Dissertations / Theses on the topic 'Psychiatric rating scales Australia'

The prevalence of psychiatric symptoms in next-of-kin (NOK) of intensive care unit (ICU) patients has been reported at higher than 70% when screening is performed using the Hospital Anxiety and Depression Scale (HADS). The primary purpose of this study was to assess the ability of the HADS to predict psychiatric illness, diagnosed with the aide of a validated tool, the Structured Clinical Interview for DSM-IV (SCID). In addition, we asked NOK to rate aspects of the ICU experience to determine possible associations with psychiatric diagnosis. Thirty-four NOK were enrolled in this study from July 2006 to November 2006. Subjects were interviewed to gather demographic information, their perception of the ICU experience, and to administer the SCID and the HADS. At least 6 months later, subjects were contacted by telephone to determine presence of psychiatric morbidity after the ICU experience. Fifty-six percent of all NOK experienced symptoms of either anxiety or depression during the ICU admission and 24% had psychiatric illness. The HADS had 100% sensitivity and 58% specificity when used as a screening tool for psychiatric diagnosis. Those with any SCID diagnosis were more likely to be a spouse (50% vs. 9%, p = 0.013) or a primary caregiver (60% vs. 8%, p = 0.003). Most NOK identified the healthcare team as supportive, though a subgroup of NOK who slept in the ICU reported that they found the healthcare team less supportive. This small study suggests the HADS is able to predict psychiatric illness in NOK of ICU patients. The ability to implement this tool as part of clinical practice to better meet the needs of families in the ICU warrants further investigation.

Thesis (M.S.)--West Virginia University, 2007.
Title from document title page. Document formatted into pages; contains vii, 29 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 25-26).

Thesis (Ph. D.)--University of Missouri-Columbia, 2008.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 4, 2009) Vita. Includes bibliographical references.

This study explores the relationship between living arrangement and psychological wellbeing in retired elderly individuals living in Yancheng, Jiangsu (PR China). Data on mode of residence, socio-economic background, daily activities, and intergenerational dynamics were collected from 200 subjects, and their potential correlations with depression (assessed via the Geriatric Depression Scale Short Version) were analyzed. Univariate as well as logistic regression confirmed mode of residence as a significant predictor of depression in this group. The following depression odds ratios associated with each mode of residence were derived via logistic regression: 1) nuclear household, i.e. living with a spouse only ¨C 1 [reference category], 2) multigenerational households in which a spouse is not present ¨C 4.341, 3) multigenerational households in which a spouse is present ¨C 0.781, and 4) living alone ¨C 3.018. Based on these ratios, we conclude that the traditional model of intergenerational coresidence is not, in itself, associated with less depression. Rather, it is the presence of a sharing spousal in a household (whether single or multigenerational) that protects against elderly depression. Other predictors of depression identified in backward logistic regression included presence of a chronic illness and self assessed wealth status. Additionally, a number of psychosocial variables were identified as independently correlated with depression, but were subsequently selected out by multivariate analysis. These included: educational background, religious affiliation, membership in an organization, attitude toward aging, and family status. Based on this study, we believe that efforts to promote mental wellbeing among today¡¯s Chinese elders should be directed toward psychosocial factors that are modifiable (education, building supportive social networks etc.) rather than insisting on the traditional ideal of multigenerational living and dependence on filial piety.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2006.
Title from first page of PDF file (viewed June 26, 2006). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 75-89).

Thesis (Ph. D.)--University of Missouri-Columbia, 2007.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on February 29, 2008) Vita. Includes bibliographical references.

BACKGROUND: Of the 22 known measures of nicotine dependence (ND), none capture the overall disease severity of physical dependence alone. Instead, they capture constructs related to dependence, such as perceived risk, psychological addiction, smoker motivations, or smoking related behaviors, but none of the measures include only physical withdrawal symptoms to capture physical dependence on nicotine. AIM: To develop a range of nicotine dependence measures that capture physical dependence on nicotine. METHODS: The final measures were developed in a cross-sectional study conducted in three phases: 1) candidate item development through literature review and cognitive interviews, 2) developing and pre-testing the survey, and 3) survey administration and psychometric evaluation to validate three distinct measures. The final survey was conducted at four health clinics and three high schools. Psychometric tests used to select the final measure items included inter-item correlations, sensitivity analyses done by subgroup, item-total correlations, convergent validity tests, and confirmatory factor analysis. The final measures were evaluated using confirmatory factor analysis (CFA), internal reliability, total score distributions, and convergent validity correlations. Relative validity analyses were also conducted using a ratio of F-Statistics to compare the ability of each new measure to differentiate dependent smokers as compared previous measures. RESULTS: The final sample included 275 smokers ranging from 14 to 76 years old (mean=30.9, SD=16.2), who smoked an average of 11.5 cigarettes per day (range=0-50, SD=9.4). The sample was 86.5% white and 57.5% male. The three new measures developed included: 1) the 4-item Withdrawal-Induced Craving Scale (WICS) used to capture severity of craving, the most common physical withdrawal symptom; 2) the 12- item Nicotine Withdrawal Symptom Checklist (NWSC), which measures both overall disease severity and the severity of a comprehensive list of individual physical withdrawal symptoms including withdrawal-induced craving, anger, anxiety, depression, headache, insomnia, loss of focus, restlessness, and stress; and 3) the 6-item brief NWSC (NWSC-b), a short measure which only captures overall disease severity. All of the new measures exhibited a unidimensional factor structure loading highly on a single factor (thought to be physical dependence). They also correlated highly (over 0.6) and significantly (p<0.001) to a battery of convergent validity indices including four widely used nicotine dependence measures: Hooked on Nicotine Checklist (HONC), the Autonomy Over Tobacco Scale (AUTOS), the Fagerström Test for Nicotine Dependence (FTND), and self-rated addiction. CONCLUSION: The WICS, NWSC, and NWSC-b provide three distinct validated tools that can be used by researchers, clinicians, and educators to track the progression of physical dependence on nicotine across a range of smoking behaviors and histories.

INTRODUÇÃO: Correlações significativas entre asma e ansiedade e entre ansiedade e distúrbios do equilíbrio têm sido consistentemente descritas. Estas observações sugerem que as anormalidades de equilíbrio também podem estar presentes em pacientes asmáticos, embora ainda não existam estudos envolvendo asma, ansiedade e desequilíbrio postural. Esta questão é clinicamente importante porque déficits posturais não tratados potencialmente podem piorar o prognóstico da asma, desencadeando a ansiedade e, conseqüentemente, sintomas respiratórios. Este estudo exploratório tem como objetivo avaliar a eficiência do controle postural em pacientes com asma e sua possível correlação com sintomas de ansiedade. MÉTODOS: 41 indivíduos com asma controlada persistente e 41 controles, pareados por idade e sexo, foram comparados. Sintomas de ansiedade foram avaliados pelo Inventário de Estado-Traço de Ansiedade de Spielberger (IDATE). O controle do equilíbrio foi avaliado pela posturografia dinâmica, que avalia o deslocamento do centro de pressão (CoP) do corpo sobre uma plataforma de pressão, gerando escores de equilíbrio e suas variáveis cinéticas, como área e velocidade de deslocamento do CoP em sentidos látero-lateral e ântero-posterior. RESULTADOS: O grupo asma apresentou escores significativamente maiores no IDATE-Estado (46,8 ± 11,38 vs 38,2 ± 13,16; t = 2,89, p = 0,005) e no IDATE-Traço (50,1 ± 13,60 versus 37,9 ± 12,67; t = 4,22, p <0,001). Na posturografia dinâmica, o teste t de Student evidenciou pior desempenho dos asmáticos nos escores de equilíbrio e na área de deslocamento do CoP, porém o teste de correlação de Pearson não evidenciou associação entre maiores escores de ansiedade com menores escores de equilíbrio (r < 0,3 em todas as condições avaliadas). CONCLUSÃO: As anormalidades de equilíbrio parecem frequentes em pacientes com asma, porém de forma independente da presença de sintomas de ansiedade. No entanto, a presença de disfunção vestibular, ainda que subclínica, pode ter um grande impacto no prognóstico desses pacientes. Estes achados sugerem que queixas relacionadas com o desequilíbrio devem ser investigadas em asmáticos, principalmente naqueles que representem níveis mais elevados de ansiedade
INTRODUCTION: Significant correlations between asthma and anxiety and between anxiety and balance disorders have been consistently described. These observations suggest that equilibrium abnormalities can also be present in asthmatic patients. This issue is clinically important because untreated postural deficits can potentially worse the prognosis of asthma by triggering anxiety and, consequently, respiratory symptoms. This exploratory study aims to evaluate the efficiency of postural control in asthma patients and its possible correlation with anxiety symptoms. METHODS: 41 subjects with persistent controlled asthma and 41 controls, matched for age and sex, were compared. Anxiety symptoms were evaluated by the Spielbergers Inventory of State-Trait Anxiety (STAI). The balance control was assessed by dynamic posturography, which assesses the displacement of center of pressure (CoP) of the body on a platform of pressure, generating scores of balance and their kinetic variables such as area and speed of displacement of the CoP in lateral and anteroposterior directions. RESULTS: The asthma group had significantly higher scores in STAIState (46.8 ± 11,38 versus 38.2 ± 13,16; t = 2,89; p=0,005) and in STAI-Trait (50.1 ± 13,60 versus 37.9 ± 12,67; t = 4,22; p<0,001). In dynamic posturography, the Student t test showed worst performance of asthmatics in balance scores and in the area of the CoP displacement, but the Pearson correlation test showed no association between higher anxiety scores with lower balance scores (r <0.3 in all conditions evaluated). CONCLUSION: Balance abnormalities seems frequent in asthma patients independently from the presence of anxiety symptoms. However, the presence of vestibular dysfunction, working via anxiety provocation, may have a major impact in the prognosis of these patients. These findings suggest that disequilibrium related complaints must be investigated in asthmatic patients mainly in those presenting higher levels of anxiety

Thesis (M.A.)--University of Toledo, 2007.
Typescript. "Submitted as partial fulfillment of the requirements for The Master of Arts Degree in Psychology." "A thesis entitled"--at head of title. Bibliography: leaves 57-82.

Background: Major depression is one of the most prevalent, disabling, and costly illnesses worldwide. Despite a 400% increase in antidepressant medication use since 1988, fewer than half of treated depression patients experience a clinically meaningful reduction in symptoms and uncertainty exists regarding how to successfully obtain symptom remission. Identifying homogenous subgroups based on clinically observable characteristics could improve the ability to efficiently predict who will benefit from which treatments. Methods: Latent class analysis and latent transition analysis (LTA) were applied to data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study to explore how to efficiently identify subgroups comprised of the multiple dimensions of depression and examine changes in subgroup membership during treatment. The specific aims of this dissertation were to: 1) evaluate latent depression subgroups for men and women prior to antidepressant treatment; 2) examine transitions in these subgroups over 12 weeks of citalopram treatment; and 3) examine differences in functional impairment between women’s depression subgroups throughout treatment. Results: Four subgroups of depression were identified for men and women throughout this work. Men’s subgroups were distinguished by depression severity and psychomotor agitation and retardation. Severity, appetite changes, insomnia, and psychomotor disturbances characterized women’s subgroups. Psychiatric comorbidities, especially anxiety disorders, were related to increased odds of membership in baseline moderate and severe depression subgroups for men and women. After 12 weeks of citalopram treatment, depression severity and psychomotor agitation were related to men’s chances of improving. Severity and appetite changes were related to women’s likelihood of improving during treatment. When functional impairment was incorporated in LTA models for women, baseline functional impairment levels were related to both depression subgroups at baseline and chances of moving to a different depression subgroup after treatment. Conclusion: Depression severity, psychomotor disturbances, appetite changes, and insomnia distinguished depression subgroups in STAR*D. Gender, functional impairment, comorbid psychiatric disorders, and likelihood of transitioning to subgroups characterized by symptom improvement differed between these subgroups. The results of this work highlight how relying solely on summary symptom rating scale scores during treatment obscures changes in depression that might be informative for improving treatment response.

Introdução: luto complicado é caracterizado pela procura persistente pelo falecido, tristeza e dor emocional intensos em resposta à morte de ente querido. Luto complicado é frequentemente pouco reconhecido e subtratado. O Texas Inventory Revised of Grief (TRIG) é um instrumento de alta confiabilidade e validade na medida de avaliação do luto. Nosso objetivo foi traduzir, adaptar e validar o TRIG para Português do Brasil e verificar se o mesmo, em uma população enlutada, é capaz de distinguir entre os que têm e os que não tem luto complicado assim como identificar quais elementos da escala contribuem para isso. Métodos: o trabalho foi realizado em duas etapas: a) tradução e adaptação transcultural do TRIG para o português do Brasil e b) estudo em corte transversal para análise da confiabilidade e validação desse instrumento. Participantes: 165 pacientes adultos foram recrutados de: a) Ambulatório de Luto do Departamento e Instituto de Psiquiatria - Universidade de São Paulo, b) Ambulatório de convênio e Particulares no mesmo departamento e, c) Colegas de trabalho que perderam um ente querido. Todos os pacientes foram entrevistados com o TRIG e de acordo com critérios clínicos, 69 dos 165 pacientes enlutados foram diagnosticados com luto complicado. Resultados: quanto à tradução e adaptação transcultural, o TRIG foi traduzido para o português, feito a retrotradução para o inglês e adaptado à cultura local. Esse processo foi realizado por dois psiquiatras bilíngues. A confiabilidade e consistência interna do instrumento foram medidos pelo coeficiente de Alpha de Cronbach que alcançou 0,735 para parte I e 0,896 para a parte II do instrumento. A sensibilidade, especificidade e ponto de corte para identificar enlutados com e sem luto complicado foram medidos pela Curva ROC. Viu-se que usando o ponto de corte encontrado de 104 (escore total das partes I, II, III + variáveis psicográficas), é possível classificar corretamente 71,3% dos indivíduos com e sem luto complicado. A validação do instrumento foi realizada pela análise fatorial exploratória e confirmatória. Pela regressão logística demonstrou-se que nível educacional, idade do falecido, idade do enlutado, perda de filho(a) e morte do tipo inesperada são fatores de risco para luto complicado. Nossos resultados também sugerem que religião pode influenciar luto complicado. Conclusões: a versão traduzida e adaptada do TRIG para o português é confiável e válida como medida do luto tanto quanto a versão original. O TRIG foi capaz de distinguir pacientes com e sem luto complicado. Nós sugerimos o uso do TRIG com ponto de corte igual a 104 para identificar enlutados com luto complicado
Background: Complicated grief is characterized by persistent yearning for the deceased, intense sorrow and emotional pain in response to death causing significant distress. Complicated grief is often underrecognized and under treated. The Texas Revised Inventory of Grief (TRIG) is a questionnaire that has been demonstrated to have high validity and reliability in the assessment of complicated grief. Our objective was to translate, adapt, and validate the TRIG to Brazilian Portuguese and to verify whether the TRIG, in a bereaved population, is able to distinguish between those with and those without complicated grief and to identify which elements in the scale contribute to this. Methods: Two stages: a) cross-culture adaptation of a questionnaire, and b) crosssectional study of reliability and validity. Setting and Participants: 165 adult patients were recruited from a) the Grief Outpatient Clinic at the Department and Institute of Psychiatry - University of São Paulo, b) private practice at the same department, and c) co-workers who have lost a loved one. All the patients were interviewed with the TRIG. According to clinical criteria 69 of 165 bereaved patients were presenting complicated grief. Results: Cross-culture adaptation: the TRIG was translated from American English, then back-translated and finally compared with the Brazilian Portuguese version by two bilingual psychiatrists. Reliability: the Cronbach\'s alpha coefficients (internal consistency) of the TRIG scales were 0,735 (part I) and 0,896 (part II). Sensitivity, specificity as well as cutoff points to identify complicated and non-complicated grief, were measured using the ROC curve Using the total score of 104 (part I + part II + Part III + psychographics variables), we can correctly classify 71.3% of individuals with and without complicated grief. The construct validity was assessed by exploratory factor analysis and confirmatory analysis. Furthermore, by logistic regression, our study demonstrated that a low education level, age of the deceased and age of the bereaved, loss of a son or daughter, and unexpected death were all risk factors for complicated grief. Our results also suggest that religion may influence complicated grief. Conclusions: The TRIG adapted to Brazilian Portuguese is as reliable and valid as the original version. In the evaluation of Brazilian bereaved, it was able to distinguish individuals with and without complicated grief. And, we suggest a cut-off value of 104 for complicated grief

O número de mulheres com problemas relacionados ao jogo vem experimentando grande crescimento nos últimos anos, a exemplo do que ocorre na dependência de álcool e de outras drogas Esse aumento, de acordo com estudos anteriores, pode ser creditado a variados fatores: a universalização de jogos mais acessíveis para as mulheres (que geram menor preconceito social), como o bingo eletrônico; o fato de mulheres utilizarem o jogo como válvula de escape para as tensões cotidianas e para eventuais crises depressivas; uma progressão média mais rápida (telescoping effect - T.E.) do jogar social ao jogar patológico para mulheres do que para homens. Embora identificado em vários estudos, o T.E. existente em mulheres não foi devidamente analisado em suas possíveis origens. Com vistas a elucidar essa questão, esta tese busca possíveis diferenças entre os gêneros que expliquem o T.E. e que possam ser relevantes para o manejo e tratamento do JP. Comparamos 78 mulheres e 78 homens jogadores patológicos quanto a características sócio-demográficas e clínicas, existência de comorbidades psiquiátricas, preferência por tipo de jogo, personalidade, e perfil de comportamentos de risco. Os instrumentos utilizados no estudo foram: para diagnóstico, a SOGS (South Oaks Gambling Screen) e os critérios diagnósticos do DSM-IV para Jogo Patológico (JP); para investigação de comorbidade, o SCAN (Schedules for Clinical Assessment in Neuropsychiatry); para estudo de personalidade, o Inventário de Temperamento e Caráter e a Barratt Impulsiveness Scale. Constata-se que há uma maior proporção de solteiros entre as jogadoras do que entre os jogadores, e que jogadoras começam a jogar e têm problemas com jogo com mais idade do que os jogadores. Uma maior proporção de jogadoras do que jogadores preferem jogos eletrônicos e mais jogadoras do que jogadores jogam por escapismo. Mais jogadores têm diagnóstico de abuso/dependência de álcool, ao passo que mais jogadoras têm diagnóstico de depressão. Para um curso acelerado de JP contribuem significativamente, além do gênero, o fato se iniciar com mais idade na atividade de jogar e a preferência por jogos eletrônicos características que, como já se mencionou, estão mais associadas a jogadoras que a jogadores. As diferenças clínicas observadas entre os gêneros levam à necessária conclusão de que essa variável tem que ser considerada para a elaboração de estratégias de prevenção e tratamento de JP, pois são justamente as jogadoras (que apresentam uma progressão mais rápida para dependência, com menor intervalo para uma possível ação preventiva), o grupo que mais resiste a procurar ajuda junto a profissionais de saúde ou a grupos de Jogadores Anônimos (J.A.).
Over the last years, more women are having gambling problems, similar to what has happened in alcohol and drug addiction. This phenomenon, according to previous studies, can be related to different variables: the growth of new gambling venues with increased access for women, such as electronic bingo venues, the fact that women gamble to escape from problems and to minimize depression, and a faster progression (telescoping effect- T.E.) of social gambling to pathological gambling (PG) in women. Even though the T.E. has been identified in different studies, little has been done to investigate its causes. As an effort to clarify this matter, this thesis investigates possible gender differences that might explain T.E. and that might be important for prevention and treatment strategies of PG. We compare 78 male and 78 female gamblers regarding: sociodemographic characteristics, clinical features, psychiatric comorbidities, personality and game preferences; and risk-taking behaviors. Pathological gamblers were assessed for diagnosis through the SOGS (South Oaks Gambling Screen) and the DSM-IV criteria for PG; the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) was used to investigate psychiatric comorbidity; and the TCI (Temperament and Character Inventory), and the BIS (Barratt Impulsiveness Scale version 11) were used to investigate personality features. More females are single; females start gambling and have gambling problems later in life than males. More females prefer electronic games and gamble to escape from problems. Males have more diagnosis of alcohol abuse/dependence, while females have more diagnosis of depression. Besides gender, starting to gamble later in life and preference for electronic games both features associated to female gamblers, are responsible for T.E. in PG. The clinical differences observed between genders lead to the conclusion that this variable should be considered in prevention and treatment strategies for PG. It must be remembered that female gamblers, who effectively have a faster progression to PG - which reduces the window for prevention - , are the ones who resist to seek professional treatment for PG or Gamblers Anonymous (G.A.) groups.

OBJECTIVES: Pain and its disruptive impact on daily life are common reasons that patients seek primary medical care. Pain contributes strongly to psychopathology, and pain and depressive symptoms are often comorbid in primary care patients. Not all those who experience pain develop depression, suggesting that the presence of individual-level characteristics, such as positive and negative affect, that may ameliorate or exacerbate this association. METHODS: We assessed the potential moderating role of positive and negative affect on the pain-depression linkage. In a sample of 101 rural, primary care patients, we administered the Brief Pain Inventory, NEO Personality Inventory-Revised positive and negative affect subclusters, and the Center for Epidemiology Scale for Depression. RESULTS: In moderation models, covarying age, sex, and ethnicity, we found that positive affect, but not negative affect, was a significant moderator of the relation between pain intensity and severity and depressive symptoms. DISCUSSION: The association between pain and depressive symptoms is attenuated when greater levels of positive affects are present. Therapeutic bolstering of positive affect in primary care patients experiencing pain may reduce the risk for depressive symptoms.

Antecedentes: Segundo as projeções da Organização Mundial de Saúde para o século XXI, as doenças não comunicáveis (DNT) serão responsáveis pelas maiores cargas das doenças no globo. As doenças cardiovasculares e os transtornos neuropsiquiátricos destacam-se como os dois principais grupos de agravos de saúde entre as DNT. O sobrepeso e a obesidade são considerados precursores e fatores agravantes de doenças cardiovasculares, cuja prevalência tem crescido ao redor do mundo, demandando esforços públicos para deter o seu crescimento e minimizar os seus efeitos deletérios. Os transtornos mentais, por sua vez, representam quase um terço das cargas da incapacitação resultante entre todas as DNT. O objetivo do presente trabalho é estimar a frequência de transtornos mentais numa amostra de indivíduos obesos que procuraram um hospital universitário com o intuito de se submeter à cirurgia bariátrica para controlar ou reduzir o excesso do peso corporal. Objetivo: Estimar, por meio de entrevista padronizada, a frequência de transtornos mentais e fatores correlacionados entre os pacientes obesos que procuram a cirurgia bariátrica. Métodos: Participaram do estudo 393 pacientes obesos grau III, candidatos à cirurgia bariátrica. Foram recrutados a partir de um centro universitário de cirurgia bariátrica. Clínicos treinados avaliaram os participantes por meio da Entrevista Clínica Estruturada para o DSM-IV Axis I Diagnóstico (SCID-I/P) e as seguintes escalas de avaliação: HCL (Manic Symptoms Checklist), MDQ (Mood Disorders Questionnarie), MADRS (Montgomery-Åsberg Depression Rating Scale), M-A QoLII (Moorehead-Ardelt Quality of Life Questionnaire II). A amostra foi composta por 79,1% de mulheres; média de idade 43 anos e média de IMC: 47,8 kg/m². Resultados: A frequência de alguns transtornos mentais ao longo da vida foi 80,9% (81,7% homens e 80,7% mulheres). A taxa de frequência de transtornos mentais no momento da entrevista foi 57,8% (57,6% homens e 58,5% mulheres). Os transtornos afetivos foram os mais frequentes (64,9%), sendo os transtornos bipolares e os transtornos depressivos os mais comuns (35,6% e 29,3%). Entre os entrevistados que apresentaram quaisquer transtornos mentais ao longo da vida, cerca de metade da amostra apresentou três ou mais transtornos simultâneos. Os transtornos de ansiedade foram os diagnósticos mais frequentes (46,3%) entre os participantes com transtorno atual. Idade e nível educacional foram associados com a probabilidade de apresentar transtornos mentais no momento da entrevista. As escalas apresentaram boa consistência interna: sendo o alfa de Cronbach da HCL-32 de 0,9, MDQ 0,8, MADRS 0,9 e M-A QoLII 0,7. A HCL-32 e o MDQ demonstraram uma boa capacidade discriminativa para classificar corretamente os casos de transtorno bipolar. A HCL-32 apresentou área sob a curva (AUC) de 0,7 (IC 95% 0,7-0,8), quando comparado com os diagnósticos da SCID-I/P, com sensibilidade de 0,7 e especificidade 0,7. O melhor ponto de corte foi 16/17 para detectar transtorno bipolar II. Em relação à estrutura fatorial do HCL-32, a variabilidade dos dados foi melhor explicada por dois fatores relevantes: elação do humor e irritação/ativação. O MDQ apresentou sensibilidade de 0,8 e especificidade 0,6. O melhor ponto de corte foi 4/5 para detectar transtorno bipolar I, com AUC de 0,8 (IC 95% 0,7-0,9). A MADRS de 5 itens apresentou sensibilidade de 0,8 e especificidade 0,9. O melhor ponto de corte foi 10/11 para detectar sintomas depressivos e AUC de 0,9. De acordo com o M-A QoL II, cerca de 50% da amostra relatou estar satisfeita com sua qualidade de vida. Há uma correlação significativa entre as escalas utilizadas que variaram de 0,6 a -0,6. Conclusões: Os transtornos mentais são condições frequentes entre os pacientes obesos antes da cirurgia bariátrica. As altas taxas de transtornos mentais sugerem que ambas as condições podem apresentar relações causais de mutualidade ou compartilham fatores etiológicos comuns. Este estudo contribuiu para compreender a relação entre transtornos mentais e obesidade mórbida. Recomenda-se conduzir avaliação sistemática de pacientes obesos com instrumentos psicométricos padronizados no período pré-cirúrgico para detectar transtornos psiquiátricos, que podem interferir na recuperação e estabilização da qualidade de vida dos pacientes no período pósoperatório. Futuros estudos de seguimento serão necessários para verificar os possíveis fatores preditivos de prognóstico nesta população
Background: According to the World Health Organization\'s projections for the 21st. century, non-communicable diseases (NCD) will account for the largest burden of diseases in the world. Cardiovascular diseases and neuropsychiatric disorders stand out as the two main groups of health problems among the NCD. Overweight and obesity are considered precursors and aggravating factors of cardiovascular disease, whose prevalence has grown around the world, claiming for public efforts to stop its growth and minimize its harmful effects. Mental disorders, in turn, account for nearly one-third of the burden of disability resulting from all NCD. The aim of the present investigation is to estimate the frequency of mental disorders in a sample of obese individuals who sought a university hospital in order to undergo bariatric surgery to control or reduce the excess of body weight. Objective: To estimate, through a standardized interview, the frequency of mental disorders and correlated factors among obese patients seeking bariatric surgery. Methods: The sample was composed of 393 treatment-seeking obese patients (79.1% women; mean age 43.0 years, mean BMI: 47.8 kg/m2), who were recruited from a university-based bariatric center. Trained clinicians assessed the participants through the Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID-I/P). HCL (Manic Symptoms Cheklist), MDQ (Mood Disorders Questionnarie), MADRS (Montgomery-Åsberg Depression Rating Scale), M-A QoLII (Moorehead-Ardelt Quality of Life Questionnaire II). Results: The lifetime rate of any mental disorders was 80.9% (81.7% men vs. 80.7% women). Lifetime affective disorders were the most frequent diagnosis (total 64.9%, bipolar disorders 35.6%, and depressive disorders 29.3%). Among those respondents presenting any lifetime mental disorders, about half of the sample presented 3 or more concurrent disorders. The rate of current frequency of any mental disorders was 57.8% (57.6% men vs. 58.5% women). Anxiety disorders were the most frequent diagnosis (46.3%) among those participants with a current disorder. Age and educational level were associated with the likelihood of presenting current mental disorders. The scales showed good internal consistency: the HCL - 32, Cronbach\'s alpha 0.9; MDQ 0.8, MADRS 0.9 and M-A QoL II 0.7. The HCL -32 and MDQ demonstrated good capacity discriminant to correctly classify cases of bipolar disorder. HCL -32 the area under the curve (AUC) was 0.7 (95 % CI 0.7-0.80, when compared to the diagnosis of SCID-I/P, with a sensitivity of 0.7 and specificity 0.7 . The best cutoff point was 16/17 to detect bipolar disorder II. In the factorial structure of the HCL -32, data variability was best explained by two important factors: elation of mood and irritation / activation. MDQ sensitivity was 0.80 and specificity 0.60. The best cutoff value of 4/ 5 for detecting bipolar disorder I, with AUC of 0.8 (95 % CI 0.7 to 0.9).The MADRS of 5 items had a sensitivity of 0.8 and specificity 0.9. The best cutoff point was 10/11 to detect depressive symptoms and AUC of 0.9. According to the MA QoL II, about 50% of the sample reported being satisfied with their quality of life. There is a significant correlation among the scales used, ranging from 0.6 to -0.6. Conclusions: Mental disorders are frequent conditions among obese patients before bariatric surgery. High rates of mental disorders suggest that both disorders might exert mutual causal relationships or share common etiological factors. This study may help to understand the relationship between mental disorders and obesity. Systematic evaluation of obese patients with standardized psychometric instruments in the pre-surgery period may clarify the existence of psychiatric disorders before the bariatric surgery. Often, some psychiatric disorders are detected only after the surgery, interfering with the recovery and stabilization of quality of life of patients in the post-operative period. Future follow-up studies are needed to verify the possible predictors of prognosis in this population

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.
This research was supported by an award from the National Institutes of Health (NIH), the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Especializado Materno Perinatal, Peru for their expert technical assistance with this research. The authors would like to thank Kathy Brenner for her help with revising this manuscript.
Revisión por pares

Thesis (Ph.D.)--Indiana University, 2009.
Title from screen (viewed on August 27, 2009). School of Social Work, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Cathy Pike, Hea-Won Kim, Margaret Adamek, Drew Appleby. Includes vita. Includes bibliographical references (leaves 317-330).

Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indivíduos acometidos por AVC, foi realizada tradução para o Português do Brasil e adaptação transcultural da versão original da TICS-M em uma amostra de 30 sujeitos não clínicos. Após esta fase, um subgrupo de 61 pacientes com AVC, participantes do Estudo da Mortalidade e Morbidade do AVC (EMMA) que ocorre no Hospital Universitário da Universidade de São Paulo, foram convidados a participar da validação da TICS-M, seis meses após o evento agudo. A TICS-M foi aplicada em três momentos: avaliação inicial (entrevista presencial), uma e duas semanas após a primeira avaliação. Na avaliação inicial, além da TICS-M, questionários adicionais foram aplicados para avaliar a cognição: MoCA (Montreal Cognitive Assessment), MEEM (Mini Exame do Estado Mental); e para a depressão, HDRS (Hamilton Depression Rating Scale). Todos os questionários foram aplicados por duas entrevistadoras treinadas para o estudo. A confiabilidade intra-observador da TICS-M foi testada através dos coeficientes de Pearson, Intraclasse e alfa de Cronbach. As características internas do TICS-M também foram avaliadas através de uma análise exploratória utilizando o método Análise de Componentes Principais. A validade discriminatória do instrumento para rastreamento de demência pós-AVC foi avaliada em comparação a MEEM pela análise da área sob a curva (AUC) determinada pela curva ROC. Foram calculadas sensibilidade e especificidade para o ponto de corte ideal para rastrear demência. Resultados: De maneira geral, a TICS-M traduzida para o português apresentou um bom entendimento dos itens na mostra de indivíduos não clínicos. Foi observada uma frequência de 23% sugestiva de demência pós-AVC. O nível de escolaridade esteve positivamente associado ao estado demencial rastreado pelo MEEM. O estado depressivo assim como outras características de base não se associou à demência sugerida pelo MEEM. A confiabilidade teste-reteste intra-observador revelou taxas quase totais nos três momentos avaliados (Pearson Coeficiente > 0,85, Coeficientes de Correlação Intraclasse > 0,85 e Coeficiente alfa de Cronbach: 0,96). A análise fatorial determinou três domínios: memória de trabalho e atenção; memória recente e de evocação e orientação. A área sob a curva (AUC) determinada para a TICS-M em comparação com MEEM foi de 0,89 (intervalo de confiança 95%: 0,80-0,98). O ponto de corte sugerido para TICS-M foi de 14 pontos (escala de 0-39 pontos) para rastrear demência com sensibilidade de 91,5% e especificidade de 71,4%. Resultados semelhantes foram observadas com o MoCA. Conclusão: A versão brasileira da TICS-M sugere ser um instrumento de pesquisa útil e confiável para rastrear demência em pacientes pós-AVC
Introduction: Stroke is one most important cause of neuropsychological disorders. An initial cognitive assessment performed by telephone resulting in an early diagnosis of cognitive impairment and dementia, reducing costs and time. Objective: To examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status Assessment (TICS-M) for assessment of dementia in post-stroke patients. Methods: Prior to validation of TICS-M in post-stroke patients, translation was performed for the Brazilian-Portuguese and cross-cultural adaptation of the original version of TICS-M in a non-clinical sample of 30 subjects. After this phase, 61 stroke patients enrolled in the Stroke Mortality and Morbidity Study (The EMMA study) that occurs at the University Hospital of the University of São Paulo, were invited to participate in this sub-study to validate the TICS-M six months after the acute event. The TICS-M was applied in three moments: first evaluation (personal interview), one and two weeks after of the first evaluation. At the first evaluation, beyond the TICS-M, additional questionnaires were applied to assess cognition: MoCA (Montreal Cognitive Assessment), MMSE (Mini-Mental Status Examination), and for depression, HDRS (Hamilton Depression Rating Scale). All questionnaires were administered by two trained interviewers for the study. Reliability of the TICS-M was tested by intra-observer rates using Pearson, Intraclass and Cronbach´s alpha coefficients. The internal characteristics of TICS-M were also evaluated by an exploratory analysis using Principal Component Analysis. The discrimination validity of the instrument to assess dementia was evaluated by comparison to the MMSE analysis of the area under the curve (AUC) determined by the ROC curve. Sensitivity and specificity for the ideal cutoff to assess dementia were calculated. Results: In general, the TICS-M translated into Portuguese version showed a good understanding of the items in non-clinical individuals. A frequency of 23% suggestive of post-stroke dementia was observed. The level of education was positively associated with dementia status assessed by MMSE. The depressive status, as well as, other baseline characteristics was not associated with dementia suggested by MMSE. Test-retest reliability intra-observer revealed almost total rates in the three evaluation moments (Pearson coefficient > 0.85, Intraclass Correlation Coefficient > 0.85 and Cronbach\'s alpha coefficient: 0.96). The factorial analysis determined three domains: working memory and attention, recent and recall memory and orientation. The area under the curve (AUC) determined by TICS-M compared to MMSE was 0.89 (95% confidence interval: 0.80-0.98). The cutoff suggested for TICS-M was equal or greater than 14 points (range 0-39 points) to assess dementia (91.5% sensitivity, 71.4 % specificity). Similar results were observed with the MoCA. Conclusion: The Brazilian version of TICSM suggests being a useful and reliable research instrument to evaluate dementia in poststroke patients in epidemiological studies

Au Wing-cheong.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2003.
Includes bibliographical references (leaves 73-91).
Abstracts in English and Chinese.
LIST OF ABBREVIATIONS --- p.i
ACKNOWLEDGEMENT --- p.ii
ABSTRACT --- p.iii
LIST OF TABLES --- p.vii
LIST OF FIGURES --- p.viii
LIST OF APPENDICES --- p.ix
Chapter CHAPTER I. --- INTRODUCTION --- p.1
Chapter CHAPTER II. --- REVIEW OF THE LITERATURE --- p.3
The construct of community living skills --- p.3
Assessment tools for community living skills --- p.6
The St. Louis Inventory of Community Living Skills --- p.9
Prediction of community level-of-care --- p.12
Training community living skills in Hong Kong --- p.15
Chapter CHAPTER III. --- RATIONALE FOR THE STUDY --- p.17
de-institutionalization movement and community living skills training --- p.17
Lack of structured community living skills assessment toolsin Hong Kong --- p.20
The choice of the SLICLS for cross-cultural validation --- p.21
Chapter CHAPTER IV. --- GENERAL METHODOLOGICAL CONSIDERATIONS --- p.23
An introduction to the test construction procedures --- p.23
An outline of the cross-cultural validation process --- p.24
Issues concerning reliability of rating scales --- p.26
Issues concerning validity of rating scales --- p.28
Chapter CHAPTER V. --- METHOD --- p.31
Translation of the SLICLS --- p.31
Content validity of the SLICLS-C --- p.32
Inter-rater reliability of the SLICLS-C --- p.34
Internal consistency of the SLICLS-C --- p.35
Construct validity of the SLICLS-C --- p.36
Concurrent validity of the SLICLS-C --- p.37
Predictive validity of the SLICLS-C --- p.38
Ethical considerations --- p.41
Chapter CHAPTER VI. --- RESULTS --- p.43
The SLICLS-C --- p.43
Content validity of the SLICLS-C --- p.44
Inter-rater reliability of the SLICLS-C --- p.46
Internal consistency of the SLICLS-C --- p.48
Construct validity of the SLICLS-C --- p.49
Concurrent validity of the SLICLS-C --- p.52
Predictive validity of the SLICLS-C --- p.54
Chapter CHAPTER VII. --- DISCUSSION --- p.59
Validity of the SLICLS-C --- p.59
Reliability of the SLICLS-C --- p.62
Accuracy of the SLICLS-C in predicting community level of care --- p.63
Significance of the study --- p.65
Limitations of the study --- p.67
Recommendations for further studies --- p.69
Chapter CHAPTER VIII. --- CONCLUSION --- p.70
REFERENCES --- p.73
APPENDICES --- p.92

by Iu Wai-yu.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2001.
Includes bibliographical references (leaves 138-146).
Abstracts in English and Chinese.
ACKNOWLEDGMENTS --- p.i-ii
abstract --- p.iii-iv
ABSTRACT (Chinese version) --- p.v-vi
TABLE OF CONTENTS --- p.vii-xii
LIST OF FIGURES --- p.xiii
LIST OF TABLES --- p.xiv-xvi
LIST OF APPENDICES --- p.xvii-xviii
Chapter CHAPTER 1 --- INTRODUCTION --- p.1
Research problem --- p.2-6
Purpose and objectives of the study --- p.7
Hypothesis --- p.8-9
Operational definitions --- p.9
Significance of the study --- p.10-13
Overview of the thesis --- p.13
Chapter CHAPTER 2 --- LITERATURE REVIEW
Introduction --- p.14
Definition of QOL --- p.15-18
Measurement of QOL --- p.18
The use of objective and subjective QOL Measurement --- p.19-23
Generic vs. Specific instruments --- p.23-24
Studies on QOL on mentally ill clients --- p.25-29
Factors influencing QOL --- p.29-33
Conceptual framework of the study --- p.34-37
Summary --- p.37
Chapter CHAPTER 3 --- METHODOLOGY
Introduction --- p.38
Research design --- p.38-39
Method --- p.39-41
Sampling --- p.41-44
Measurements --- p.45-51
The Brief Psychiatric Rating Scale --- p.45-46
The WHOQOL-BREF-HK --- p.47-48
The Lehman QOLI-brief version --- p.48-51
Demographic data sheet --- p.51
Pilot study --- p.52
Data collection --- p.53-54
Ethical consideration --- p.55-56
Data analysis --- p.56-58
Summary --- p.58
Chapter CHAPTER 4 --- RESULT
Introduction --- p.59
Sociodemographic characteristics of the participants --- p.59-65
Clinical characteristics of the participants --- p.66-70
Results from QOLI --- p.71-79
Results from WHOQOL --- p.80-81
Different perception of QOL in different groups --- p.81-94
Difference in perception of QOL between different gender --- p.82
Difference in perception of QOL between among different age ranges --- p.83-85
Relationships between employment status and perception of QOL --- p.86-87
Relationships between mental status and perception of QOL --- p.88-90
Relationships between years of onset of mental illness and perception of QOL --- p.91
Relationships between number of hospitalization and one's QOL --- p.91-92
Relationships between CPNS and perception of QOL --- p.93
Relationships between attending DH and perception of QOL --- p.94
Predictors of QOL --- p.95-98
Summary --- p.99
Chapter CHAPTER 5 --- DISCUSSION
Introduction --- p.100
Sociodemographic and clinical characteristics of the participants --- p.100-104
Perception of QOL --- p.104-109
Social relationships --- p.109-111
Family relationships --- p.111-112
Sexual relationships --- p.113
Environment --- p.113-114
Financial situation --- p.114-115
Mental status and QOL --- p.115-116
Service utilization and QOL --- p.117-118
Predictors of QOL --- p.118-120
Objective indicators and subjective perception of QOL --- p.121
Summary --- p.122
Chapter chapter 6 --- conclusion and implications
Introduction --- p.123
Summary of the study --- p.123-124
Implications to health care policy --- p.125-130
Implications to nursing practice --- p.130-134
Implications for future research --- p.135-136
Limitations of the study --- p.137
references --- p.138-146
appendices --- p.147-178

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
Introdução: Existem múltiplas razões pelas quais as pessoas com doença mental por vezes adiam ou evitam a procura de ajuda nos serviços de saúde, diminuindo o acesso ao tratamento e recuperação. O objetivo deste estudo foi validar um instrumento em Portugal para identificar as principais barreiras no acesso aos cuidados de saúde mental na população com doença mental, de modo a que no futuro se encontrem estratégias para ultrapassá-las.Métodos: A escala de Avaliação de Barreiras no Acesso a Cuidados (BACE-3) foi traduzida consoante as normas padrão de adaptação. A amostra foi constituída por 162 participantes com doença mental que foram a consulta em cuidados da saúde primários ou especializados. O inquérito incluiu outras escalas, entre elas a Escala de Comportamento de Procura de Ajuda e de Doença (IHSBS), uma adaptação do Questionário de Estado de Saúde (SF-36) e a Escala do Estigma (SS).Resultados: Obtivemos um α de Cronbach de 0,961 para a escala BACE-3 e de 0,964 para a subescala de estigma no tratamento. Respetivamente, a escala BACE-3 e os seus componentes relacionados e não relacionados com o estigma apresentaram uma correlação positiva com a SS, com coeficientes de correlação de 0,570 (p<0,001), 0,656 (p<0,001) e 0,422 (p<0,001), e uma correlação negativa com a Saúde Psicológica, com coeficientes de -0,221 (p=0,009), -0,219 (p=0,010) e -0.171 (p=0,044). Em adição, a escala BACE-3 e os seus itens não relacionados com o estigma correlacionaram-se negativamente com a Saúde Física, correspondentemente com coeficientes de correlação de -0,230 (p=0,006) e -0,248 (p=0,003).Discussão: Apesar do tamanho reduzido da amostra, a escala apresentou boa validade. Estudos futuros com avaliação teste-reteste e com amostras maiores são necessários para perceber melhor a consistência temporal e o impacto relativo destas barreiras.Conclusão: A versão portuguesa da BACE-3 é um instrumento útil para avaliar as principais barreiras no acesso aos cuidados de saúde nas pessoas com doença mental.
Introduction: There are multiple reasons why people with mental diseases occasionally delay or avoid seeking for help from health services, decreasing access to treatment and recovery. The aim of this study was to validate an instrument in Portugal to identify the main barriers to access to mental healthcare in patients diagnosed with a mental disorder, so that in the future we can find strategies to overcome them.Methods: Barriers to Access to Care Evaluation (BACE-3) scale was translated according to standard adaptation procedures. The sample consisted in 162 participants with mental disorders that attended consultation in primary or specialized care. The survey included other scales, such as the Illness and Help-Seeking Behaviour Scale (IHSBS), an adaptation of the 36-Item Short-Form Health Survey (SF-SP) and the Stigma Scale (SS).Results: We obtained a Cronbach’s α of 0.961 for the full BACE-3 scale and of 0.964 for the treatment stigma subscale. Respectively, BACE-3 and its stigma and non-stigma-related items presented a positive correlation with the SS, with correlation coefficients of 0.570 (p<0.001), 0.656 (p<0.001) and 0.422 (p<0.001), and a negative correlation with psychological health, with coefficients of -0.221 (p=0.009), -0.219 (p=0.010) and -0.171 (p=0.044). Also, BACE-3 and its non-stigma-related items negatively correlated with physical health, correspondingly with correlation coefficients of -0.230 (p=0.006) and -0.248 (p=0.003).Discussion: In spite of the small sample size, the scale showed good validity. Further studies with test-retest evaluation with bigger samples are needed for better understanding the temporal constancy and the relative impact of these barriers.Conclusion: The European Portuguese version of BACE-3 scale is a useful instrument to evaluate the main barriers to access to care in people with mental disorders.

Indiana University-Purdue University Indianapolis (IUPUI)
GREGORY RESEARCH BELIEFS SCALE: FACTOR STRUCTURE AND PSYCHOMETRIC PROPERTIES The study at hand involves developing the Gregory Research Beliefs Scale (GRBS) to reliably and validly measure social work students’ beliefs about the function of research in social work practice. Research has considerable actual and potential benefits for practice. Social work students’ beliefs about this construct are vital. A description of the advantages of using research to inform practice is given. Additionally, the Council on Social Work Education and National Association of Social Workers’ policies that mandate the merger of research and practice are also provided to further justify the need for adequate psychometric evaluation of the construct. Details of the literature search strategy are described and critical evaluations of the empirical articles are conducted. Based on critical evaluations of instruments which have previously measured the same construct, a number of psychometric shortcomings are outlined to validate the need for further scale development of the construct. The present study’s objectives were to develop a scale which has an empirically and theoretically supported factor structure, acceptable coefficient alpha levels, empirically supported discriminant (divergent) validity, concurrent criterion validity, and known–groups criterion validity. Steps for developing the GRBS’s items, response format, sample, research design, and statistical tests are specified and conducted to determine the factor structure and psychometric properties. Finally, the strengths, limitations, and areas for future research are discussed.