scholarly journals Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care

2003 ◽  
Vol 182 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Petros Skapinakis ◽  
Glyn Lewis ◽  
Venetsanos Mavreas
Keyword(s):  
Primary Care ◽  
Secondary Analysis ◽  
Composite International Diagnostic Interview ◽  
Developed Countries ◽  
Diagnostic Interview ◽  
World Health ◽  
Less Developed Countries ◽  
Cross Cultural Differences ◽  
International Data ◽  
Health Organization

BackgroundUnexplained fatigue has been extensively studied but most of the samples used were from Western countries.AimsTo present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care.MethodSecondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview.ResultsThe prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17–4.33) and 15.05 (95% CI 10.85–20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries.ConclusionsIn less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.

Daily smoking and the subsequent onset of psychiatric disorders

2004 ◽  
Vol 34 (2) ◽  
pp. 323-333 ◽  
Author(s):  
N. BRESLAU ◽  
S. P. NOVAK ◽  
R. C. KESSLER
Keyword(s):  
Smoking Cessation ◽  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Daily Smoking ◽  
Smoking Intensity ◽  
Health Organization ◽  
Subsequent Onset

Background. Recent research has demonstrated that smokers are at an elevated risk for psychiatric disorders. This study extends the enquiry by examining: (1) the specificity of the psychiatric sequelae of smoking; and (2) the variability in the likelihood of these sequelae by proximity and intensity of smoking.Method. Data come from the National Comorbidity Survey (NCS), a representative sample of the US population 15–54 years of age. The Smoking Supplement was administered to a representative subset of 4414 respondents. A modified World Health Organization – Composite International Diagnostic Interview was used to measure DSM-III-R disorders. Survival analysis with smoking variables as time-dependent covariates was used to predict the subsequent onset of specific psychiatric disorders.Results. The estimated effects of daily smoking varied across disorders. In the case of mood disorders, daily smoking predicted subsequent onset, with no variation between current versus past smokers or by smoking intensity. In the case of panic disorder and agoraphobia, current but not past smoking predicted subsequent onset; furthermore, the risk of these disorders in past smokers decreased with increasing time since quitting. In the case of substance use disorders, current but not past smoking predicted subsequent onset, with no variation by time since quitting or smoking intensity.Conclusions. The data suggest that smoking cessation programmes would not prevent the onset of mood disorder, as ex-smokers do not differ from current smokers in their risk for these disorders. In comparison, daily smoking might be a causal factor in panic disorder and agoraphobia, conditions that might be preventable by smoking cessation. Additionally, current smoking might serve as a marker for targeting interventions to prevent alcohol and drug disorders.

scholarly journals A Combined Digital and Biomarker Diagnostic Aid for Mood Disorders (the Delta Trial): Protocol for an Observational Study

10.2196/18453 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e18453 ◽  
Author(s):  
Tony Olmert ◽  
Jason D Cooper ◽  
Sung Yeon Sarah Han ◽  
Giles Barton-Owen ◽  
Lynn Farrag ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Statistical Power ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Accurate Diagnosis ◽  
Diagnostic Methods ◽  
World Health ◽  
Diagnostic Aid ◽  
Health Organization

Background Mood disorders affect hundreds of millions of people worldwide, imposing a substantial medical and economic burden. Existing diagnostic methods for mood disorders often result in a delay until accurate diagnosis, exacerbating the challenges of these disorders. Advances in digital tools for psychiatry and understanding the biological basis of mood disorders offer the potential for novel diagnostic methods that facilitate early and accurate diagnosis of patients. Objective The Delta Trial was launched to develop an algorithm-based diagnostic aid combining symptom data and proteomic biomarkers to reduce the misdiagnosis of bipolar disorder (BD) as a major depressive disorder (MDD) and achieve more accurate and earlier MDD diagnosis. Methods Participants for this ethically approved trial were recruited through the internet, mainly through Facebook advertising. Participants were then screened for eligibility, consented to participate, and completed an adaptive digital questionnaire that was designed and created for the trial on a purpose-built digital platform. A subset of these participants was selected to provide dried blood spot (DBS) samples and undertake a World Health Organization World Mental Health Composite International Diagnostic Interview (CIDI). Inclusion and exclusion criteria were chosen to maximize the safety of a trial population that was both relevant to the trial objectives and generalizable. To provide statistical power and validation sets for the primary and secondary objectives, 840 participants were required to complete the digital questionnaire, submit DBS samples, and undertake a CIDI. Results The Delta Trial is now complete. More than 3200 participants completed the digital questionnaire, 924 of whom also submitted DBS samples and a CIDI, whereas a total of 1780 participants completed a 6-month follow-up questionnaire and 1542 completed a 12-month follow-up questionnaire. The analysis of the trial data is now underway. Conclusions If a diagnostic aid is able to improve the diagnosis of BD and MDD, it may enable earlier treatment for patients with mood disorders. International Registered Report Identifier (IRRID) DERR1-10.2196/18453

CIDI, SCAN and IPDE: structured diagnostic interviews for ICD 10 and DSM III-R

1991 ◽  
Vol 6 (6) ◽  
pp. 277-285 ◽  
Author(s):  
CB Pull ◽  
HU Wittchen
Keyword(s):  
Mental Health ◽  
Composite International Diagnostic Interview ◽  
The United States ◽  
Scientific Basis ◽  
Diagnostic Interview ◽  
World Health ◽  
Health Administration ◽  
Icd 10 ◽  
Diagnosis And Classification ◽  
Health Organization

SummaryThe Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the International Personality Disorder Examination (IPDE) constitute part of a family of instruments which have been designed for the assessment of mental disorders as defined by the explicit diagnostic criteria and algorithms in ICD 10 and DSM III-R. They have been developed at the request of the World Health Organization and the United States Alcohol, Drug Abuse, and Mental Health Administration to foster a common language in the mental health field, to facilitate comparisons of clinical and research findings from different settings, countries and cultures, and to improve the scientific basis of diagnosis and classification in psychiatry. This report describes the background, purpose and essential features of the three instruments.

scholarly journals The Ebola Epidemic and Cholera Outbreak and The International Response

2017 ◽  
Vol 10 (2) ◽  
pp. 105-120
Author(s):  
Richard B. Roberts
Keyword(s):  
West Africa ◽  
International Health ◽  
Disease Outbreaks ◽  
Developed Countries ◽  
World Health ◽  
Less Developed Countries ◽  
Cholera Outbreak ◽  
Therapeutic Modalities ◽  
International Response ◽  
Health Organization

Infectious diseases are responsible for 15 million of the 57 million deaths worldwide despite the remarkable discoveries of antibiotics and vaccines. Many individuals succumb to microbial diseases in poor and less-developed countries where these preventive and therapeutic modalities are not available. Furthermore these less fortunate countries do not have the resources or public health infrastructure to combat unforeseen and explosive outbreaks. Two relatively recent outbreaks are reviewed in this article; the Ebola epidemic in West Africa and the cholera outbreak in Haiti. This outbreak of cholera, in a country of only 7.8 million inhabitants, is one of the largest ever recorded worldwide. Early intervention by international health organizations is critical to curtail and ultimately control infectious disease outbreaks and epidemics. This responsibility, especially for less-developed countries, lies in the hands of the United Nations and World Health Organization. Unfortunately, the international response from the UN and WHO was slow, cumbersome and poorly coordinated both in West Africa and Haiti.

Multiple risk behaviour intervention to prevent depression in primary care

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711677
Author(s):  
Irene Gómez-Gómez ◽  
Patricia Moreno-Peral ◽  
Tomás López ◽  
Ana Clavería ◽  
Barbara Oliván ◽  
...  
Keyword(s):  
Primary Care ◽  
Communicable Disease ◽  
Secondary Analysis ◽  
Composite International Diagnostic Interview ◽  
Risk Behaviour ◽  
Diagnostic Interview ◽  
Prevention Interventions ◽  
Multiple Risk ◽  
Multiple Risk Behaviour ◽  
The Ideal

BackgroundPrimary care is the ideal setting for promotion and prevention intervention. Multiple risk behaviour interventions present several advantages over single-risk lifestyle interventions. Multiple risk behaviour interventions could be easily implemented in primary care to prevent non-communicable disease and depression.AimTo test the effectiveness of a multiple risk behaviour intervention to promote Mediterranean diet, physical activity, and/or smoking cessation in people attending Spanish primary health care with incidence of depression and symptoms of depression.MethodThis was a secondary analysis of the EIRA study that aims to test the effectiveness of a multiple risk behaviour intervention to promote healthy lifestyles. Twenty-six primary care centres were randomised to receive multiple risk behaviour intervention or usual care. The multiple risk behaviour intervention included individual sessions, group sessions, communitarian activities, and SMS reception. Participants were followed for 10–14 months. The primary outcomes of this study were incidence of depression and reductions of depressive symptoms.ResultsThree thousand and sixty-seven participants were included. Females accounted for 45.13% and 93.88% were Spanish. Age varied between 45 and 75 years old. The effectiveness of the intervention will be calculated using the Patient Health Questionnaire (PHQ-9) and the Composite International Diagnostic Interview (‎CIDI)‎ depression section. Linear and logistic regression will be used to create predictive models.ConclusionPrimary care is the most accessible service in the health system for patients. Hence primary care is the ideal setting for health education, promotion, and prevention interventions. This study will provide high-quality evidence about the effectiveness of multiple risk behaviour interventions over depression prevention.

scholarly journals Composite International Diagnostic Interview screening scales for DSM-IV anxiety and mood disorders

2012 ◽  
Vol 43 (8) ◽  
pp. 1625-1637 ◽  
Author(s):  
R. C. Kessler ◽  
J. R. Calabrese ◽  
P. A. Farley ◽  
M. J. Gruber ◽  
M. A. Jewell ◽  
...  
Keyword(s):  
Primary Care ◽  
Common Mental Disorders ◽  
Clinical Epidemiology ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Operating Characteristics ◽  
Epidemiological Surveys ◽  
The World ◽  
Dsm Iv

BackgroundLack of coordination between screening studies for common mental disorders in primary care and community epidemiological samples impedes progress in clinical epidemiology. Short screening scales based on the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), the diagnostic interview used in community epidemiological surveys throughout the world, were developed to address this problem.MethodExpert reviews and cognitive interviews generated CIDI screening scale (CIDI-SC) item pools for 30-day DSM-IV-TR major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder (PD) and bipolar disorder (BPD). These items were administered to 3058 unselected patients in 29 US primary care offices. Blinded SCID clinical reinterviews were administered to 206 of these patients, oversampling screened positives.ResultsStepwise regression selected optimal screening items to predict clinical diagnoses. Excellent concordance [area under the receiver operating characteristic curve (AUC)] was found between continuous CIDI-SC and DSM-IV/SCID diagnoses of 30-day MDE (0.93), GAD (0.88), PD (0.90) and BPD (0.97), with only 9–38 questions needed to administer all scales. CIDI-SC versus SCID prevalence differences are insignificant at the optimal CIDI-SC diagnostic thresholds (χ21 = 0.0–2.9, p = 0.09–0.94). Individual-level diagnostic concordance at these thresholds is substantial (AUC 0.81–0.86, sensitivity 68.0–80.2%, specificity 90.1–98.8%). Likelihood ratio positive (LR+) exceeds 10 and LR− is 0.1 or less at informative thresholds for all diagnoses.ConclusionsCIDI-SC operating characteristics are equivalent (MDE, GAD) or superior (PD, BPD) to those of the best alternative screening scales. CIDI-SC results can be compared directly to general population CIDI survey results or used to target and streamline second-stage CIDIs.

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