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A Comparison of Individual Change using Item Response Theory and Sum Scoring on the Patient Health Questionnaire-9: Implications for Measurement-Based Care 病人健康问卷-9中使用项目反应理论和总评分的个体变化比较:对基于测量的护理的影响
Pub Date : 2019-04-01 DOI: 10.26420/ANNDEPRESSANXIETY.1098.2019
Jones Smw
We examined change over time in depression with standard sum vs. Item Response Theory (IRT) scoring. Patient Health Questionnaire 9 item responses were extracted from the electronic health records of 5,405 people receiving depression treatment at the start of treatment and 30 to 180 days later. We used four methods to classify change: the Reliable Change Index (RCI), the 5-point change and 50% change from baseline for sum scores and the z-test for IRT scoring. The 5-point change and 50% change from baseline are both Health Effectiveness Data and Information Set measures. The z-test mostly agreed with the RCI, 5-point change or 50% change. More people had change using 5-point change or 50% change but not IRT scoring than no change using 5-point or 50% change but change using IRT scoring. Kappas between changes on IRT and sum scores ranged from 0.620 to 0.813. This difference in agreement is likely meaningful at the individual, patient level. People classified differently between IRT and sum scoring had moderate symptom change. Differences in conclusions from IRT and sum scoring may be most relevant in challenging clinical situations such as small or moderate symptom change.
我们用标准总和与项目反应理论(IRT)评分来检查抑郁症随时间的变化。患者健康问卷从5405名接受抑郁症治疗的患者的电子健康记录中提取9个项目的回答,这些患者在治疗开始时和30至180天后接受治疗。我们使用四种方法对变化进行分类:可靠变化指数(RCI),总得分的5点变化和与基线的50%变化以及IRT评分的z检验。5个点的变化和与基线的50%的变化都是健康有效性数据和信息集的度量。z检验基本上与RCI, 5点变化或50%变化一致。使用5分变化或50%变化但不使用IRT评分的人比使用5分没有变化或使用50%变化但使用IRT评分的人更多。IRT变化与总得分之间的Kappas在0.620 ~ 0.813之间。这种一致性的差异在个体和患者层面上可能是有意义的。在IRT和sum评分中被分类不同的人有中度的症状改变。在具有挑战性的临床情况下,如轻微或中度症状变化,IRT和总评分结论的差异可能最为相关。
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引用次数: 4
The Kessler Psychological Distress Scale (K6) as a Screening Instrument: a Study of Iranian University Students Kessler心理困扰量表(K6)作为筛选工具:伊朗大学生的研究
Pub Date : 2018-10-31 DOI: 10.26420/anndepressanxiety.1097.2018
Momeni Safarabad N
The Kessler Psychological Distress Scale (K6) provides a brief diagnostic measure for psychological distress. The aim of the present study was to study the validity and usefulness of the K6 as a screening instrument for psychiatric problems in a non-clinical sample of Iranian university students. A convenience sample of 157 Iranian volunteer students was selected from the Medical School in the Iran University of Medical Sciences. The students completed the K6 Scale and the Symptom Checklist 90 Revised (SCL-90-R). The mean score for the K6 was 9.39 (SD=5.48). Cronbach’s α was 0.87. K6 scores correlated 0.62 with the SCL-90-R Anxiety score (ANX), and 0.77 with the Depression score (DEP). K6 items loaded on a single factor labeled: Psychological Distress. The K6, therefore, had adequate psychometric properties and appears to be useful for screening non-clinical samples for the presence of psychiatric problems.
Kessler心理困扰量表(K6)提供了一个简短的心理困扰诊断方法。本研究的目的是研究K6在伊朗大学生非临床样本中作为精神问题筛查工具的有效性和有用性。从伊朗医科大学医学院挑选了157名伊朗志愿学生作为方便样本。学生完成K6量表和症状检查表90 (SCL-90-R)。K6的平均得分为9.39 (SD=5.48)。Cronbach’s α为0.87。K6与SCL-90-R焦虑评分(ANX)相关0.62,与抑郁评分(DEP)相关0.77。K6项被加载在单一因素标签上:心理困扰。因此,K6具有足够的心理测量特性,似乎可用于筛选精神问题存在的非临床样本。
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引用次数: 3
Suicide Prevention by Agency, Not an Easy Task 机构预防自杀并非易事
Pub Date : 2018-09-17 DOI: 10.26420/anndepressanxiety.1096.2019
John E. Berg
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引用次数: 0
Measurements of Electroencephalogram (EEG), Galvanic Skin Resistance (GSR) and Heart Rate Variability (HRV) during the Application of a System that Gives Simultaneously tVNS and Brain Entrainment on Subjects Affected by Depression and Anxiety 同时给予tVNS和脑夹带系统对抑郁和焦虑受试者的脑电图(EEG)、皮肤电电阻(GSR)和心率变异性(HRV)测量
Pub Date : 2018-09-11 DOI: 10.26420/anndepressanxiety.1095.2019
C. E
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引用次数: 0
Anxiolytic and Explorative Potentials of the Methanol Leaf Extract of Vernonia Amygdalina in Male Wistar Rats 苦杏仁叶甲醇提取物对雄性Wistar大鼠的抗焦虑作用及其探索潜力
Pub Date : 2018-06-29 DOI: 10.26420/ANNDEPRESSANXIETY.1094.2019
L. Adedayo
Anxiety is an unpleasant state of inner turmoil which causes nervous behavior like fear, apprehension and worries. Vernonia amygdalina commonly called bitter leaf, belongs to the family Astaraceae, and has been reported to be used locally in the management of psychiatric disorders. However, no work has been reported on pharmacological potentials of Vernonia amygdalina on anxiety in male rats. This study was therefore designed to investigate the effect of Vernonia amygdalina (VA) on anxiety status in male rats. The air-dried leaves of Vernonia amygdalina (VA) pulverized and macerated in methanol for 72 hours. The methanol was filtered with cotton wool and filter paper and concentrated using rotary evaporator at 40oC and further concentrated in a vacuum oven at temperature of 40oC and pressure of 600mmHg. The anxiolytic-like effect of VA was investigated using the Open Field Test (OPF), Hole-board apparatus and Y-maze apparatus. The results obtained were expressed as mean ± S.E.M. Data were analyzed using Oneway Analysis of Variance (ANOVA), followed by Newman– Keuls’ multiple comparisons test P<0.05. Vernonia amygdalina showed anxiolytic-like effect in rat, 50 mg/kg were significantly different from control in open field test, hole board test. In conclusion, this study has shown that methanol extract Vernonia amygdalina possess anxiolytic-like effects in male rats.
焦虑是一种不愉快的内心混乱状态,它会导致恐惧、忧虑和担忧等紧张行为。苦杏仁通常被称为苦叶,属于天星科,据报道在当地用于精神疾病的治疗。然而,苦杏仁对雄性大鼠焦虑的药理作用尚未见报道。本研究旨在探讨苦杏仁果对雄性大鼠焦虑状态的影响。风干的苦杏仁叶(VA)粉碎并在甲醇中浸泡72小时。甲醇用棉絮和滤纸过滤后,用旋转蒸发器在40℃下浓缩,再在温度40℃、压力600mmHg的真空烘箱中浓缩。采用开放场试验(OPF)、孔板仪和y型迷宫仪研究VA的类焦虑作用。数据分析采用单因素方差分析(ANOVA),并采用Newman - Keuls多重比较检验P<0.05。在野外试验、孔板试验中,50 mg/kg苦杏仁果对大鼠表现出抗焦虑样作用,与对照组相比差异显著。综上所述,甲醇提取物苦杏仁对雄性大鼠具有抗焦虑作用。
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引用次数: 3
Analysis of Heart Rate variability (HRV) in Frequency Domain and Recurrence Quantification Analysis during the Treatment by Transcutaneous Vagus Nerve Stimulation 经皮迷走神经刺激治疗期间心率变异性频域分析及复发量化分析
Pub Date : 2018-06-25 DOI: 10.26420/anndepressanxiety.2018.1093
C. E
The aim of the present work has a methodological profile. It aims to analyze the HRV during thirty minutes transcutaneous Vagus Nerve Stimulation tVNS treatment. We used the linear methodology of the Fast Fourier Transform and an analysis of the variability of the R-R signal in frequency domain under such conditions of stimulation. As specialized method of analysis we used also the Recurrence Quantification Analysis (RQA). The importance to use a combination of such linear and non linear methodologies was to give results of physiological interest that is to say to ascertain, as well as possible, the influence of such tVNS treatment on HRV. We examined 50 young subjects in normal health conditions and 50 young subjects with Autonomic Nervous Dysfunction (ANS) as well as it is evidenced by HRV. The experiments were arranged in three phases, recording the data before, during, and after a 30-minute treatment. The analysis of the data was performed in the frequency domain evaluating the VLF, the LF, and the HF and the variability of the tachogram according to the 1996 Task Force Standards of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. In addition the Recurrence Quantification Analysis (RQA) was used. The indication arising from such methodological study is that the unbalanced initial ANS dysfunction of the examined subjects, as mirrored from the HRV analysis, compensates and balances with also a prevailing tendency to parasympathetic HRV modulation during the tVNS treatment.
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引用次数: 2
Cognitive-Behavioral Care of an Old Patient 一位老年病人的认知行为护理
Pub Date : 2018-06-06 DOI: 10.26420/anndepressanxiety.2018.1092
Palazzolo J
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引用次数: 0
Hypnosis and Neuro-degenerative Pathology, Towards a Reassurance of the Anxious Symptomatology 催眠与神经退行性病理,迈向焦虑症候学的保证
Pub Date : 2015-08-25 DOI: 10.26420/anndepressanxiety.2015.1060
Parra Alain, Rossi Roxanne, Vaillant Ciszewicz Anne Julie
We wish, through this article to underline the therapeutic effects obtained thanks to hypnotic practices with institutionalized elderly reached (affected) by the Alzheimer’s disease. The hypnosis is effective on the behavior disorders associated to the insane pathology. She indeed allows to reduce the anxiety and the depressive character of the patient thanks to protocols which the clinician will have known suited and to adapt to the subjectivity of the subject.
我们希望通过这篇文章来强调催眠疗法对老年痴呆症患者的治疗效果。催眠对与精神病理相关的行为障碍有效。她确实允许减少病人的焦虑和抑郁特征,这要归功于临床医生所知道的适合并适应主体主观性的协议。
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引用次数: 0
Depression in Childhood and Early Adolescence: Parental Expressed Emotion and Family Functioning. 儿童和青少年早期的抑郁:父母表达的情绪和家庭功能。
Pub Date : 2015-01-01 Epub Date: 2015-12-10
M C Tompson, E E O Connor, G N Kemp, D A Langer, J R Asarnow

Across development depression is associated with impairments in interpersonal and family functioning. In turn, these impairments may predict a more negative depression course and outcome. This study examined family functioning and parental Expressed Emotion (EE) among depressed youth during middle childhood and early adolescence and their relationship to demographic and clinical factors. Data were drawn from pretreatment evaluations of 132 depressed youth ages 7-14 and their families enrolled in a randomized clinical trial comparing family to individual treatment for youth depressive disorders. Families completed semi-structured diagnostic interviews, self-report measures of family functioning, and the Five Minute Speech Sample EE measure. High parental EE was more common in one-parent, as opposed to two-parent families, and early adolescent youth were more likely than pre-adolescent youth to have high critical EE parents. Severity and chronicity of child depression, child comorbidity, functional impairment, and maternal depressive symptoms were not associated with parental EE. Parental high EE overall and critical EE in particular were associated with reports of higher conflict and lower cohesion by both parents and children when compared to low parental EE. Similar patterns of associations were evident for youth across pre-adolescent and early adolescent developmental periods. Single parent status may be an indicator of greater family stress; and higher levels of critical EE may reflect the higher levels of parent-child conflict characteristic of the transition from late childhood to early adolescence. Among youth with depression parental EE appears to reflect potentially important impairments in family functioning.

在整个发展过程中,抑郁症与人际关系和家庭功能的损害有关。反过来,这些损伤可能预示着更消极的抑郁过程和结果。本研究探讨了童年中期和青春期早期抑郁青少年的家庭功能和父母表达情绪(EE)及其与人口学和临床因素的关系。数据来自132名7-14岁的抑郁青少年及其家庭的预处理评估,他们参加了一项比较家庭与个人治疗青少年抑郁症的随机临床试验。家庭完成了半结构化的诊断访谈,家庭功能的自我报告测量,以及五分钟语音样本EE测量。高父母情感表达在单亲家庭中比在双亲家庭中更常见,青春期早期的青少年比青春期前的青少年更有可能拥有高临界情感表达的父母。儿童抑郁症的严重程度和慢性程度、儿童合并症、功能损害和母亲抑郁症状与父母情感表达无关。与低父母情感表达相比,父母总体上的高情感表达,尤其是临界情感表达,与父母和孩子之间更高的冲突和更低的凝聚力有关。类似的关联模式在青春期前和青春期早期发育时期也很明显。单亲状态可能是家庭压力较大的一个指标;高水平的临界情感表达可能反映了从童年晚期到青春期早期过渡的高水平的亲子冲突特征。在青少年抑郁症患者中,父母情感表达似乎反映了家庭功能中潜在的重要障碍。
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引用次数: 0
Can Speed of Processing Training Ameliorate Depressive Symptomatology in Adults with HIV? 处理训练的速度能改善成人HIV感染者的抑郁症状吗?
Pub Date : 2014-09-04
David E Vance, Shameka C Humphrey, William C Nicholson, Rita Jablonski-Jaudon

Despite advances in combination Antiretroviral Therapy (cART), adults with HIV continue to experience cognitive impairments. In addition to these cognitive impairments, research suggests as many as 40% and 20% of adults with HIV are diagnosed with depression and anxiety, respectively. The impact of these cognitive and emotional deficits increases caregiver burden, impairs occupational and driving performance, contributes to poor emotional processing, increases cognitive complaints, and reduces quality of life. Fortunately, cognitive remediation therapy improves targeted cognitive abilities along with general cognitive processes. Speed of processing training, a type of cognitive remediation therapy, has been shown to improve cognitive performance on measures of visual attention, speed of processing, and timed-task performances. Furthermore, studies suggest that speed of processing training could also enhance neuromodulatory systems which have direct implications for improving mood functions (depression and anxiety). The benefits of the improvement in these cognitive and emotional systems are a decrease or slowing in cognitive decline along with the potential to protect against clinically significant depressive symptoms. Studies support the need for deeper investigation into the short-term and long-term benefits of speed of processing training as a behavioral adjunct for the pharmacologically-burdened HIV population.

尽管抗逆转录病毒联合疗法(cART)取得了进展,但成年艾滋病毒感染者仍会出现认知障碍。除了这些认知障碍外,研究表明,多达40%和20%的成年艾滋病毒感染者分别被诊断患有抑郁症和焦虑症。这些认知和情绪缺陷的影响增加了照顾者的负担,损害了职业和驾驶表现,导致情绪处理不良,增加认知抱怨,降低生活质量。幸运的是,认知修复疗法改善了目标认知能力以及一般认知过程。加工速度训练是一种认知补救疗法,已被证明可以改善视觉注意力、加工速度和时间任务表现等方面的认知表现。此外,研究表明,处理训练的速度也可以增强神经调节系统,这对改善情绪功能(抑郁和焦虑)有直接的影响。改善这些认知和情绪系统的好处是减少或减缓认知衰退,同时有可能防止临床显著的抑郁症状。研究支持有必要深入研究处理速度训练作为药物负担艾滋病毒人群的行为辅助手段的短期和长期效益。
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引用次数: 0
期刊
Annals of Depression and Anxiety
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