improved accessibility and better monitoring of cognitive health on a larger scale than traditional in-person assessments.
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Affiliation(s)
- Graham Reid
- Department of Psychiatry, University of Oxford, UK
| | | | | | - Triin Ojakäär
- Five Lives SAS, Tours, France; and Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | | | - Erin G Lawrence
- Five Lives SAS, Tours, France; and Wolfson Institute of Population Health, Queen Mary University of London, UK
| | - Jenny Barnett
- Five Lives SAS, Tours, France; and Department of Psychiatry, University of Cambridge, UK
| | - Malika Tapparel
- Five Lives SAS, Tours, France; and Department of Medicine, University of Fribourg, Switzerland
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, UK; and Five Lives SAS, Tours, France
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McCarthy L, Rubinsztein J, Lowry E, Flanagan E, Menon V, Vearncombe S, Mioshi E, Hornberger M. Cut-off scores for mild and moderate dementia on the Addenbrooke's Cognitive Examination-III and the Mini-Addenbrooke's Cognitive Examination compared with the Mini-Mental State Examination. BJPsych Bull 2024; 48:12-18. [PMID: 37272617 PMCID: PMC10801363 DOI: 10.1192/bjb.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/01/2023] [Accepted: 04/02/2023] [Indexed: 06/06/2023] Open
Abstract
AIMS AND METHOD We aimed to establish cut-off scores to stage dementia on the Addenbrooke's Cognitive Examination-III (ACE-III) and the Mini-Addenbrooke's Cognitive Examination (M-ACE) compared with scores traditionally used with the Mini-Mental State Examination (MMSE). Our cross-sectional study recruited 80 patients and carers from secondary care services in the UK. RESULTS A score ≤76 on the ACE-III and ≤19 on the M-ACE correlated well with MMSE cut-offs for mild dementia, with a good fit on the receiver operating characteristic analysis for both the ACE-III and M-ACE. The cut-off for moderate dementia had lower sensitivity and specificity. There were low to moderate correlations between the cognitive scales and scales for everyday functioning and behaviour. CLINICAL IMPLICATIONS Our findings allow an objective interpretation of scores on the ACE-III and the M-ACE relative to the MMSE, which may be helpful for clinical services and research trials.
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Affiliation(s)
| | | | - Ellen Lowry
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Emma Flanagan
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Vandana Menon
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, UK
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Herron SJ, Saunders R, Sani F, Feigenbaum J. The Psychological Emptiness Scale: a psychometric evaluation. BJPsych Open 2024; 10:e42. [PMID: 38299317 PMCID: PMC10897692 DOI: 10.1192/bjo.2023.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Feelings of emptiness are commonly reported as deeply distressing experiences. Despite established relationships between emptiness and many mental health difficulties, alongside self-harm and suicide, further study into this phenomenon has been restricted by vague definition and clinical measures with limited utility. Recently the first definition validated by individuals with lived experience of emptiness has been conceptualised, providing an opportunity to create a new measure of emptiness. AIMS This study aimed to psychometrically evaluate the 31-item Psychological Emptiness Scale (PES), identifying redundancy, and thus creating a psychometrically robust scale with optimised clinical utility. METHOD Utilising an online survey design, 768 participants completed the 31 items of the initial PES alongside other measures of mental health. Exploratory factor analysis was conducted, and item response theory employed to identify item redundancy and reduce test burden. Expert clinicians provided ratings of each item's clinical relevance and, combined with the psychometric analysis, led to the removal of a number of items. Confirmatory factor analysis was then undertaken. Reliability including test-retest, validity and sensitivity of the measure were evaluated. RESULTS A two-factor structure encompassing 'nothingness' and 'detachment' was identified, and found to have acceptable fit. The resulting 19-item PES was found to have internal consistency (α = 0.95), convergent validity and test-retest reliability. CONCLUSIONS This study demonstrated strong psychometric properties of the PES. The PES has potential to support research into the role of emptiness in psychological distress and treatment in clinical practice.
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Affiliation(s)
- Shona Joyce Herron
- Acute Mental Health Services, Central and North West London NHS Foundation Trust, UK; and Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Rob Saunders
- CORE Data Lab, Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Fabio Sani
- Division of Psychology, University of Dundee, UK
| | - Janet Feigenbaum
- Department of Clinical, Educational and Health Psychology, University College London, UK
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Burke JD, Butler EJ, Shaughnessy S, Karlovich AR, Evans SC. Evidence-Based Assessment of DSM-5 Disruptive, Impulse Control, and Conduct Disorders. Assessment 2024; 31:75-93. [PMID: 37551425 DOI: 10.1177/10731911231188739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The assessment of oppositional defiant disorder, conduct disorder, antisocial personality disorder, and intermittent explosive disorder-the Disruptive, Impulse Control and Conduct Disorders-can be affected by biases in clinical judgment, including overestimating concerns about distinguishing symptoms from normative behavior and stigma associated with diagnosing antisocial behavior. Recent nosological changes call for special attention during assessment to symptom dimensions of limited prosocial emotions and chronic irritability. The present review summarizes best practices for evidence-based assessment of these disorders and discusses tools to identify their symptoms. Despite the focus on disruptive behavior disorders, their high degree of overlap with disruptive mood dysregulation disorder can complicate assessment. Thus, the latter disorder is also included for discussion here. Good practice in the assessment of disruptive behavior disorders involves using several means of information gathering (e.g., clinical interview, standardized rating scales or checklists), ideally via multiple informants (e.g., parent-, teacher-, and self-report). A commitment to providing a full and accurate diagnostic assessment, with careful and attentive reference to diagnostic guidelines, will mitigate concerns regarding biases.
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Teoh KRH, Dunning A, Taylor AK, Gopfert A, Chew-Graham CA, Spiers J, Appleby L, Van Hove M, Buszewicz M, Riley R. Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors. BJPsych Open 2023; 10:e14. [PMID: 38099399 PMCID: PMC10755551 DOI: 10.1192/bjo.2023.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/01/2023] [Accepted: 11/01/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Evidence attests a link between junior doctors' working conditions and psychological distress. Despite increasing concerns around suicidality among junior doctors, little is known about its relationship to their working conditions. AIMS To (a) establish the prevalence of suicidal ideation among junior doctors in the National Health Service; (b) examine the relationships between perceived working conditions and suicidal ideation; and (c) explore whether psychological distress (e.g. symptoms of depression and anxiety) mediates these relationships. METHOD Junior doctors were recruited between March 2020 and January 2021, for a cross-sectional online survey. We used the Health and Safety Executive's Management Standards Tool; Depression, Anxiety and Stress Scale 21; and Paykel Suicidality Scale to assess working conditions, psychological distress and suicidality, respectively. RESULTS Of the 424 participants, 50.2% reported suicidal ideation, including 6.1% who had made an attempt on their own life. Participants who identified as LGBTQ+ (odds ratio 2.18, 95% CI 1.15-4.12) or reported depression symptoms (odds ratio 1.10, 95% CI 1.07-1.14) were more likely to report suicidal ideation. No direct relationships were reported between working conditions (i.e. control, support, role clarity, strained relationships, demand and change) and suicidal ideation. However, depression symptoms mediated all six relationships. CONCLUSIONS This sample of junior doctors reported alarming levels of suicidal ideation. There may be an indirect relationship between working conditions and suicidal ideation via depressive symptoms. Clearer research exploring the experience of suicidality in junior doctors is needed, including those who identify as LGBTQ+. Systematic interventions addressing working environment are needed to support junior doctors' mental health.
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Affiliation(s)
- Kevin Rui-Han Teoh
- Department of Organizational Psychology, Birkbeck, University of London, UK
| | - Alice Dunning
- School of Health and Related Research, University of Sheffield, UK
| | - Anna Kathryn Taylor
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, UK
| | - Anya Gopfert
- Department of Sports Sciences and Public Health, University of Exeter, UK
| | | | | | - Louis Appleby
- Division of Psychology and Mental Health, School of Medicine, University of Manchester, UK
| | - Maria Van Hove
- Department of Health and Community Sciences, University of Exeter, UK
| | - Marta Buszewicz
- UCL Great Ormand Street Institute of Child Health, University College London, UK
| | - Ruth Riley
- School of Health Sciences, University of Surrey, UK
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Kassam F, Chen H, Nosheny R, McGirr A, Williams T, Ng N, Camacho M, Mackin R, Weiner M, Ismail Z. Cognitive profile of people with mild behavioral impairment in Brain Health Registry participants. Int Psychogeriatr 2023; 35:643-652. [PMID: 35130991 PMCID: PMC10063171 DOI: 10.1017/s1041610221002878] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Dementia assessment includes cognitive and behavioral testing with informant verification. Conventional testing is resource-intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. The aim of this study was to assess the relationship between informant-rated behavioral changes and participant-completed neuropsychological test performance in older adults, both measured remotely via an online unsupervised platform, the Brain Health Registry (BHR). DESIGN Observational cohort study. SETTING Community-dwelling older adults participating in the online BHR. Informant reports were obtained using the BHR Study Partner Portal. PARTICIPANTS The final sample included 499 participant-informant dyads. MEASUREMENTS Participants completed online unsupervised neuropsychological assessment including Forward Memory Span, Reverse Memory Span, Trail Making B, and Go/No-Go tests. Informants completed the Mild Behavioral Impairment Checklist (MBI-C) via the BHR Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity. RESULTS Mean age of the 499 participants was 67, of which 308/499 were females (61%). MBI + status was associated with significantly lower memory and executive function test scores, measured using Forward and Reverse Memory Span, Trail Making Errors and Trail Making Speed. Further, significant associations were found between poorer objectively measured cognitive performance, in the domains of memory and executive function, and MBI symptom severity. CONCLUSION These findings support the feasibility of remote, informant-reported behavioral assessment utilizing the MBI-C, supporting its validity by demonstrating a relationship to online unsupervised neuropsychological test performance, using a previously validated platform capable of assessing early dementia risk markers.
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Affiliation(s)
- F. Kassam
- University of Calgary, Hotchkiss Brain Institute
| | - H. Chen
- University of Calgary, Hotchkiss Brain Institute
| | - R.L. Nosheny
- University of California, San Francisco, Department of Psychiatry
| | - A. McGirr
- University of Calgary, Department of Psychiatry
| | - T. Williams
- University of California, San Francisco, Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology
| | | | - Monica Camacho
- University of California, San Francisco, Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology
| | - R.S. Mackin
- University of California, San Francisco, Department of Psychiatry
| | - M.W. Weiner
- University of California, San Francisco, Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology
| | - Z. Ismail
- University of Calgary, Hotchkiss Brain Institute
- University of Calgary, Department of Psychiatry
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Mulder RT, Jorm AF. The impact of antidepressants and human development measures on the prevalence of sadness, worry and unhappiness: cross-national comparison. BJPsych Open 2023; 9:e182. [PMID: 37814546 PMCID: PMC10594156 DOI: 10.1192/bjo.2023.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/22/2023] [Accepted: 09/02/2023] [Indexed: 10/11/2023] Open
Abstract
Depression is a major public health concern. Depressed individuals have received increasing treatment with antidepressants in Western countries. In this study, we examine the relationship among individual symptoms (sadness, worry and unhappiness), human development factors and antidepressant use in 29 OECD countries. We report that increased antidepressant prescribing is not associated with decreased prevalence of sadness, worry or unhappiness. However, income, education and life expectancy (measured using the Human Development Index) are associated with lower prevalence of all these symptoms. This suggests that increasing spending on depression treatment may not be as effective as general public health interventions at reducing depression in communities.
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Affiliation(s)
- Roger T. Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Anthony F. Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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13
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Niileksela CR, Jones NB. Measurement Equality of Frequency and Severity Item Response Options on Depression and Generalized Anxiety Scales. Assessment 2023; 30:2016-2028. [PMID: 36341537 DOI: 10.1177/10731911221134599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Rating scales are commonly used in psychological research and practice. It is important to consider how different item response options used on rating scales, such as those based on frequency or severity, may affect how they measure psychological constructs. In this study, participants were randomly assigned to conditions where they completed two depression and two generalized anxiety rating scales that used either frequency or severity item response options. Descriptive statistics and reliability estimates across depression and generalized anxiety scales using different item response options were similar. Measurement invariance tests indicated that depression and generalized anxiety scales with different item response options could be considered practically invariant. Finally, depression and generalized anxiety scales with different item response options had similar correlations with measures of impairment and other psychological constructs. There were essentially no differences in psychometric and measurement properties of these depression and generalized anxiety scales when using different item response options, suggesting this may not substantially affect the measurement of these constructs.
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14
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Bhatt J, Brohan E, Blasco D, Oliveira D, Bakolis I, Comas-Herrera A, D'Amico F, Farina N, Knapp M, Stevens M, Thornicroft G, Wilson E, Salcher-Konrad M, Yang LH, Evans-Lacko S. The development and validation of the Discrimination and Stigma Scale Ultra Short for People Living with Dementia (DISCUS-Dementia). BJPsych Open 2023; 9:e164. [PMID: 37650126 PMCID: PMC10594093 DOI: 10.1192/bjo.2023.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The recent World Health Organization (WHO) blueprint for dementia research and Lancet Commission on ending stigma and discrimination in mental health has identified a gap around dementia-related measures of stigma and discrimination that can be used in different cultural, language and regional contexts. AIMS We aimed to characterise experiences of discrimination, and report initial psychometric properties of a new tool to capture these experiences, among a global sample of people living with dementia. METHOD We analysed data from 704 people living with dementia who took part in a global survey from 33 different countries and territories. Psychometric properties were examined, including internal consistency and construct validity. RESULTS A total of 83% of participants reported discrimination in one or more areas of life, and this was similar across WHO Regions. The exploratory factor analysis factor loadings and scree plot supported a unidimensional structure for the Discrimination and Stigma Scale Ultra Short for People Living with Dementia (DISCUS-Dementia). The instrument demonstrated excellent internal consistency, with most of the construct validity hypotheses being confirmed and qualitative responses demonstrating face validity. CONCLUSIONS Our analyses suggest that the DISCUS-Dementia performs well with a global sample of people living with dementia. This scale can be integrated into large-scale studies to understand factors associated with stigma and discrimination. It can also provide an opportunity for a structured discussion around stigma and discrimination experiences important to people living with dementia, as well as planning psychosocial services and initiatives to reduce stigma and discrimination.
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Affiliation(s)
- Jem Bhatt
- UCL Unit for Stigma Research, Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Elaine Brohan
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Drew Blasco
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Michigan, USA; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA; and Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, USA
| | - Déborah Oliveira
- Faculty of Nursing, Universidad Andrés Bello, Campus Vina del Mar,Chile; and Millennium Institute for Care Research (MICARE), Santiago,Chile
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Francesco D'Amico
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Madeleine Stevens
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Emma Wilson
- ESRC Centre for Society and Mental Health, King's College London, UK
| | - Maximilian Salcher-Konrad
- WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Austrian National Public Health Institute (Gesundheit Österreich GmbH/GÖG), Austria
| | - Lawrence H. Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
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15
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Doherty AM. Screening for depressive illness in adult populations. BJPsych Open 2023; 9:e162. [PMID: 37605975 PMCID: PMC10486234 DOI: 10.1192/bjo.2023.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023] Open
Abstract
Depression is a major cause of disability worldwide. Screening in at-risk populations is important in identifying those at most need of treatment. Pengpid et al report on high rates of incident and persistent symptoms of depression identified in an epidemiological study in a Thai population and their association with physical comorbidities. However, there are limitations to screening, due to both resource implications and the risk of diagnostic overshadowing. Although screening is useful in providing an overview of the prevalence of depressive symptoms from an epidemiological perspective, there may be justified concerns in translating this approach to clinical settings. This is especially true where the resources to provide further comprehensive assessment and treatment may be inadequate. Clinically there is a need to consider a more complete approach to screening that utilises screening tools embedded in a wider diagnostic approach which allows the detection and management of other confounding conditions.
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Affiliation(s)
- Anne M. Doherty
- Department of Psychiatry, School of Medicine, University College Dublin, Ireland; and Department of Liaison Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
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16
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Monk-Cunliffe J, Kadra-Scalzo G, Finamore C, Dale O, Khondoker M, Barrett B, Shetty H, Hayes RD, Moran P. Defining severity of personality disorder using electronic health records: short report. BJPsych Open 2023; 9:e137. [PMID: 37524373 PMCID: PMC10486230 DOI: 10.1192/bjo.2023.509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 08/02/2023] Open
Abstract
Severity of personality disorder is an important determinant of future health. However, this key prognostic variable is not captured in routine clinical practice. Using a large clinical data-set, we explored the predictive validity of items from the Health of Nation Outcome Scales (HoNOS) as potential indicators of personality disorder severity. For 6912 patients with a personality disorder diagnosis, we examined associations between HoNOS items relating to core personality disorder symptoms (self-harm, difficulty in interpersonal relationships, performance of occupational and social roles, and agitation and aggression) and future health service use. Compared with those with no self-harm problem, the total healthcare cost was 2.74 times higher (95% CI 1.66-4.52; P < 0.001) for individuals with severe to very severe self-harm problems. Other HoNOS items did not demonstrate clear patterns of association with service costs. Self-harm may be a robust indicator of the severity of personality disorder, but further replication work is required.
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Affiliation(s)
- Jonathan Monk-Cunliffe
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Giouliana Kadra-Scalzo
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chloe Finamore
- Research Unit, The Cassel Hospital, West London NHS Trust, Richmond, UK
| | - Oliver Dale
- Research Unit, The Cassel Hospital, West London NHS Trust, Richmond, UK
| | | | - Barbara Barrett
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hitesh Shetty
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard D. Hayes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul Moran
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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17
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Kandola A, Hayes JF. Real-time air pollution and bipolar disorder symptoms: remote-monitored cross-sectional study. BJPsych Open 2023; 9:e107. [PMID: 37313799 DOI: 10.1192/bjo.2023.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Air pollution is associated with unipolar depression and other mental health problems. We assessed the real-time association between localised mean air quality index and the severity of depression and mania symptoms in people with bipolar disorder. We found that as air quality worsened, symptoms of depression increased. We found no association between air quality and mania symptoms.
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Affiliation(s)
- Aaron Kandola
- MRC Unit of Lifelong Health and Ageing, University College London, UK
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18
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Martino D, Karnik V, Bhidayasiri R, Hall DA, Hauser RA, Macerollo A, Pringsheim TM, Truong D, Factor SA, Skorvanek M, Schrag A. Scales for Antipsychotic-Associated Movement Disorders: Systematic Review, Critique, and Recommendations. Mov Disord 2023; 38:1008-1026. [PMID: 37081740 DOI: 10.1002/mds.29392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/13/2023] [Accepted: 03/13/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Antipsychotic-associated movement disorders remain common and disabling. Their screening and assessment are challenging due to clinical heterogeneity and different use of nomenclature between psychiatrists and neurologists. OBJECTIVE An International Parkinson and Movement Disorder Society subcommittee aimed to rate psychometric quality of severity and screening instruments for antipsychotic-associated movement disorders. METHODS Following the methodology adopted by previous International Parkinson and Movement Disorders Society subcommittee papers, instruments for antipsychotic-associated movement disorders were reviewed, applying a classification as "recommended," "recommended with caveats," "suggested," or "listed." RESULTS Our review identified 23 instruments. The highest grade of recommendation reached is "recommended with caveats," assigned to seven severity rating instruments (Extrapyramidal Symptoms Rating Scale, Barnes Akathisia Rating Scale, Abnormal Involuntary Movements Scale, Drug-Induced Extra-Pyramidal Symptoms Scale, Maryland Psychiatric Research Centre involuntary movements scale, Simpson Angus Scale, and Matson Evaluation of Drug Side effects). Only three of these seven (Drug-Induced Extra-Pyramidal Symptoms Scale, Maryland Psychiatric Research Centre, Matson Evaluation of Drug Side effects) were also screening instruments. Their main caveats are insufficient demonstration of psychometric properties (internal consistency, skewing, responsiveness to change) and long duration of administration. Eight "suggested" instruments did not meet requirements for the "recommended" grade also because of insufficient psychometric validation. Other limitations shared by several instruments are lack of comprehensiveness in assessing the spectrum of antipsychotic-associated movement disorders and ambiguous nomenclature. CONCLUSIONS The high number of instruments "recommended with caveats" does not support the need for developing new instruments for antipsychotic-associated movement disorders. However, addressing the caveats with new psychometric studies and revising existing instruments to improve the clarity of their nomenclature are recommended next steps. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Vikram Karnik
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - Deborah A Hall
- Division of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert A Hauser
- Parkinson's Disease and Movement Disorders Center, Parkinson Foundation Center of Excellence, Department of Neurology, University of South Florida, Tampa, Florida, USA
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Tamara M Pringsheim
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada
| | - Daniel Truong
- The Parkinson's and Movement Disorder Institute, Orange Coast Memorial Medical Center, Fountain Valley, California, USA
| | - Stewart A Factor
- Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Matej Skorvanek
- Department of Neurology, P.J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Anette Schrag
- Department of Clinical Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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19
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Petrescu C, Petrescu DM, Marian G, Focseneanu BE, Iliuta FP, Ciobanu CA, Papacocea S, Ciobanu AM. Neurological Soft Signs in Schizophrenia, a Picture of the Knowledge in the Last Decade: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11101471. [PMID: 37239757 DOI: 10.3390/healthcare11101471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Neurological Soft Signs (NSS) are subtle neurological abnormalities that are more common in schizophrenia patients than in healthy individuals and have been regularly observed in neuroleptic-naive first-episode patients, supporting the hypothesis that they are an intrinsic component of schizophrenia. (2) Methods: a review of articles published in the last ten years (from January 2013 to January 2023) was carried out on articles published in ScienceDirect and PubMed, by following the PRISMA Statement extension for scoping reviews (PRISMA-ScR), which evaluated the impact of NSS in correlation with the symptomatology, neuroleptic treatment, and the cerebral structural changes of patients with schizophrenia. (3) Results: thirty articles were included, among them twelve included MRI structural evaluation and four studies with a longitudinal design. (4) Conclusions: interest in researching NSS has increased in recent years, but questions remain about their origin and relationship to schizophrenia symptoms, thus this study aims to fill in information gaps in the hope that future research will help provide individualized treatment. It is suggested that NSS in schizophrenia might have an inherited genetic relationship pattern, thus being in line with a trait viewpoint. Most of the research revealed that schizophrenia patients had higher NSS scores than healthy controls, however, they were rather similar to their first-degree relatives, thus, also arguing in favor of a trait perspective. The greatest improvement in scores is seen in those with a remitting course, as shown by declining NSS ratings concurrent with symptomatology.
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Affiliation(s)
- Cristian Petrescu
- Department of Psychiatry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Diana M Petrescu
- Neurology Clinic Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Gabriela Marian
- Academy of Romanian Scientists, 050045 Bucharest, Romania
- Department of Psychiatry and Psychology, Titu Maiorescu University of Medicine, 040441 Bucharest, Romania
| | - Brindusa E Focseneanu
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Department of Psychiatry and Psychology, Titu Maiorescu University of Medicine, 040441 Bucharest, Romania
| | - Floris Petru Iliuta
- Department of Psychiatry and Psychology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | | | - Serban Papacocea
- Department of Neurosurgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adela M Ciobanu
- Department of Psychiatry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
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20
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Gottschick C, Diexer S, Massag J, Klee B, Broda A, Purschke O, Binder M, Sedding D, Frese T, Girndt M, Hoell JI, Michl P, Gekle M, Mikolajczyk R. Mental health in Germany in the first weeks of the Russo-Ukrainian war. BJPsych Open 2023; 9:e66. [PMID: 37057843 PMCID: PMC10134205 DOI: 10.1192/bjo.2023.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND In the connected world, although societies are not directly involved in a military conflict, they are exposed to media reports of violence. AIMS We assessed the effects of such exposures on mental health in Germany during the military conflict in Ukraine. METHOD We used the German population-based cohort for digital health research, DigiHero, launching a survey on the eighth day of the Russo-Ukrainian war. Of the 27 509 cohort participants from the general population, 19 444 (70.7%) responded within 17 days. We measured mental health and fear of the impact of war compared with other fears (natural disasters or health-related). RESULTS In a subsample of 4441 participants assessed twice, anxiety in the population (measured by the Generalised Anxiety Disorder-7 screener) was higher in the first weeks of war than during the strongest COVID-19 restrictions. Anxiety was elevated across the whole age spectrum, and the mean was above the cut-off for mild anxiety. Over 95% of participants expressed various degrees of fear of the impact of war, whereas the percentage for other investigated fears was 0.47-0.82. A one-point difference in the fear of the impact of war was associated with a 2.5 point (95% CI 2.42-2.58) increase in anxiety (11.9% of the maximum anxiety score). For emotional distress, the increase was 0.67 points (0.66-0.68) (16.75% of the maximum score). CONCLUSIONS The population in Germany reacted to the Russo-Ukrainian war with substantial distress, exceeding reactions during the strongest restrictions in the COVID-19 pandemic. Fear of the impact of war was associated with worse mental health.
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Affiliation(s)
- Cornelia Gottschick
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Janka Massag
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Bianca Klee
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Anja Broda
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Oliver Purschke
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Mascha Binder
- Department of Internal Medicine IV - Oncology/Haematology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Daniel Sedding
- Mid-German Heart Centre, Department of Cardiology and Intensive Care Medicine, University Hospital, Martin-Luther-University Halle-Wittenberg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg, Germany
| | - Jessica I Hoell
- Paediatric Haematology and Oncology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Patrick Michl
- Department of Internal Medicine I, Martin-Luther-University Halle-Wittenberg, Germany
| | - Michael Gekle
- Julius Bernstein-Institute of Physiology, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometry and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Germany
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21
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Abas MA, Müller M, Gibson LJ, Derveeuw S, Dissanayake N, Smith P, Verhey R, Danese A, Chibanda D. Prevalence of post-traumatic stress disorder and validity of the Impact of Events Scale - Revised in primary care in Zimbabwe, a non-war-affected African country. BJPsych Open 2023; 9:e37. [PMID: 36794523 PMCID: PMC9970167 DOI: 10.1192/bjo.2022.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND A critical step in research on the epidemiology of post-traumatic stress disorder (PTSD) in low-resource settings is the validation of brief self-reported psychometric tools available in the public domain, such as the Impact Event Scale - Revised (IES-R). AIMS We aimed to investigate the validity of the IES-R in a primary healthcare setting in Harare, Zimbabwe. METHOD We analysed data from a survey of 264 consecutively sampled adults (mean age 38 years; 78% female). We estimated the area under the receiver operating characteristic curve and sensitivity, specificity and likelihood ratios for different cut-off points of the IES-R, against a diagnosis of PTSD made using the Structured Clinical Interview for DSM-IV. We performed factor analysis to evaluate construct validity of the IES-R. RESULTS The prevalence of PTSD was 23.9% (95% CI 18.9-29.5). The area under the curve for the IES-R was 0.90. At a cut-off of ≥47, the sensitivity of the IES-R to detect PTSD was 84.1 (95% CI 72.7-92.1) and specificity was 81.1 (95% CI 75.0-86.3). Positive and negative likelihood ratios were 4.45 and 0.20, respectively. Factor analysis revealed a two-factor solution, with both factors showing good internal consistency (Cronbach's factor-1 α = 0.95, factor-2 α = 0.76). In a post hoc analysis, we found the brief six-item IES-6 also performed well, with an area under the curve of 0.87 and optimal cut-off of 15. CONCLUSIONS The IES-R and IES-6 had good psychometric properties and performed well for indicating possible PTSD, but at higher cut-off points than those recommended in the Global North.
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Affiliation(s)
- Melanie A Abas
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Monika Müller
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Clinic for Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Bern, Switzerland
| | - Lorna J Gibson
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK
| | - Sarah Derveeuw
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nirosha Dissanayake
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Patrick Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, UK
| | - Dixon Chibanda
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK; Friendship Bench, Harare, Zimbabwe; and Department of Psychiatry, University of Zimbabwe, Zimbabwe
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22
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Baker KM, Phelan AM, Reilly JB, Lansing RW, Schwartzstein RM, Banzett RB. Rating Dyspnea and Pain: "No" is Not Always "Zero". Clin Nurs Res 2023; 32:15-21. [PMID: 36367118 PMCID: PMC10989776 DOI: 10.1177/10547738221134564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Nurses routinely assess pain in hospitalized patients; similar assessment of dyspnea is increasing. Most nurses start with a yes-no question when assessing pain or dyspnea; many record "no" as a zero rating, skipping the rating scale. We tested the hypothesis that recording "no" answers as "zero" fails to detect the symptoms that would have been detected with a rating scale. Nurses asked 60 patients yes-no questions about the presence of dyspnea and pain, then asked patients to rate the symptoms using a 0-10 scale. All "yes" answers were followed by a concordant rating (i.e., greater than zero). More than 25% of "no" answers were followed by a discordant rating (> zero). Documenting "no" as "zero" missed information potentially useful in care planning; patients who rate dyspnea above zero are at greater risk of adverse outcomes. This information can also provide opportunity to start a discussion with patients who may benefit from symptom management.
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Affiliation(s)
- Kathy M. Baker
- Lois E. Silverman Dept of Nursing, Beth Israel Deaconess
Medical Center, Boston, MA, 02115 USA
| | | | - Jennifer B Reilly
- Lois E. Silverman Dept of Nursing, Beth Israel Deaconess
Medical Center, Boston, MA, 02115 USA
| | - Robert W. Lansing
- Department of Medicine, Division of Pulmonary, Critical
Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02115
USA
| | - Richard M Schwartzstein
- Department of Medicine, Division of Pulmonary, Critical
Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02115
USA
- Harvard Medical School, Boston, MA, 02115 USA
| | - Robert B. Banzett
- Department of Medicine, Division of Pulmonary, Critical
Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02115
USA
- Harvard Medical School, Boston, MA, 02115 USA
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Revuelta J, Ximénez C, Minaya N. Overfactoring in rating scale data: A comparison between factor analysis and item response theory. Front Psychol 2022; 13:982137. [PMID: 36533017 PMCID: PMC9750161 DOI: 10.3389/fpsyg.2022.982137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/01/2022] [Indexed: 10/15/2023] Open
Abstract
Educational and psychological measurement is typically based on dichotomous variables or rating scales comprising a few ordered categories. When the mean of the observed responses approaches the upper or the lower bound of the scale, the distribution of the data becomes skewed and, if a categorical factor model holds in the population, the Pearson correlation between variables is attenuated. The consequence of this correlation attenuation is that the traditional linear factor model renders an excessive number of factors. This article presents the results of a simulation study investigating the problem of overfactoring and some solutions. We compare five widely known approaches: (1) The maximum-likelihood factor analysis (FA) model for normal data, (2) the categorical factor analysis (FAC) model based on polychoric correlations and maximum likelihood (ML) estimation, (3) the FAC model estimated using a weighted least squares algorithm, (4) the mean corrected chi-square statistic by Satorra-Bentler to handle the lack of normality, and (5) the Samejima's graded response model (GRM) from item response theory (IRT). Likelihood-ratio chi-square, parallel analysis (PA), and categorical parallel analysis (CPA) are used as goodness-of-fit criteria to estimate the number of factors in the simulation study. Our results indicate that the maximum-likelihood estimation led to overfactoring in the presence of skewed variables both for the linear and categorical factor model. The Satorra-Bentler and GRM constitute the most reliable alternatives to estimate the number of factors.
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Liu R, Liu H, Shi D, Jiang Z. Diagnostic Classification Models for a Mixture of Ordered and Non-ordered Response Options in Rating Scales. Appl Psychol Meas 2022; 46:622-639. [PMID: 36131839 PMCID: PMC9483220 DOI: 10.1177/01466216221108132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
When developing ordinal rating scales, we may include potentially unordered response options such as "Neither Agree nor Disagree," "Neutral," "Don't Know," "No Opinion," or "Hard to Say." To handle responses to a mixture of ordered and unordered options, Huggins-Manley et al. (2018) proposed a class of semi-ordered models under the unidimensional item response theory framework. This study extends the concept of semi-ordered models into the area of diagnostic classification models. Specifically, we propose a flexible framework of semi-ordered DCMs that accommodates most earlier DCMs and allows for analyzing the relationship between those potentially unordered responses and the measured traits. Results from an operational study and two simulation studies show that the proposed framework can incorporate both ordered and non-ordered responses into the estimation of the latent traits and thus provide useful information about both the items and the respondents.
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Affiliation(s)
- Ren Liu
- University of California, Merced, CA, USA
| | - Haiyan Liu
- University of California, Merced, CA, USA
| | - Dexin Shi
- University of South Carolina, Columbia, SA, USA
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Abstract
BACKGROUND Levels of mental health stigma experienced can vary as a function of the presenting mental health problem (e.g. diagnosis and symptoms). However, these studies are limited because they exclusively use pairwise comparisons. A more comprehensive examination of diagnosis-specific stigma is needed. AIMS The aim of our study was to determine how levels of mental health stigma vary in relation to a number of psychiatric diagnoses, and identify what attributions predict levels of diagnosis-specific stigma. METHOD We conducted an online survey with members of the public. Participants were assessed in terms of how much stigma they had, and their attributions toward, nine different case vignettes, each describing a different mental health diagnosis. RESULTS We recruited 665 participants. After controlling for social desirability bias and key demographic variables, we found that mental health stigma varied in relation to psychiatric diagnosis. Schizophrenia and antisocial personality disorder were the most stigmatised diagnoses, and depression, generalised anxiety disorder and obsessive-compulsive disorder were the least stigmatised diagnoses. No single attribution predicted stigma across diagnoses, but fear was the most consistent predictor. CONCLUSIONS Assessing mental health stigma as a single concept masks significant between-diagnosis variability. Anti-stigma campaigns are likely to be most successful if they target fearful attributions.
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Affiliation(s)
| | - Clio Berry
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex and University of Brighton, UK; and School of Psychology, University of Sussex, UK
| | - Leanne Bogen-Johnston
- Research & Development Department, Sussex Partnership NHS Foundation Trust, UK; and School of Psychology, University of Sussex, UK
| | - Moitree Banerjee
- Institute of Education, Social and Life Sciences, University of Chichester, UK
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Mulraney M, Arrondo G, Musullulu H, Iturmendi-Sabater I, Cortese S, Westwood SJ, Donno F, Banaschewski T, Simonoff E, Zuddas A, Döpfner M, Hinshaw SP, Coghill D. Systematic Review and Meta-analysis: Screening Tools for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2022; 61:982-996. [PMID: 34958872 DOI: 10.1016/j.jaac.2021.11.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 11/02/2021] [Accepted: 12/17/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to determine the accuracies of a broad range of screening tools for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, and to compare the diagnostic accuracy of tools between population-based and clinical/high-risk samples, and across reporters. METHOD MEDLINE, PsycINFO, EMBASE, and PubMed were searched up until February 20, 2020, with no language restrictions. Studies reporting diagnostic accuracy of a screening tool against a diagnosis of ADHD in children and adolescents <18 years of age were eligible for inclusion. Meta-analyses were undertaken to provide pooled estimates of the area under the curve (AUC), and sensitivity and specificity of groups of measures. RESULTS A total of 75 studies published between 1985 and 2021 reporting on 41 screening tools that were grouped into 4 categories (Achenbach System of Empirically Based Assessment [ASEBA], DSM-IV symptom scales, SDQ, and Other Scales) were retained. The pooled AUC for studies using a combined ADHD symptoms score was 0.82 (95% CI = 0.78-0.86), although this varied considerably across reporters (0.67-0.92) and populations (CI = 0.60-0.95). None of the measures met minimal standards for acceptable sensitivity (0.8) and specificity (0.8). CONCLUSION Most tools have excellent overall diagnostic accuracy as indicated by the AUC. However, a single measure completed by a single reporter is unlikely to have sufficient sensitivity and specificity for clinical use or population screening.
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Affiliation(s)
- Melissa Mulraney
- Murdoch Children's Research Institute, Melbourne, Australia; University of Melbourne, Australia; Institute for Social Neuroscience, Ivanhoe, Australia.
| | - Gonzalo Arrondo
- University of Navarra, Pamplona, Spain; University of Southampton, Southampton, United Kingdom
| | - Hande Musullulu
- University of Navarra, Pamplona, Spain; University of Southampton, Southampton, United Kingdom
| | - Iciar Iturmendi-Sabater
- University of Navarra, Pamplona, Spain; University College London, United Kingdom; University of Toronto, Canada
| | - Samuele Cortese
- University of Southampton, Southampton, United Kingdom; Solent NHS Trust, Southampton, United Kingdom; New York University, New York; University of Nottingham, United Kingdom
| | - Samuel J Westwood
- University of Westminster, London United Kingdom; King's College London, United Kingdom; University of Wolverhampton, United Kingdom
| | - Federica Donno
- University of Cagliari, Italy; "A. Cao" Pediatric Hospital, "G. Brotzu" Hospital Trust, Cagliari, Italy
| | | | - Emily Simonoff
- University of Westminster, London United Kingdom; NIHR South London and Maudsley Biomedical Research Centre for Mental Health, London, United Kingdom
| | - Alessandro Zuddas
- University of Cagliari, Italy; "A. Cao" Pediatric Hospital, "G. Brotzu" Hospital Trust, Cagliari, Italy
| | - Manfred Döpfner
- University Cologne (AKiP), Germany; University of Cologne, Germany
| | - Stephen P Hinshaw
- University of California, Berkeley; University of California, San Francisco
| | - David Coghill
- Murdoch Children's Research Institute, Melbourne, Australia; University of Melbourne, Australia
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Weiss MD. A Paradigm for Targeting Functional Impairment as an Outcome in Attention-Deficit/Hyperactivity Disorder. Brain Sci 2022; 12:brainsci12081014. [PMID: 36009077 PMCID: PMC9405930 DOI: 10.3390/brainsci12081014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 02/03/2023] Open
Abstract
Although functional impairment is required for a diagnosis in the DSM 5, the time frame and definition of functional impairment is ambiguous. We present a conceptual review clarifying the difference between functional impairment as a stable trait representing strength or disability in various domains, and functional impairment as secondary to emotional or behavior problems, which is a state sensitive to change with treatment intervention. Functional impairment as a measure of treatment outcome includes both change from baseline and status at the endpoint of treatment. When using a validated measure of function, functional improvement can be defined as the percentage of patients who achieve the Minimal Important Clinical Difference (MCID) and functional remission as the percentage of patients who normalize at treatment endpoint. True treatment remission should be defined as both symptomatic and functional remission.
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Riccio CA, Jimenez EM, Schwartz J, Chien HY. Do parent and self-report rating scales of executive function measure the same constructs with adolescents? Appl Neuropsychol Child 2022; 11:212-219. [PMID: 32567369 DOI: 10.1080/21622965.2020.1780129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE There are numerous measures of executive function (EF), yet the multiple definitions and constructions of EF suggest that these measures may not be measuring the same construct or domains within EF. The purpose of this study was to examine the concurrent validity of the BRIEF and the CEFI parent and self-report forms with adolescents. METHOD Adolescent participants, ages 12-17 years, were recruited using a snowball method with recruitment targeting individuals from under-represented groups, as well as the general population. The resulting sample consisted of 52 cases with parent report. The adolescents were predominantly female (55.77%) and white (40.38%) with a mean age of 14.56 (1.72). RESULTS For parent and adolescent self-report on both the BRIEF and CEFI, mean global scores were within the average range. To examine whether the two rating scales were measuring the same underlying constructs of EF, a multi-trait-multi-method (MTMM) model was conducted using correlated traits correlated methods (CTCM) and correlated traits uncorrelated methods (CTUM). CONCLUSION While the global scores obtained for the instruments measure EF similarly, there is less consistency in how the subdomains parse out and are labeled for each of the two scales. Implications for practice are discussed.
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Sirimanna P, Boyce S, Gunanayagam P, Gladman MA, Naganathan V. Development of a rating scale for objective assessment of performance in laparoscopic appendicectomy surgery. ANZ J Surg 2022; 92:1724-1730. [PMID: 35338678 PMCID: PMC9544375 DOI: 10.1111/ans.17601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/09/2022] [Accepted: 02/25/2022] [Indexed: 11/26/2022]
Abstract
Backgrounds Laparoscopic appendicectomy (LA) is the most common index procedure for junior surgical trainees. Despite the shift towards competency‐based training, there is no method of quantitatively assessing performance during LA. This study aimed to obtain expert consensus regarding the items required to create a LA Rating Scale (LARS). Methods A list of steps required for LA surgery, as well as descriptors of “poor”, “average” and “excellent” performance for each of these steps were created for potential inclusion into an objective assessment tool for LA surgery. Using a Delphi method, 20 experts from multiple institutions rated on a Likert scale from 1 to 5 the suitability of these steps and descriptors of performance. Responses were obtained until consensus (Cronbach's α > 0.8) was achieved. Results Fifteen experts participated in the study. Consensus was achieved for all items during the first iteration of the Delphi with a Cronbach's α of 0.96. The Cronbach's α for the steps was 0.87 and 0.92 for the descriptors of performance. Steps and descriptors of performance that >80% of experts rated as ≥4 were used to create the final LARS tool. Conclusion Multi‐institutional expert consensus was obtained regarding the steps and, for the first time, descriptors of performance for LA, demonstrating their face and content validity, as well as generalisability. Subsequently, the LARS tool was created that can be used to quantitatively assess intra‐operative performance. This instrument can be used to identify weaknesses in performance and facilitate deliberate practice, thus shifting training in LA to a competency‐based approach.
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Affiliation(s)
- Pramudith Sirimanna
- Faculty of Medicine and Health, Concord Clinical School, University of Sydney, Sydney, Australia
| | | | - Prashanth Gunanayagam
- Faculty of Medicine and Health, Concord Clinical School, University of Sydney, Sydney, Australia
| | - Marc A Gladman
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Vasi Naganathan
- Faculty of Medicine and Health, Concord Clinical School, University of Sydney, Sydney, Australia.,Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, Australia
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Wakely H, Radakovic R, Bateman A, Simblett S, Fish J, Gracey F. Psychometric Properties of the Revised Dysexecutive Questionnaire in a Non-clinical Population. Front Hum Neurosci 2022; 16:767367. [PMID: 35308604 PMCID: PMC8924056 DOI: 10.3389/fnhum.2022.767367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Aims The aim of this study was to assess the psychometric properties of the revised self-rated version of the Dysexecutive Questionnaire (DEX-R) within a non-clinical sample. Methods The study was hosted online, with 140 participants completing the DEX-R, GAD-2 and PHQ-2. Sixty participants also completed the FrSBe, with 99 additionally completing the DEX-R again 3 weeks later. Correlations with demographic factors and symptoms of anxiety and depression were conducted. Rasch and factor analysis were also used to explore underlying subconstructs. Results The DEX-R correlated highly with the FrSBe, indicating sound concurrent validity. Internal consistency, split-half reliability and test-retest reliability were excellent. Age and symptoms of depression and anxiety correlated with DEX-R scores, with older age associated with less dysexecutive problems. The Rasch analysis confirmed the multidimensionality of the rating scale, and a three-factor structure was found relating to activation-self-regulatory, cognitive and social-emotional processes. Frequencies of responses on DEX-R items varied, many were not fully endorsed indicating specific relevance of most but not all items to patients. Conclusion Interpretations of DEX-R ratings of dysexecutive problems should consider mood and individual variation. Systematic comparison of DEX-R responses between healthy and clinical groups could help identify a suitable cut off for dysexecutive symptoms.
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Affiliation(s)
- Hannah Wakely
- Faculty of Medicine and Health Sciences, Cambridgeshire and Peterborough NHS Foundation Trust, University of East Anglia, Norwich, United Kingdom
| | - Ratko Radakovic
- Faculty of Medicine and Health Sciences, Cambridgeshire and Peterborough NHS Foundation Trust, University of East Anglia, Norwich, United Kingdom
- The Euan MacDonald Centre for Motor Neurone Disease, University of Edinburgh, Edinburgh, United Kingdom
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Cognitive Aging and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew Bateman
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
| | - Sara Simblett
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
| | - Jessica Fish
- Department of Clinical Neuropsychology and Clinical Health Psychology, St George’s Hospitals NHS Foundation Trust, London, United Kingdom
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Fergus Gracey
- Faculty of Medicine and Health Sciences, Cambridgeshire and Peterborough NHS Foundation Trust, University of East Anglia, Norwich, United Kingdom
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Racine E, Taylor BP, Ferretti CJ, Doernberg E, Noone R, Nezgovorova V, Vats T, Hollander E. Challenges in assessing change in autistic adults: scale limitations and discrepancies in reporting in clinical trials. Int J Psychiatry Clin Pract 2022; 26:3-7. [PMID: 33779470 DOI: 10.1080/13651501.2021.1900871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Autism Spectrum Disorder (ASD) is a developmental disorder marked by deficits in social communication and social interaction, together with restricted and/or repetitive patterns of behaviours, activities or interests. As more adults are being diagnosed with ASD, and more diagnosed children are aging into adulthood, the need for effective treatments and support services for autistic adults is quickly growing. As such, clinical research targeting autistic adults has emerged in recent years. Currently, caregiver ratings are commonly used as outcome measures in child treatment studies, but these scales present challenges when utilised to assess the autistic adult population. In this commentary, we seek to unveil the difficulties and obstacles in assessing change in clinical treatment trials for autistic adults. Specifically, this article uses case examples to explore the limitations of rating scales. Steps for improving the accuracy of ratings, and for developing novel self-rating scales for autistic adults are discussed. It is hoped that in exploring these difficulties in more depth, clinical research with adult ASD populations will continue to improve and that reliable, valid and sensitive outcome measures will be developed to ensure the highest quality treatments emerge.
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Affiliation(s)
- Emma Racine
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Bonnie P Taylor
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Casara J Ferretti
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Ellen Doernberg
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Rachel Noone
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Vera Nezgovorova
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Tarini Vats
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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Seppänen M, Lankila T, Auvinen J, Miettunen J, Korpelainen R, Timonen M. Cross-cultural comparison of depressive symptoms on the Beck Depression Inventory-II, across six population samples. BJPsych Open 2022; 8:e46. [PMID: 35144711 PMCID: PMC8867877 DOI: 10.1192/bjo.2022.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Beck Depression Inventory (BDI) and BDI-II (revised version) are some of the most widely used and comparable self-report scales for assessing the presence and severity of depressive symptoms in many countries. However, although the relative mean score of each symptom in different countries may vary, the cultural differences of BDI-II symptoms for each item have not been previously studied. AIMS To examine the overall picture of the magnitude of the symptoms in the Finnish population, and compare the relative mean score of each symptom between all published population-based samples from different countries fulfilling the search criteria. METHOD We conducted a search for population-based studies reporting BDI-II item, using Scopus, PsycINFO and PubMed, and five population-based samples were identified. Relative average scores for each item of the scale were calculated for the Finnish population and five populations from other countries. Meta-regression methods were used to test the differences in the relative score of each symptom between each country separately, and results were then visually compared with spider charts. RESULTS We found significant differences in several BDI-II item scores between countries: lower indecisiveness, higher changes in sleep pattern and higher irritability in Finland; higher loss of pleasure in Norway; higher loss of interest in the Dominic Republic; higher self-criticalness and feelings of punishment in Mexico; and higher sadness in Japan. CONCLUSIONS Based on the study fundings and including all currently published population-based samples with BDI-II scores, cultural differences in depressive symptoms should be considered when interpreting BDI-II item scores.
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Affiliation(s)
- Marjo Seppänen
- Geography Research Unit, University of Oulu, Finland; Center for Life Course Health Research, University of Oulu, Finland; and Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation, Finland
| | - Tiina Lankila
- Geography Research Unit, University of Oulu, Finland; and Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Finland; and Medical Research Center, Oulu University Hospital and University of Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Finland; and Medical Research Center, Oulu University Hospital and University of Oulu, Finland
| | - Raija Korpelainen
- Center for Life Course Health Research, University of Oulu, Finland; Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation, Finland; and Medical Research Center, Oulu University Hospital and University of Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, Finland; and Unit of General Practice, Oulu University Hospital, Finland
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Citrome L, Abi-Dargham A, Bilder RM, Duffy RA, Dunlop BW, Harvey PD, Pizzagalli DA, Tamminga CA, McIntyre RS, Kane JM. Making Sense of the Matrix: A Qualitative Assessment and Commentary on Connecting Psychiatric Symptom Scale Items to the Research Domain Criteria (RDoC). Innov Clin Neurosci 2022; 19:26-32. [PMID: 35382070 PMCID: PMC8970242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Research Domain Criteria (RDoC) initiative aims to organize research according to domains of brain function. Dysfunction within these domains leads to psychopathology that is classically measured with rating scales. Examining the correspondence between the specific measures assessed within rating scales and RDoC domains is necessary to assess the needs for new RDoC-focused scales. Such RDoC-focused scales have the potential of allowing translation of this work into the clinical domain of measuring psychopathology and designing treatment. Here, we describe an initial qualitative assessment by a group of 10 clinician-scientists of the alignment between RDoC domains and the items within five commonly used rating scales. In this commentary, we report limited correspondence and make recommendations for future work needed to address these limitations.
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Affiliation(s)
- Leslie Citrome
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Anissa Abi-Dargham
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Robert M Bilder
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Ruth A Duffy
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Boadie W Dunlop
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Philip D Harvey
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Diego A Pizzagalli
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Carol A Tamminga
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - Roger S McIntyre
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
| | - John M Kane
- Dr. Citrome is with New York Medical College in Valhalla, New York
- Dr. Abi-Dargham is with Stony Brook University in Stony Brook, New York
- Dr. Bilder is with the University of California in Los Angeles, California
- Dr. Duffy is with Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey
- Dr. Dunlop is with Emory University in Atlanta, Georgia
- Dr. Harvey is with the Miller School of Medicine, University of Miami in Miami, Florida
- Dr. Pizzagalli is with Harvard Medical School in Boston, Massachusetts
- Dr. Tamminga is with the University of Texas Southwestern in Dallas, Texas
- Dr. McIntyre is with the University of Toronto in Toronto, Canada
- Dr. Kane is with the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York
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Rush AJ, Madia ND, Carmody T, Trivedi MH. Psychometric and Clinical Evaluation of the Clinician (VQIDS-C 5) and Self-Report (VQIDS-SR 5) Versions of the Very Quick Inventory of Depressive Symptoms. Neuropsychiatr Dis Treat 2022; 18:289-302. [PMID: 35210776 PMCID: PMC8860726 DOI: 10.2147/ndt.s342457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/20/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Evaluate the psychometric properties of the 5-item Very Quick Inventory of Depressive Symptomatology self-report and clinician-rated versions (VQIDS-SR5/VQIDS-C5), compare their relative performance, create crosswalks between their total scores and other accepted depressive symptom ratings, and define clinically relevant depressive symptom severity thresholds and categorical outcomes for both versions. PATIENTS AND METHODS The Sequenced Treatment Alternatives to Relieve Depression trial obtained baseline and exit 17-item Hamilton Rating Scale for Depression (HRSD17) and 30-item Inventory of Depressive Symptomatology - Clinician-rated scores, and baseline and visit-wise QIDS-SR16 and QIDS-C16 ratings from the first treatment step (citalopram). The VQIDS-C5 and the VQIDS-SR5 items (sad mood, self-outlook, involvement, fatigue, psychomotor slowing) (each rated 0-3), extracted from the corresponding 16-item ratings, were selected to best reflect the 6-item HRSD (HRSD6) (exclusive of anxiety). Classical Test Theory (CTT) and Item-Response Theory (IRT) analyses assessed psychometric features. IRT analyses produced total score crosswalks between the VQIDS5, QIDS-C16, QIDS-SR16 and HRSD6. Clinically relevant VQIDS symptom severity thresholds and treatment outcomes were estimated based on cross-walks from the parent QIDS16 ratings. RESULTS Both VQIDS versions were unifactorial with acceptable internal consistencies (Cronbach's alphas >0.80), item-total correlations (0.57-0.74) by CCT, and strong IRT item performance. Based on QIDS16 severity thresholds (none 0-5; mild 6-10; moderate 11-15; severe 16-20; and very severe 21-27), comparable thresholds were 0-2; 3-5; 6-9; 9-12; and >12 for VQIDS-C5, and 0-2; 2-5; 6-8; 9-12; and >12 for VQIDS-SR5. Kappa values were acceptable in comparing categories of outcomes (eg, no benefit, remission, etc) based on VQIDS and corresponding QIDS categories. CONCLUSION The VQIDS-C5 and VQIDS-SR5 assess selected core depressive symptoms with psychometrically acceptable properties. Theelf-report and clinician-rated versions provide virtually identical information, symptom severity thresholds and symptom change categories. Both are as sensitive to change as the corresponding QIDS16, making them suitable for use in busy practices.
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Affiliation(s)
- A John Rush
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Duke-National University of Singapore, Singapore
| | - Nancy D Madia
- Texas Tech University Health Sciences Center Permian Basin, Odessa, TX, USA
| | - Thomas Carmody
- Department of Population and Data Science, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Madhukar H Trivedi
- Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Abstract
BACKGROUND Human-animal interactions are known to have many beneficial psychosocial and psychophysiological effects on persons with and without medical health conditions. There are no previous prospective studies with long follow-up times on the effects of domestic pets on the persons with Alzheimer's disease (AD) living at home. OBJECTIVE To investigate the effects of pets on the activities of daily living (ADL), disease progression, and neuropsychiatric symptoms (NPS) during a five-year follow-up on the persons with AD. METHODS Altogether 223 home-dwelling persons (mean age 75.2 years) with very mild (CDR 0.5) or mild (CDR 1) AD at baseline were included for this study. ADCS-ADL, NPI, MMSE, and CDR-SOB were measured at baseline, annually for three years and after five years. RESULTS Totally 40 (17.9%) participants had a pet. At the baseline, pet owners and non-pet owners had no significant differences in age, gender, or the ADCS-ADL, NPS, and CDR-SOB scores, while MMSE was lower in pet owners than non-pet owners (20.2 versus 21.7; p = 0.009). Over the follow-up, pet owners had significantly better mean ADCS-ADL (57.5 versus 54.0; p = 0.031), NPI (9.3 versus 13.0; p = 0.038), and CDR-SOB scores (5.7 versus 6.6; p = 0.004) compared to non-pet owners. The differences in the MMSE scores between the groups detected at baseline attenuated over time. CONCLUSION Significant positive effects of the pets on ADL functions, NPS, and disease progression were detected over the whole follow-up suggesting that having a pet may support daily activity and slow the disease progression in AD.
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Affiliation(s)
- Minna Rusanen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuomas Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Virve Kärkkäinen
- Neurosurgery of Neuro Center, Kuopio University Hospital, Kuopio, Finland
| | - Anne Koivisto
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland.,Geriatrics, Internal Medicine and Rehabilitation, Helsinki University Hospital, and Department of Neurosciences, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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36
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Heru AM. Cultural research deconstructs the psychosocial construct 'expressed emotion'. Br J Psychiatry 2021; 219:565-568. [PMID: 32778202 DOI: 10.1192/bjp.2020.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Expressed emotion (EE) is a highly researched psychosocial construct. Cultural research challenges the assumption that high family criticism is a universal determinant of poor outcome, especially for chronic illness. The concept of warmth, an original component of EE, was dropped owing to the complexity of its measurement. Warmth has now been resurrected as an important predictor of good patient outcome. Cultural scrutiny and appropriate adaptation of any psychosocial construct is necessary before its acceptance into the medical lexicon of healthcare.
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Affiliation(s)
- Alison M Heru
- Professor, Department of Psychiatry, University of Colorado Denver, USA
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37
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Papadopoulos A, Nichols ES, Mohsenzadeh Y, Giroux I, Mottola MF, Van Lieshout RJ, Duerden EG. Depression in pregnant women with and without COVID-19. BJPsych Open 2021; 7:e173. [PMID: 34635872 PMCID: PMC8485035 DOI: 10.1192/bjo.2021.1010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/23/2022] Open
Abstract
Evidence suggests that pregnant women who test positive for COVID-19 may develop more severe illness than non-pregnant women and may be at greater risk for psychological distress. The relationship between COVID-19 status (positive, negative, never tested) and symptoms of depression was examined in a survey study (May to September 2020) of pregnant women (n = 869). Pregnant women who reported testing positive for COVID-19 were significantly more likely to report depressive symptoms compared with women who tested negative (P = 0.027) and women who were never tested (P = 0.005). Findings indicate that pregnant women who test positive for COVID-19 should be screened and monitored for depressive symptoms.
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Affiliation(s)
- Alissa Papadopoulos
- Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada
| | - Emily S. Nichols
- Applied Psychology, Faculty of Education, and The Brain and Mind Institute, Western University, London, Ontario, Canada
| | - Yalda Mohsenzadeh
- The Brain and Mind Institute and Department of Computer Science, Western University, London, Ontario, Canada
| | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, and Insititut du Savoir Monfort, Ottawa, Ontario, Canada
| | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation – Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, Western University, London, Ontario, Canada
| | - Ryan J. Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Emma G. Duerden
- Applied Psychology, Faculty of Education, The Brain and Mind Institute, and Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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38
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Montes JM, Pascual A, Molins Pascual S, Loeck C, Gutiérrez Bermejo MB, Jenaro C. Assessment Tool of Bipolar Disorder for Primary Health Care: The SAEBD. Int J Environ Res Public Health 2021; 18:8318. [PMID: 34444069 DOI: 10.3390/ijerph18168318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 12/03/2022]
Abstract
Mixed states are highly prevalent in patients with bipolar disorder and require comprehensive scales. Considering this, the current study aims to develop a measure to assess the full spectrum of clinical manifestations of bipolar disorder. A sample of 88 patients was evaluated; the Hamilton Depression Scale (HAM-D), Montgomery-Asberg Depression Scale (MADRS), and the Young Mania Rating Scale (YMRS) were applied, together with the preliminary version of the Scale for the Assessment of Episodes in Bipolar Disorder (SAEBD). After analyzing the appropriateness and statistical properties of the items, discriminant analysis and analysis of diagnostic capacity were performed. The discriminant functions correctly classified 100% of the cases in euthymia, predominant depressive symptoms or mixed symptoms, as well as 92.3% of the cases with predominant manic symptoms. Overall, the functions correctly classified 98.9% of the cases. The area under the curve (0.935) showed high capacity to discriminate between clinical and non-clinical cases (i.e., in euthymia). The SAEBD sensitivity was 0.95, specificity was 0.71, the Positive Predictive Value (PPV) was 0.88, the Negative Predictive Value (NPV) was 0.87, the Positive Likelihood Ratio (+LR) was 3.33, and the Negative Likelihood Ratio (−LR) was 0.07. In conclusion, the SAEBD is a promising scale that shows high reliability and validity, as well as diagnostic utility as a screening tool for use in diverse health care settings.
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Shiina K. Commentary: The Historical Roots of Visual Analog Scale in Psychology as Revealed by Reference Publication Year Spectroscopy. Front Hum Neurosci 2021; 15:711691. [PMID: 34335215 PMCID: PMC8320287 DOI: 10.3389/fnhum.2021.711691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kenpei Shiina
- Department of Educational Psychology, School of Education, Waseda University, Tokyo, Japan
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40
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Gilmoor AR, Vallath S, Peters RMH, van der Ben D, Ng L. Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study. BJPsych Open 2021; 7:e122. [PMID: 34218840 PMCID: PMC8280791 DOI: 10.1192/bjo.2021.952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Trauma History Questionnaire (THQ) is one of the most widely used traumatic event inventories, but its lack of validation makes it unsuitable for the millions of homeless people with severe mental illness in India, who are particularly vulnerable to trauma exposure. AIMS To translate and culturally adapt the THQ for use in a population of homeless people with severe mental illness in Tamil Nadu, India. METHOD We used Herdman et al's model of cultural equivalence to conduct an in-depth qualitative assessment of the cultural validity of the THQ. Following several translations, conceptual, item, semantic and operational equivalence of the THQ was assessed through four focus groups with user-survivors (n = 20) and two focus groups with mental health professionals (n = 11). RESULTS Several adaptations, including the addition of 18 items about relationships, homelessness and mental illness, were necessary to improve cultural validity. Three items, such as rape, were removed for reasons of irrelevance or cultural insensitivity. Items like 'adultery' and 'mental illness' were reworded to 'extramarital affair' and 'mental health problem', respectively, to capture the cultural nuances of the Tamil language. Findings revealed a divergence in views on tool acceptability between user-survivors, who felt empowered to voice their experiences, and mental health professionals, who were concerned for patient well-being. Providing a sense of pride and autonomy, user-survivors preferred self-administration, whereas mental health professionals preferred rater administration. CONCLUSIONS Culture significantly affects what types of events are considered traumatic, highlighting the importance of cultural validation of instruments for use in novel populations and settings.
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Affiliation(s)
- Andrew R Gilmoor
- Department of Science, Vrije Universiteit Amsterdam, The Netherlands
| | - Smriti Vallath
- Department of Science, Vrije Universiteit Amsterdam, The Netherlands; Department of Psychology, Banyan Academy of Leadership in Mental Health, India; and The Banyan, India
| | - Ruth M H Peters
- Department of Science, Vrije Universiteit Amsterdam, The Netherlands; and Department of Global Health and Social Medicine, Harvard Medical School, USA
| | | | - Lauren Ng
- Department of Psychiatry, Boston University School of Medicine, USA; and Department of Psychology, University of California Los Angeles, USA
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41
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Müssig M, Kubiak J, Egloff B. The Agony of Choice: Acceptance, Efficiency, and Psychometric Properties of Questionnaires With Different Numbers of Response Options. Assessment 2021; 29:1700-1713. [PMID: 34218677 DOI: 10.1177/10731911211029379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Questionnaires are one of the most important tools in psychological assessment, yet the impact of different numbers of response options on psychometric properties of questionnaires is limited. This study extends existing research by analyzing respondents' acceptance of and the efficiency of different numbers of response options and replicate findings on reliability and validity. We studied these questions in 540 respondents who filled out the Big Five Inventory-2 and the Emotion Regulation Questionnaire. Two response options, 11 response options and the visual analog scale showed disadvantages in acceptance compared with the original number of response options. The completion time increased by 1.7s per item when moving from 2 to 11 response options. Cronbach's alpha (but not ordinal alpha based on polychoric covariance) was lowest for two response options. Validity was unaffected. Overall, compared with the typical choice of five or seven response options, fewer or more response options resulted in disadvantages.
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Affiliation(s)
- Markus Müssig
- Department of Psychology, Johannes Gutenberg University Mainz, Germany
| | - Jeanette Kubiak
- Department of Psychology, Johannes Gutenberg University Mainz, Germany
| | - Boris Egloff
- Department of Psychology, Johannes Gutenberg University Mainz, Germany
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42
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Boulton KA, Guastella AJ. Social anxiety symptoms in autism spectrum disorder and social anxiety disorder: Considering the reliability of self-report instruments in adult cohorts. Autism Res 2021; 14:2383-2392. [PMID: 34213050 DOI: 10.1002/aur.2572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/20/2021] [Accepted: 06/22/2021] [Indexed: 11/08/2022]
Abstract
Adults with autism spectrum disorder (ASD) are at elevated risk for social anxiety disorder (SAD). Limited information exists on the reliability of social anxiety instruments with these adults and their performance when compared to individuals with SAD without ASD. This study examines psychometric properties of self-report social anxiety instruments in autistic adults without intellectual disability, compared to adults with SAD. Additionally, we compared instrument scores between a subgroup of autistic adults with a dual diagnosis of SAD (ASD + SAD) and adults with SAD only. Adults diagnosed with SAD (N = 316) or ASD (N = 102) were recruited from the Brain and Mind Centre in New South Wales, Australia. Sixty autistic participants also received a diagnosis of SAD (ASD + SAD). Participants completed the Liebowitz Social Anxiety Scale-self-report, the Social Interaction Anxiety Scale, the Social Phobia Scale, and the Brief Fear of Negative Evaluation Scale. All instruments showed excellent internal consistency in autistic adults. The instruments showed evidence of convergent validity, and the strength of relationships between measures were equivalent between ASD and SAD groups. For all instruments, performance of these instruments in autistic adults with a SAD diagnosis was very similar to performance in adults diagnosed with SAD but without ASD. Findings support the use of these instruments for identifying social anxiety symptoms in autistic adults without intellectual disability and have utility for mental health clinical services. LAY SUMMARY: Autistic adults often experience social anxiety. We examined the use of four social anxiety questionnaires in autistic adults, compared to adults with SAD. We found similar results between autistic adults and adults with SAD, suggesting that these questionnaires can be useful for measuring social anxiety symptoms in autistic adults. These findings have implications for clinical services, as they show that these instruments are reliable when used with autistic adults.
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Affiliation(s)
- Kelsie A Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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43
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Murray CA, Hastings RP, Totsika V. Clinical utility of the parent-reported Strengths and Difficulties Questionnaire as a screen for emotional and behavioural difficulties in children and adolescents with intellectual disability. Br J Psychiatry 2021; 218:323-325. [PMID: 33198827 DOI: 10.1192/bjp.2020.224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We assessed the clinical utility of the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a screen for emotional and behavioural difficulties in 626 children and young people with intellectual disability. Using the Developmental Behavior Checklist (DBC2-P) to determine clinical caseness, the area under the curve for the SDQ total difficulties score was 0.876 (95% CI 0.841-0.911), indicating that it is a good measure for identifying significant emotional and behavioural difficulties requiring further investigation. Analyses supported the use of the same SDQ cut-off for those with and without intellectual disability, which may assist with consistent and comparable assessment in clinical practice.
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Affiliation(s)
- Caitlin A Murray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK; and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK; and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia; and Division of Psychiatry, University College London, UK
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44
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Siuda J, Boczarska-Jedynak M, Budrewicz S, Dulski J, Figura M, Fiszer U, Gajos A, Gorzkowska A, Koziorowska-Gawron E, Koziorowski D, Krygowska-Wajs A, Rudzińska-Bar M, Sławek J, Toś M, Wójcik-Pędziwiatr M, Lin J, Luo S, Martinez-Martin P, Stebbins GT, Goetz CG, Opala G, Koszewicz M, Leńska-Mieciek M, Michałowska M, Piaścik-Gromada M, Potasz-Kulikowska K, Śmiłowski M, Wasilewska A, Opala G. Validation of the Polish version of the Unified Dyskinesia Rating Scale (UDysRS). Neurol Neurochir Pol 2021; 55:186-194. [PMID: 33528833 DOI: 10.5603/pjnns.a2021.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/12/2020] [Accepted: 12/22/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND In 2008, the Movement Disorders Society published the Unified Dyskinesia Rating Scale (UDysRS). This has become the established tool for assessing the severity and disability associated with dyskinesia in patients with Parkinson's Disease (PD). We translated and validated the Polish version of the UDysRS, explored its dimensionality, and compared it to the Spanish version, which is the Reference Standard for UDysRS translations. MATERIAL AND METHODS The UDysRS was translated into Polish by a team led by JS and GO. The back-translation, completed by colleagues fluent in both Polish and English who were not involved in the original translation, was reviewed and approved by the Executive Committee of the MDS Rating Scales Programme. Then the translated version of the UDysRS underwent cognitive pretesting, and the translation was modified based on the results. The approved version was considered to be the Official Working Document of the Polish UDysRS and was tested on 250 Polish PD patients recruited at movement disorder centres. Data was compared to the Reference Standard used for validating UDysRS translations. RESULTS The overall factor structure of the Polish version was consistent with that of the Reference Standard version, as evidenced by the high Confirmatory Fit Index score (CFI = 0.98). The Polish UDysRS was thus confirmed to share a common factor structure with the Reference Standard. CONCLUSIONS The Official Polish UDysRS translation is recommended for use in clinical and research settings. Worldwide use of uniform rating measures offers a common ground to study similarities and differences in disease manifestations and progression across cultures.
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Affiliation(s)
- Joanna Siuda
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | | | | | - Jarosław Dulski
- Department of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland,Department of Neurology and Stroke, St. Adalbert Hospital, Gdansk, Poland
| | - Monika Figura
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Fiszer
- Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland
| | - Agata Gajos
- Department of Extrapyramidal Diseases, Medical University of Łódź, Łódź, Poland
| | - Agnieszka Gorzkowska
- Department of Neurorehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Anna Krygowska-Wajs
- Department of Neurology, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Monika Rudzińska-Bar
- Department of Neurology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Jarosław Sławek
- Department of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland,Department of Neurology and Stroke, St. Adalbert Hospital, Gdansk, Poland
| | - Mateusz Toś
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Wójcik-Pędziwiatr
- Department of Neurology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Jeffrey Lin
- Department of Biostatistics, Gilead Sciences, Inc., Foster City, California, United States
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States
| | - Pablo Martinez-Martin
- Centre for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Centre, Chicago, Illinois, United States
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Centre, Chicago, Illinois, United States
| | - Grzegorz Opala
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland,Department of Neurology, Wroclaw Medical University, Wroclaw, Poland,Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland,Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland,Department of Extrapyramidal Diseases, Medical University of Łódź, Łódź, Poland,Department of Neurology, Jagiellonian University, Collegium Medicum, Krakow, Poland,Department of Neurology, John Paul II Specialised Hospital, Krakow, Poland
| | | | - Marta Leńska-Mieciek
- Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland
| | - Małgorzata Michałowska
- Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland
| | - Marta Piaścik-Gromada
- Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland
| | | | - Marek Śmiłowski
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anna Wasilewska
- Department of Neurology, John Paul II Specialised Hospital, Krakow, Poland, Poland
| | - Grzegorz Opala
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Abstract
Objective: This study provides independent examination of the validity of the Barkley Deficits of Executive Functioning Scale-Children and Adolescents (BDEFS-CA) in a sample of children diagnosed with ADHD (n = 50) and typically developing controls (n = 50). Method: Parents of participants completed the BDEFS-CA and the Conners 3 rating scales. Validity of BDEFS-CA was examined using a confirmatory factor analysis, correlational analyses with Conners 3 ratings, and receiver operating characteristic (ROC) curve analysis of diagnostic accuracy. Results: Findings support the construct, concurrent, and discriminant validity of the BDEFS-CA in a mixed sample. Conclusion: Findings provide independent examination of the validity of the BDEFS-CA as a measure of executive dysfunction and a screening tool for ADHD.
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Tai G, Corben LA, Woodcock IR, Yiu EM, Delatycki MB. Determining the Validity of Conducting Rating Scales in Friedreich Ataxia through Video. Mov Disord Clin Pract 2021; 8:688-693. [PMID: 34307740 DOI: 10.1002/mdc3.13204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 12/26/2022] Open
Abstract
Background The Friedreich Ataxia Rating Scale (FARS) and the Scale for the Assessment and Rating of Ataxia (SARA) are commonly used neurological rating scales in Friedreich ataxia (FRDA). The modified Friedreich Ataxia Rating Scale (mFARS) has been accepted as an appropriate outcome measure for clinical trials in FRDA. Objectives The COVID-19 pandemic has resulted in limited face-to-face interactions with individuals involved in natural history studies and clinical trials. The aim of this study was to determine the validity of conducting the mFARS and SARA through video. Methods Individuals who had the mFARS administered face-to-face in the previous 6 months were invited to participate. Participants were sent instructions and asked to have a carer present to assist. The mFARS and SARA were then administered by video. Differences between face-to-face and video scores and the reliability between scores obtained face-to-face and by video were examined. Results The mFARS and SARA were conducted by video with 19 individuals. Excellent test-retest reliability was seen in the mFARS lower limb coordination (ICC = 0.96, 95% CI 0.90-0.98) and upright stability sections (ICC = 0.97, 95% CI 0.93-0.99), total mFARS (ICC = 0.97, 95% CI 0.92-0.99) and SARA scores (ICC = 0.98, 95% CI 0.95-0.99). Conclusions Excellent test-retest reliability was demonstrated in the majority of the mFARS sections, and in the total mFARS and SARA scores, suggesting that video is a valid method of conducting these scales. This method enables inclusion of participants who are unable to travel to study sites. A larger cohort will be required to further validate the use of video mFARS and SARA for future studies.
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Affiliation(s)
- Geneieve Tai
- Bruce Lefroy Centre for Genetic Health Research Murdoch Children's Research Institute Parkville Victoria Australia
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research Murdoch Children's Research Institute Parkville Victoria Australia.,Department of Paediatrics University of Melbourne Parkville Victoria Australia.,School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Ian R Woodcock
- Department of Paediatrics University of Melbourne Parkville Victoria Australia.,Department of Neurology Royal Children's Hospital Parkville Victoria Australia.,Division of Neuroscience Murdoch Children's Research Institute Parkville Victoria Australia
| | - Eppie M Yiu
- Bruce Lefroy Centre for Genetic Health Research Murdoch Children's Research Institute Parkville Victoria Australia.,Department of Paediatrics University of Melbourne Parkville Victoria Australia.,Department of Neurology Royal Children's Hospital Parkville Victoria Australia.,Division of Neuroscience Murdoch Children's Research Institute Parkville Victoria Australia
| | - Martin B Delatycki
- Bruce Lefroy Centre for Genetic Health Research Murdoch Children's Research Institute Parkville Victoria Australia.,Department of Paediatrics University of Melbourne Parkville Victoria Australia.,School of Psychological Sciences Monash University Clayton Victoria Australia.,Victorian Clinical Genetics Service Parkville Victoria Australia
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47
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Sánchez-Cueva S, Alonso-Esteban Y, Sánchez-Cueva P, Birmaher B, Alcantud-Marín F. Psychometrics of the Spanish Version of the Screen for Adult Anxiety Related Disorders (SCAARED). Front Psychiatry 2021; 12:589422. [PMID: 33643088 PMCID: PMC7904889 DOI: 10.3389/fpsyt.2021.589422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/19/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives: To translate and validate the Screen for Adult Anxiety Related Disorders (SCAARED) questionnaire into Spanish. Method: The original SCAARED was translated into Spanish and administered to a non-clinical sample of 131 university students (92.4% women, mean age 22 years) in Valencia, Spain. To assess the concurrent validity of the SCAARED, the Depression, Anxiety and Stress Scale-21(DASS) and the Beck's Anxiety Inventory (BAI) were also administered. Test-retest reliability was evaluated 2 weeks after the first administration. Results: The internal consistency of SCAARED was high (α = 0.91) and the stability of the measurement was also high (test-retest 0.81). The results of the Exploratory Factor Analysis showed four factors comparable to the original SCAARED (generalized anxiety disorder, social phobia disorder, panic disorder, and separation anxiety disorder). The Area Under the Curve was excellent (0.88). Conclusions: The Spanish version of the SCAARED showed good psychometric properties comparable to the original SCAARED suggesting that it may be a useful instrument to screen for anxiety disorders in Spanish-speaking adult populations. Future studies are needed to replicate these findings in larger community and clinical samples.
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Affiliation(s)
- Sarah Sánchez-Cueva
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Yurena Alonso-Esteban
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | | | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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48
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Abstract
As in previous periods of quarantine, lockdown confinement measures dictated to control SARS-CoV-2 would be expected to negatively affect mental health. We investigated the immediate effects (over a 10 day period) of a strict nationwide stay-at-home order imposed in Spain, one of the countries most affected by the COVID-19 pandemic. Focusing our analysis on the feelings of loneliness, we obtained our measures within a social context characterised by strong and continuous public and governmental support for increasing social bonds and cooperation in order to face the common public threat. Leveraging data from the Barcelona Brain Health Initiative, a prospective population-based study cohort, the short UCLA Loneliness Scale was administered to 1604 participants 2 years and 1 year before the stay-at-home lockdown and repeated, on average, 10 days after the official confinement order issued by the Spanish government. Ratings of loneliness remained stable during the 2 years before lockdown; however, they decreased significantly during the early stages of home confinement. This effect was particularly significant for the item 'feeling excluded from others' and was also observed among individuals who were confined alone. Overall, the results suggest that gestures and manifestations of appreciation by people for the labour and efforts of certain individuals, along with official campaigns designed to promote feelings of inclusion and belonging, may have beneficial effects on feelings of loneliness, a negative emotional state strongly regarded as a risk factor for impaired mental and general health status. Further assessments during the later stages of home confinement are now warranted.
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Affiliation(s)
- David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Spain; and Guttmann Institute, University Institute of Neurorehabilitation affiliated to the Autonomous University of Barcelona (UAB), Spain
| | - Dídac Macià
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Spain
| | - Gabriele Cattaneo
- Guttmann Institute, University Institute of Neurorehabilitation affiliated to the Autonomous University of Barcelona (UAB), Spain; and Autonomous University of Barcelona, Spain
| | - Roger Borràs
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Cllinical Neurosciences, Clinical and Provincial Hospital of Barcelona, Spain
| | - Clara Tarrero
- Guttmann Institute, University Institute of Neurorehabilitation affiliated to the Autonomous University of Barcelona (UAB), Spain; and Autonomous University of Barcelona, Spain
| | - Javier Solana
- Guttmann Institute, University Institute of Neurorehabilitation affiliated to the Autonomous University of Barcelona (UAB), Spain; and Autonomous University of Barcelona, Spain
| | - José M Tormos
- Guttmann Institute, University Institute of Neurorehabilitation affiliated to the Autonomous University of Barcelona (UAB), Spain; and Autonomous University of Barcelona, Spain
| | - Alvaro Pascual-Leone
- Guttmann Institute, University Institute of Neurorehabilitation affiliated to the Autonomous University of Barcelona (UAB), Spain; and Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts, USA
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49
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Mok Z, Steel G, Russell C, Conway E. Measuring the interactions of people with dementia and their conversation partners: a preliminary adaption of the Kagan measures of support and participation in conversation. Aging Ment Health 2021; 25:13-21. [PMID: 31591908 DOI: 10.1080/13607863.2019.1671314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE While dementia can negatively affect communication, positive interactions can be facilitated by the conversation partners of people with dementia. There are few assessment tools designed to evaluate the support provided by the conversation partner and the resulting participation of the person with dementia. This study reports on an adaptation of the Measure of Support in Conversation (MSC) and Measure of Participation in Conversation (MPC) scales for use with people with dementia and their conversation partners (the MSC Dementia and MPC Dementia, respectively) and investigates the inter-and intra-rater reliability of these adapted measures. METHOD The MSC-D and MPC-D scales were adapted from the original MSC and MPC scales to reflect current knowledge of communication and interaction involving people with dementia. Audio recordings of a total of 25 casual conversations, lasting 5-10 min, between a person with dementia and familiar aged care staff were independently rated by two raters to investigate inter-rater reliability and by one rater on two separate occasions to investigate intra-rater reliability. RESULTS ICC analyses on the MSC-D indicated good inter-rater reliability (ICC = 0.718-0.812) and intra-rater reliability (ICC = 0.628-0.760). The MPC-D had excellent inter-rater reliability (ICC = 0.904-0.945) and intra-rater reliability (ICC = 0.925-0.957). 93.6% of all ratings were within 0.5 of each other on a nine point scale from 0 to 4. CONCLUSION The results provide preliminary support for the use of these adapted scales. Further research is required to investigate the validity and reliability of these scales using video recordings and across a wider range of communication genres.
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Affiliation(s)
- Zaneta Mok
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Gillian Steel
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Cailey Russell
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Erin Conway
- School of Allied Health, Australian Catholic University, Brisbane, Australia
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50
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Pellas J, Damberg M. Accuracy in detecting major depressive episodes in older adults using the Swedish versions of the GDS-15 and PHQ-9. Ups J Med Sci 2021; 126:7848. [PMID: 34754407 PMCID: PMC8559588 DOI: 10.48101/ujms.v126.7848] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/18/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the diagnostic accuracy at different cut-off values for the Swedish versions of the 15-item Geriatric Depression Scale (GDS-15) and Patient Health Questionnaire (PHQ-9) compared with a structured clinical psychiatric interview in older adults. METHODS Community-dwelling participants (N = 113) aged 65 years or older completed the Swedish versions of the GDS-15 and PHQ-9 and were then interviewed using the Mini International Neuropsychiatric Interview (MINI) to establish the presence or absence of current major depressive episodes (MDEs). Areas under the curve (AUC) were calculated for each scale, as well as the sensitivity, specificity, and Youden's index for different cut-off values. RESULTS Seventeen participants met the criteria for MDEs. The AUC was 0.97 for the GDS-15 and 0.95 for the PHQ-9. A cut-off of ≥6 on the GDS-15 yielded a sensitivity of 94%, a specificity of 88%, and a Youden's index of 0.82. A cut-off of ≥5 on the PHQ-9 yielded a sensitivity of 100%, a specificity of 81%, and a Youden's index of 0.81. The proposed cut-off of ≥10 on the PHQ-9 produced excellent specificity of 95% but a lower sensitivity of 71%. CONCLUSIONS This study indicates that the Swedish versions of the GDS-15 and PHQ-9 have comparable accuracy as screening instruments for older adults with MDEs. However, the proposed cut-off of 10 on the PHQ-9 might be too high when applied to older individuals in Sweden, and further investigations in larger samples in different healthcare settings are warranted.
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Affiliation(s)
- Johnny Pellas
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- CONTACT Johnny Pellas
| | - Mattias Damberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
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