摘要:

This study aimed to determine the replicability of the interrater reliability coefficients obtained with a standardized and expanded Brief Psychiatric Rating Scale (BPRS‐E) in a 1991 psychometric evaluation. Furthermore, intrarater reliability was assessed. At item level, interrater concordance turned out to be satisfactory for most of the BPRS‐E items. However, only a few of the items reached acceptable chance‐corrected coefficients. In contrast to the previous study, the anxiety‐depression subscale met the standard of acceptable interrater reliability in the present study. As in the 1991 study, the 10‐item psychotic disintegration scale as well as BPRS‐18 global scores met (or closely approximated) this standard. The 6 additional items of BPRS‐E did not contribute to the scale's reliability. Joining the samples of the 1991 and replication studies (to cover the range of symptoms’ severity and heterogeneity more fully) did not improve interrater reliability. Intrarater reliability coefficients were globally comparable to interrater reliability coefficients. In all, the results of this replication study suggest that only the anxiety‐depression subscale, the 10‐item psychotic disintegration scale and the BPRS‐18 global scale can be used reliably in unselected groups of psychiatric inpatie

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03464.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This article compares the Feighner criteria, the DSM‐III criteria for somatization disorder and a modified version of the proposed ICD‐10 criteria. Working with a data set collected from the charts of 250 patients considered likely to have unexplained somatic symptoms, the kappa statistic and percentage agreement was calculated. The kappa between the DSM‐III and DSM‐III‐R criteria is 0.93. Between the modified ICD‐10 and DSM‐III it was 0.71, but between Feighner and the modified ICD‐10 it was 0.44. However, the different criteria identify the same patient population based on mental co‐morbidity and demographics. The authors suggest that the modified version of the proposed ICD‐10 should be investigated further, as it can use data sets previously collected for assessments of so

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03465.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The Lundby study is a prospective, epidemiological survey of mental health in a total population. When evaluating the material of 2550 individuals followed from 1947 to 1972, we found a large group with mental tiredness as the dominating symptom. Next to depression this was the most frequent diagnosis in the population. According to our concept of Tiredness, one third of the women ran a lifetime risk of developing a first‐ever episode of Tiredness, while the risk for men was one fifth. The incidence of Tiredness is described together with the total frequency of episodes. The course of mental illness starting with a first episode of Tiredness within the 25‐year investigation period shows that about one third of the men and half of the women relapsed into Tiredness or other mental illnesses, not infrequently with a serious outcome. However, most of the episodes of Tiredness lasted less than 2 years and were of milder impairment. We emphasize the importance of further investigations by means of epidemiological, clinical and neurochemical methods as regards the heterogeneous syndrome of mental fati

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03466.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A group of transsexuals, 9 biological men and 10 women, was assessed according to clinical DSM‐III‐R diagnosis and a self‐report instrument for Axis II diagnoses based on the Structured Clinical Interview for DSM‐III‐R (SCID screen). A control group of 133 individuals was assessed by the same instrument. Combined with a functional criterion according to the Global Assessment of Functioning, the SCID screen showed good agreement with clinical Axis II diagnoses. The overall proportion of Axis II criteria fulfilled, proportion of criteria fulfilled for every single personality disorder and number of personality disorders were calculated from the modified version of the SCID screen. Personality disorders, mainly within cluster B, were identified among 5 of 19 transsexuals, and a majority had multiple personality disorders. Among controls, no personality disorder was identified. Personality traits as measured by the SCID screen revealed significantly more subthreshold pathology among transsexuals than controls in 8 of 12 personality categories. The proportion of overall Axis II criteria fulfilled was 29% among transsexuals versus 17% among controls. Sex differences among transsexuals, the usefulness of the SCID screen and diagnostic problems in DSM‐III‐R with respect to gender identity disorders

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03467.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We examined the relationship between influenza epidemics and the number of schizophrenic and affective psychotic individuals born each month between 1938 and 1965 in England and Wales. Increased death rates from influenza were followed 5 months later by a significant increase in schizophrenic births and a concurrent fall in the number of births of affective psychotic individuals. When the sexes were examined separately, both the positive effect of influenza on schizophrenic births and its negative effect on affective psychotic births were evident for females but not for males. Furthermore, during February to June in high influenza years, there was an inverse relationship between the number of female schizophrenic and affective psychotic births. The explanation for these surprising findings may be that prenatal exposure to influenza impairs the neurodevelopment of some females with a predisposition to affective psychosis, in such a way that their later illness shows schizophrenic rather than affective features.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03468.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Although clinical experience points to the frequent use of sedatives and hypnotics in suicide, remarkably few data are available to characterize the demographics of the population involved. The San Diego study, in which toxicological examinations were performed in over 90% of 204 consecutive suicides seen by the San Diego County Coroner during 1981–1982, provides an opportunity to examine suicide victims who were taking various medicines and drugs of abuse. Drugs were detected in 68% of tested subjects. Anxiolytics and hypnotics were found in 10.7% and 12.3% of the cases respectively. Women were more than 4 times as likely as men to have tested positive for an anxiolytic or hypnotic. Antidepressants were found in 5.9%. Alcohol had been ingested by 28.3% of subjects. Barbiturates and benzodiazepines were found in approximately equal proportions, although nationally the number of barbiturate prescriptions filled in drugstores was only one‐sixth that of benzodiazepines. Major depression was found in 22.5%; among cases with positive histories of major depression, only a small proportion ranging from 4–10% were positive for antidepressants, anxiolytics or hypnotics. Interestingly, approximately equal proportions (4.8% and 6.2%) of depressed and non‐depressed patients were positive for antidepressants. Among subjects whose deaths were attributed to drug ingestion, benzodiazepines, barbiturates and antidepressants were found in approximately one‐third each, with little overlap. Although benzodiazepines were found in less than 10% of the group as a whole, they were found in one‐third of subjects who committed suicide by overdose. Several clinical concerns arise from these data, including: 1) the importance of recognizing depression in patients who complain of poor sleep, 2) the issue of multiple drug ingestion in suicide victims and 3) the rising rate of barbiturate use in areas in which benzodiazepines are increasingly restricted by regulato

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03469.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This study attempted to identify a specific personality disorder (PD) or PD cluster that independently worsens the 4‐month treatment outcome of major depression under adequate antidepressant. The material of the study was 96 consecutive outpatients with major depression. For the Axis I and Axis II diagnoses, the Structured Clinical Interview for DSM‐III‐R (SCID) was used. In the material, the presence of any PD significantly worsened the 4‐month outcome. The discriminant function analysis, conducted to identify a specific PD or PD cluster that influences the outcome, found that the number of PD from only cluster A and the number of criteria met for only schizoid PD was significantly correlated with the 4‐month outcome of d

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03470.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Forty anxiety patients diagnosed according to DSM‐III‐R criteria were included: panic disorder (n= 12), agoraphobia (n= 11), generalized anxiety disorder (n= 9), anxiety disorder not otherwise specified (n= 8) and compared with 12 controls. Millon Clinical Multiaxial Inventory and Symptom Checklist‐90R symptom and personality scales did not separate the diagnostic groups. Electrodermal activity showed delayed habituation and high spontaneous skin resistance fluctuations in the panic and agoraphobia groups compared with the non‐panic groups. The generalized anxiety disorder patients could not be separated from the controls, and the anxiety disorder not otherwise specified patients showed less electrodermal activity than the controls on most variables. In contrast to self‐report instruments, electrodermal activity discriminated between diagnostic groups of patients with DSM‐III‐R anxiety disorders, more specifically between patients with and without

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03471.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

To compare the frequency distribution of body weight of the depressed patients with that of a standard group and to evaluate the change in distribution during treatment, body weight was measured in 106 depressed inpatients with major depressive disorder as defined by DSM‐III criteria both on admission and on discharge. The body weight distribution in the depressed patients skewed towards a high frequency of lower weights on admission but shifted to the normal pattern on discharge. In women, this tendency was more obvious and was statistically significant. The body weight distribution in the depressed patients with melancholia maintained high frequencies of lower body weight on discharge, while that in those without melancholia did not, suggesting that there could be a difference in the pattern of body weight distributions between those with endogenous and nonendogenous depression. Three tricyclic antidepressants examined (imipramine, clomipramine and desipramine) did not seem to have the side effect of pathological weight gain in the frequency distribution patter

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03472.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The atypical complaints of Seasonal Affective Disorder (SAD) are usually assessed clinically by means of 7 questions added to the Hamilton Rating Scale for Depression (HRSDadd). In this study, these complaints were assessed by means of relevant and modified items of the Beck Depression Inventory (BDIadd), a self‐rating instrument. A highly significant correlation between the two assessment procedures was found. This suggests that the BDIadd is a very useful alternative to the HRSDad

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03473.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY