scholarly journals Is there a correlation between physicians' clinical impressions and patients' perceptions of change? Use of the Perceived Change Scale with inpatients with mental disorders

2016 ◽  
Vol 38 (4) ◽  
pp. 234-241 ◽  
Author(s):  
Gabriela Pavan ◽  
◽  
Julia Almeida Godoy ◽  
Ricardo Tavares Monteiro ◽  
Hugo Karling Moreschi ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Clinical Global Impression ◽  
Clinical Impression ◽  
Results Of Treatment ◽  
Sociodemographic Data ◽  
Perceived Change ◽  
Negative Perceptions ◽  
Patient’S Perception ◽  
Coherent Relationship ◽  
Moderate Positive Correlation

Abstract Introduction: Assessment of the results of treatment for mental disorders becomes more complete when the patient's perspective is incorporated. Here, we aimed to evaluate the psychometric properties and application of the Perceived Change Scale - Patient version (PCS-P) in a sample of inpatients with mental disorders. Methods: One hundred and ninety-one psychiatric inpatients answered the PCS-P and the Patients' Satisfaction with Mental Health Services Scale (SATIS) and were evaluated in terms of clinical and sociodemographic data. An exploratory factor analysis (EFA) was performed and internal consistency was calculated. The clinical impressions of the patient, family, and physician were correlated with the patient's perception of change. Results: The EFA indicated a psychometrically suitable four-factor solution. The PCS-P exhibited a coherent relationship with SATIS and had a Cronbach's alpha value of 0.856. No correlations were found between the physician's clinical global impression of improvement and the patient's perception of change, although a moderate positive correlation was found between the patients' clinical global impression of improvement and the change perceived by the patient. Conclusions: The PCS-P exhibited adequate psychometric proprieties in a sample of inpatients with mental disorders. The patient's perception of change is an important dimension for evaluation of outcomes in the treatment of mental disorders and differs from the physician's clinical impression of improvement. Evaluation of positive and negative perceptions of the various dimensions of the patient's life enables more precise consideration of the patient's priorities and interests.

A comparison of the ‘Hamilton Rating Scale for Depression’ and the ‘Montgomery-Asberg Depression rating Scale’

1999 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
I.P.A.M. Huijbrechts ◽  
P.M.J. Haffmans ◽  
K. Jonker ◽  
A. van Dijke ◽  
E. Hoencamp
Keyword(s):  
Clinical Practice ◽  
Clinical Global Impression ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Structured Interview ◽  
Clinical Impression ◽  
Clinical Relationship ◽  
Hamilton Rating Scale ◽  
Depressive States

SummaryAlthough the Hamilton Rating Scale for Depression (HRSD) is the most frequently used rating scale for quantifying depressive states, it has been criticized for its reliability and its usability in clinical practice. This criticism is less applying to the Montgomery-Asberg Depression Rating Scale (MADRS). Goal of the present study is to investigate the reliability and validity, and clinical relationship between the HRSD and the MADRS. For 60 out-patients with diagnosed depression (DSM IV296.2x, 296.3x, 300.40 and 311.00), the HRSD and MADRS were scored at baseline and 6 weeks later by an independent rater according to a structured interview. Also the Clinical Global Impression (CGI) was assessed by a psychiatrist. Satisfying agreement was found between the totalscores (r= .75, p>.000 en r=.92, p>.000 respectively, at baseline and 6 weeks later). Furthermore agreement was found between the items of both scales, and these agree with the clinical impression. The reliability of the MADRS is more stable than the reliability of the HRSD (α = .6367 and α =.8900 vs α = .2193 and α = .8362 at baseline and at endpoint respectively). Considering the ease of scoring both scales in one interview and the widely international use of the HRSD, scoring both the HRSD and the MADRS to measure the severity of a depression seems to be an acceptabel covenant.

Prevalence of psychiatric disorders among patients with Multiple Sclerosis: a cross-sectional study.

2020 ◽  
Author(s):  
Michał Błachut ◽  
Anna Rebeka Szczegielniak ◽  
Krzysztof Świerzy ◽  
Magdalena Zając- Tarska ◽  
Katarzyna Kubicka-Bączyk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Underlying Disease ◽  
Psychiatric Evaluation ◽  
Cross Sectional ◽  
Mini International Neuropsychiatric Interview ◽  
Sociodemographic Data ◽  
Number Of Patients

Abstract Background: Multiple Sclerosis is one of the leading autoimmune disorders causing disability among young adults. Various types of mood, affect, and behaviour disorders along with cognitive impairment can be manifested in a course of MS, with affective and anxiety disorders being the most prevalent. Mental health challenges, in addition to the neurological burden of MS, significantly affect quality of life and the course of the underlying disease. Objective: The aim of this work was to determine the prevalence of mental disorders in a sample of MS patients during outpatient treatment in Zabrze, Poland, with a focus on those with mood and anxiety disorders, and to compare the results obtained in these groups with clinical and sociodemographic data. Method: The study was conducted between 2017 and 2018 on 103 MS patients of the Neurological Outpatient Clinic of the Medical University of Silesia Hospital No.1 in Zabrze, Poland. During the study, sociodemographic data were collected, as well as the type and course of the underlying disease, comorbidities, and medicines used. The MINI-international neuropsychiatric interview and a psychiatric examination were utilized to assess the occurrence of mental disorders. Result: 68% of all patients received a psychiatric diagnosis at some point in their life with only 4% having been hospitalized before; 49.5% met the diagnostic criteria for various psychiatric disorders. Measured by the MINI International Neuropsychiatric Interview, 33% of patients reported a past episode of major depression while 8.7% met the criteria for a current episode. The same number of patients admitted ongoing treatment due to recurrent depressive disorder. In regards to anxiety disorders, the most common was generalized anxiety disorder (10.7%), followed by agoraphobia (8.7%), panic disorder (7.8%), and social phobia (4.9%). Most of the patients (94.2%) at the time of the psychiatric evaluation presented a low level of suicide risk, while 1.9% of the patients presented a medium risk, and 3.9% - a high risk. Conclusion(s): The study confirmed a significantly higher prevalence of mental disorders among MS patients; thus, the psychiatric state of patients in this group should be investigated systematically, simultaneously with the assessment of their neurological state. Trial registration: N/A Key words: Multiple Sclerosis, psychiatric disorders, comorbidity, psychiatric care, clinical characteristics.

Stability of Results of Treatment and Therapeutic Compliance of Patients with Organic Non-psychotic Mental Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S716-S716
Author(s):  
V. Rudnitsky ◽  
V.B. Nikitina ◽  
M.M. Axenov ◽  
N.P. Garganeeva ◽  
E.D. Schastnyy
Keyword(s):  
Mental Disorders ◽  
Educational Approach ◽  
Social Approach ◽  
Results Of Treatment ◽  
Organic Mental Disorders ◽  
Cognitive Disturbances ◽  
Organic Process ◽  
Competing Interest ◽  
Unrealistic Expectations ◽  
Positive Results

IntroductionNon-psychotic mental disorders of organic register tend to have protracted progressive course, to respond poorly to treatment. Traditionally it is explained by features of cerebral-organic process. However, affective, behavioural and cognitive disturbances can be complicated by medico-social problems including treatment-related.ObjectiveTo analyse efficiency and stability of results of the therapy of organic mental disorders and propose approaches and means of their improvement.MethodsClinical-psychopathological, epidemiological, clinical-dynamic, catamnestic, experimental-psychological, medical statistics.ResultsThe most frequent causes of decompensations of organic mental disorders in patients with positive results of the therapy were analyzed. Sixty-four percent (58 patients) after 6 months showed partial recurrence of symptoms and after a year the condition practically returned to the initial one. However, only 12.22% (11 patients) passed recommended course of maintenance therapy to sufficiently full extent, 23.33% (21 persons) have discontinued it due to subjective causes during a month after discharge, about 2/3 of patients during the first two months of the therapy. Patients showed low indicators of therapeutic compliance, low level of therapeutic alliance, little familiarity with the illness and treatment and unrealistic expectations about prospects of the therapy. During insignificant difficulties in the therapy, it usually was discontinued and renewed during relapse of symptoms. A medico-social approach with support of psychotherapeutic and psycho-corrective work and information educational programs were developed.ConclusionProposed psychotherapeutic and educational approach heightens efficiency and stability of treatment and can serve a basis for further improvement of psychiatric, psychotherapeutic and medico-social assistance for patients with organic mental disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Adherence to treatment in patients with rheumatoid arthritis

2019 ◽  
pp. 28-34
Author(s):  
Alejandro Benítez ◽  
Graciela Betancur ◽  
Adrián Estévez ◽  
Ezequiel Klimovsk ◽  
María Julia Papagno ◽  
...  
Keyword(s):  
Disease Status ◽  
Cross Sectional Study ◽  
Medical Institute ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Sociodemographic Data ◽  
Private Center ◽  
Patient’S Perception ◽  
Medical Volunteers ◽  
Total Compliance

Objective: this study aims to evaluate the compliance of pharmacological treatment in patients with RA and identify the factors that may affect it. Materials and methods: observational, analytical and cross-sectional study. Surveys were conducted on 176 randomly selected patients from a private center specialized in Rheumatology located in the southern suburbs of the province of Buenos Aires (CER Medical Institute - Quilmes), between September 2015 and July 2016, by telephone by trained non-medical volunteers of the Articular Foundation. The BAM, CQR19 questionnaires were used and the patient’s perception of their degree of adherence to the treatment was investigated, dividing it into two groups: total compliance or partial/no compliance. Sociodemographic data, disease status, treatment, comorbidities and habits were collected.

scholarly journals Burnout syndrome and associated factors among health professionals of a public hospital

2012 ◽  
Vol 34 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Márcia Ebling ◽  
Mary Sandra Carlotto
Keyword(s):  
Job Satisfaction ◽  
Mental Disorders ◽  
Personality Traits ◽  
Health Professionals ◽  
Self Efficacy ◽  
Public Hospital ◽  
Common Mental Disorders ◽  
Burnout Syndrome ◽  
Psychosocial Variables ◽  
Sociodemographic Data

OBJECTIVE: To identify the prevalence of burnout syndrome (BS) dimensions and their relationship with sociodemographic data, working variables, psychosocial variables, job satisfaction, hardiness, self-efficacy, and common mental disorders among health professionals of a public hospital. METHOD: This cross-sectional study assessed 234 health professionals working at a public hospital in southern Brazil. Participants answered the Maslach Burnout Inventory, the Job Satisfaction Questionnaire, the Hardiness Scale, The General Self-Efficacy Scale, the Self-Reporting Questionnaire, and a questionnaire specifically designed for the present study to assess sociodemographic and variables related to work. Data were analyzed using descriptive and inferential statistics. RESULTS: An association was identified between the three dimensions of BS and sociodemographic data, variables related to work, psychosocial variables, hardy personality traits, and common mental disorders. CONCLUSION: The study allowed to define a risk profile for BS, namely male, young, undergraduate workers, with a low income, who see a large number of patients per day, physicians, government employees, absence of commitment, control and challenge (hardy personality traits), low self-efficacy, job dissatisfaction, presence of common mental disorders, and intention to change career, institution, or position at current institution.

scholarly journals Minimal important change and responsiveness of the Migraine Disability Assessment Score (MIDAS) questionnaire

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gabriela F. Carvalho ◽  
Kerstin Luedtke ◽  
Tobias Braun
Keyword(s):  
Area Under The Curve ◽  
Important Change ◽  
Global Rating ◽  
Minimal Important Change ◽  
Perceived Change ◽  
Midas Questionnaire ◽  
Assess Treatment Response ◽  
Clinically Important Change ◽  
Moderate Positive Correlation

Abstract Background The MIDAS is the most used questionnaire to evaluate migraine-related disability, but its utility to assess treatment response remains unclear. Our aim was to estimate the MIDAS’ minimal important change (MIC) value and its responsiveness. Methods A total of 103 patients were enrolled in a non-pharmacological, preference-based clinical trial. MIDAS and global rating of self-perceived change (GRoC) scores were collected at baseline, after 5 weeks of treatment, 4-weeks and 3-months follow-up after treatment. Anchor-based approaches were used to establish MIC values and responsiveness. Findings In all 3 timepoint comparisons, MIDAS presented a MIC of 4.5 points. A moderate positive correlation was identified between the MIDAS change and GRoC scores. The area under the curve ranged from 0.63 to 0.68. Conclusions This study showed that MIDAS has a limited responsiveness to change. A change of 4.5 points or more represents a clinically important change for patients with high frequent migraine and chronic migraine receiving non-pharmacological treatment.

A Comparison of Therapy Alone Versus Therapy and Medication in a Community Clinic

2005 ◽  
Vol 19 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Jessica S. Brown ◽  
Nadia E. Stellrecht ◽  
Foluso M. Williams ◽  
Jillian M. Denoma ◽  
LaRicka R. Wingate ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Clinical Global Impression ◽  
Real World ◽  
Global Assessment ◽  
Psychotropic Medications ◽  
Global Assessment Of Functioning ◽  
Clinical Global Impression Scale ◽  
Community Clinic ◽  
Better Than

Research to date suggests that the best treatment for many mental disorders is provided through the combination of medications and psychotherapy (e.g., Hollon, Thase, & Markowitz, 2002). However, the majority of studies supporting this point have been done utilizing highly restricted, controlled samples that may not accurately reflect the way mental illness is treated in the community. The present study attempted to replicate those findings in an outpatient community clinic. One hundred seventy-four adult clients who presented to a community clinic were rated as to their illness severity at both intake and termination of therapy using the Clinical Global Impression Scale and the Global Assessment of Functioning. These clients were divided into groups based on whether or not they took psychotropic medications at any point during therapy. Results showed that clients who took medications fared no better than clients who did not. These preliminary findings suggest that the combination of medications and psychotherapy may not be as effective in the “real world” as prior studies have implied, and point to the need for further research utilizing community samples.

Reductionist thinking and animal models in neuropsychiatric research

2019 ◽  
Vol 42 ◽  
Author(s):  
Nicole M. Baran
Keyword(s):  
Animal Models ◽  
Mental Disorders ◽  
Environmental Factors ◽  
Neuropsychiatric Disorders ◽  
Model Organisms ◽  
Developmental Genetic ◽  
Term Study ◽  
Genetic And Environmental Factors ◽  
Mechanisms Of Plasticity

AbstractReductionist thinking in neuroscience is manifest in the widespread use of animal models of neuropsychiatric disorders. Broader investigations of diverse behaviors in non-model organisms and longer-term study of the mechanisms of plasticity will yield fundamental insights into the neurobiological, developmental, genetic, and environmental factors contributing to the “massively multifactorial system networks” which go awry in mental disorders.

Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches

2008 ◽  
Vol 13 (6) ◽  
pp. 1-7
Author(s):  
Norma Leclair ◽  
Steve Leclair ◽  
Robert Barth
Keyword(s):  
Mental Disorders ◽  
Behavioral Disorders ◽  
Psychotic Disorders ◽  
Behavioral Disorder ◽  
Behavioral Impairment ◽  
Central Nervous System Damage ◽  
Brain Functioning ◽  
Sixth Edition ◽  
Diagnostic And Statistical Manual ◽  
Mental And Behavioral Disorders

Abstract Chapter 14, Mental and Behavioral Disorders, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, defines a process for assessing permanent impairment, including providing numeric ratings, for persons with specific mental and behavioral disorders. These mental disorders are limited to mood disorders, anxiety disorders, and psychotic disorders, and this chapter focuses on the evaluation of brain functioning and its effects on behavior in the absence of evident traumatic or disease-related objective central nervous system damage. This article poses and answers questions about the sixth edition. For example, this is the first since the second edition (1984) that provides a numeric impairment rating, and this edition establishes a standard, uniform template to translate human trauma or disease into a percentage of whole person impairment. Persons who conduct independent mental and behavioral evaluation using this chapter should be trained in psychiatry or psychology; other users should be experienced in psychiatric or psychological evaluations and should have expertise in the diagnosis and treatment of mental and behavioral disorders. The critical first step in determining a mental or behavioral impairment rating is to document the existence of a definitive diagnosis based on the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The article also enumerates the psychiatric disorders that are considered ratable in the sixth edition, addresses use of the sixth edition during independent medical evaluations, and answers additional questions.

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