Clinical computing. Computer-administered symptom rating scales

SummaryThe algorithms for the demonstration of shared phenomenology of psychiatric syndromes in DSM-III are resistant to quantification. In contrast, the rating scale approach quantifies clinical target syndromes in psychiatry. The two most useful statistical models for quantifying shared phenomenology by symptom rating scales have been reviewed; namely factor analysis and latent structure analysis. Results have shown that factor analysis has demonstrated dimensions of dementia, delirium, schizophrenia, mania, outward aggression, depression and anxiety. Latent structure analysis has confirmed that the items of brief rating scales (such as the Melancholia Scale) are additively related implying that their total scores are sufficient statistics for the measurement of these factors or dimensions. Latent structure analysis should be considered as a psychometric “glasnost” compared to algorithm-resistant logic of quantification in DSM-III.

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Symptom Dimensions of the Psychotic Symptom Rating Scales in Psychosis: A Multisite Study

Schizophrenia Bulletin ◽

10.1093/schbul/sbu014 ◽

2014 ◽

Vol 40 (Suppl_4) ◽

pp. S265-S274 ◽

Cited By ~ 54

Author(s):

Todd S. Woodward ◽

Kwanghee Jung ◽

Heungsun Hwang ◽

John Yin ◽

Laura Taylor ◽

...

Keyword(s):

Psychotic Symptom ◽

Rating Scales ◽

Symptom Dimensions ◽

Symptom Rating

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Feasibility study of culturally adapted cognitive behaviour therapy for psychosis in Pakistan

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2144 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S578-S579 ◽

Cited By ~ 1

Author(s):

N. Husain ◽

N. Mehmood ◽

M.O. Husain ◽

T. Kiran ◽

F. Naeem ◽

...

Keyword(s):

Psychotic Symptom ◽

Low Income ◽

Rating Scales ◽

Intervention Group ◽

Income Country ◽

Psychotic Symptoms ◽

Low Income Country ◽

Culturally Adapted ◽

Cognitive Behaviour ◽

Symptom Rating

BackgroundIt is becoming well established that CBT is both effective and cost efficient in the treatment of positive and negative symptoms of schizophrenia. However, there is a need to adapt CBT to the cultural, linguistic, and socioeconomic context of diverse cultural groups. We aimed to establish the feasibility of culturally adaptive cognitive behavior therapy for treatment of psychosis in a low-income country.MethodsThis is a rater-blind, randomized, controlled trial of the use of CBT in patients with psychosis from a low-income country. Patients with a DSM-IV diagnosis of schizophreniform disorder were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Participants were randomized into the intervention group (n = 18) and TAU group (n = 18). The intervention group received 12 weekly sessions of culturally adapted CBT for psychosis (CaCBTp).ResultsThere were no significant differences between the two groups at baseline. At three months follow-up, there was a statistically significant improvement in the CaCBTp group on PANSS general Psychopathology subscale, PANSS overall score and Insight scale, as compared to the TAU group. The CaCBTp group had lower scores on PANSS positive, PANSS negative sub-scales, and the two subscales of Psychotic Symptom Rating Scale, but differences were not statistically significant.ConclusionCulturally adapted CBT added to pharmacological treatment as usual was acceptable to patients and was helpful in reduction of severity of psychotic symptoms. Adjunctive culturally adapted CBT should be further investigated in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Investigating Resilience to Depression in Adults With ADHD

Journal of Attention Disorders ◽

10.1177/1087054716636937 ◽

2016 ◽

Vol 22 (5) ◽

pp. 497-505 ◽

Cited By ~ 9

Author(s):

Lauren E. Oddo ◽

Laura E. Knouse ◽

Craig B. H. Surman ◽

Steven A. Safren

Keyword(s):

Life Events ◽

Depressive Disorders ◽

Rating Scales ◽

Stressful Life Events ◽

Self Report ◽

Cognitive Behavioral ◽

Adhd Symptoms ◽

Diagnostic Interviews ◽

Adhd Treatment ◽

Symptom Rating

Objective: ADHD is associated with elevated rates of comorbid depressive disorders, yet the nature and development of this comorbidity remain understudied. We hypothesized that a longer period of prior ADHD treatment, being less likely to engage in maladaptive cognitive/behavioral coping strategies, and less severe ADHD symptoms would predict greater likelihood of lifetime resilience to depression. Method: Seventy-seven adults with ADHD completed diagnostic interviews, clinician-administered symptom rating scales, a stressful life events measure, and self-report questionnaires. We used logistic regression analyses to identify factors associated with resilience to depression. Results: Adults with more extensive ADHD treatment histories were more likely to be resilient to depression. Those who were less likely to report ruminative thinking patterns and cognitive-behavioral avoidance were also more resilient. Severity of current or childhood ADHD symptoms and recent negative life events did not predict resilience. Conclusion: Results identify protective factors that may promote the resiliency to ADHD-depression comorbidity.

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Individual response to antidepressants for depression in adults – a meta-analysis and simulation study

10.31219/osf.io/srzx5 ◽

2019 ◽

Author(s):

Klaus Munkholm ◽

Stephanie Winkelbeiner ◽

Philipp Homan

Keyword(s):

Rating Scales ◽

Rating Scale ◽

Meta Analysis ◽

Simulated Data ◽

Individual Treatment ◽

Depression Symptom ◽

Individual Response ◽

Inverse Variance ◽

The Individual ◽

Symptom Rating

Background The observation that some patients appear to respond better to antidepressants for depression than others encourages the assumption that the effect of antidepressants differs between individuals and that treatment can be personalized. Objective To compare the outcome variance in patients receiving antidepressants with the outcome variance in patients receiving placebo in randomized controlled trials (RCTs) of adults with major depressive disorder (MDD) and to illustrate, using simulated data, components of variation of RCTs. Methods From a dataset comprising 522 RCTs of antidepressants for adult MDD, we selected the placebo-controlled RCTs reporting outcomes on the 17 or 21 item Hamilton Depression Rating Scale or the Montgomery-Asberg Depression Rating Scale and extracted the means and SDs of raw endpoint scores or baseline to endpoint changes scores on eligible depression symptom rating scales. We conducted inverse variance random-effects meta-analysis with the variability ratio (VR), the ratio between the outcome variance in the group of patients receiving antidepressants and the outcome variance in the group receiving placebo, as the primary outcome. An increased variance in the antidepressant group would indicate individual differences in response to antidepressants. Results We analysed 222 RCTs that investigated 19 different antidepressants compared with placebo in 345 comparisons, comprising a total of 61144 adults with an MDD diagnosis. Across all comparisons, the VR for raw endpoint scores was 0.98 (95% CI 0.96 to 1.00, I^2^ = 0%) and 1.00 (95% CI 0.99 to 1.02, I^2^ = 0%) for baseline-to-endpoint change scores. Conclusion Based on these data, we cannot reject the null hypothesis of equal variances in the antidepressant group and the placebo group. Given that RCTs cannot provide direct evidence for individual treatment effects, it may be most reasonable to assume that the average effect of antidepressants applies also to the individual patient.

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Medication use in Australian children with attention-deficit/hyperactivity disorder and autism

10.31234/osf.io/txagy ◽

2021 ◽

Author(s):

Olivia Mellahn ◽

Rachael Knott ◽

Jeggan Tiego ◽

Kathryn Kallady ◽

Katrina Williams ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Rating Scales ◽

Medication Use ◽

Treatment Strategies ◽

Autism Spectrum ◽

Hyperactivity Disorder ◽

Current Medication ◽

Comorbid Adhd ◽

Symptom Rating

Attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are commonly treated with psychotropic medications. There is however a paucity of research examining the prevalence of pharmacotherapy and polypharmacy (>2 medications) in these groups. Caregivers of 505 children (2-18 years) with ADHD (n=239), ASD (n=117) or ADHD-ASD (n=149) reported on current medication use and completed symptom rating scales. ADHD was associated with the highest rate of psychotropic medication use (90%), followed by ADHD-ASD (86%) and ASD (39%). Children with ADHD-ASD reported the highest rate of polypharmacy (41%). Although ADHD was associated with the highest overall medication use, comorbid ADHD-ASD was associated with higher odds of experiencing polypharmacy. This research should help to inform treatment strategies for children with comorbid ADHD-ASD.

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Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000270 ◽

2017 ◽

Vol 27 (3) ◽

pp. 219-224 ◽

Cited By ~ 8

Author(s):

J. W. Keeley ◽

W. Gaebel

Keyword(s):

Negative Symptoms ◽

Rating Scales ◽

Psychotic Disorders ◽

Rating Scale ◽

Field Testing ◽

International Classification Of Diseases ◽

Severity Rating ◽

Classification Of Diseases ◽

The Cost ◽

Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

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