scholarly journals Assessment of Catatonia and Inter-Rater Reliability of Three Instruments: A Descriptive Study in an Acute Mental Health Unit in Urban South Africa

Author(s):  
Zuksiwa Zingela ◽  
Louise Stroud ◽  
Johan Cronje ◽  
Max Fink ◽  
Stephan Van Wyk

Abstract BackgroundClinical assessment of catatonia includes the use of diagnostic systems, like the Diagnostic and Statistical Manual 5 (DSM-5) and International Classification of Disease Manual 10 (ICD-10), or screening tools such as the Bush Francis Screening Instrument (BFCSI)/Bush Francis Catatonia Rating Scale (BFCRS) and Braunig’s Catatonia Rating Scale. In this study, we describe the inter-rater reliability (IRR), utilizing the BFCSI, BFCRS and DSM-5 to screen for catatonia. MethodData from 10 participants recruited as part of a larger prevalence study were used to determine IRR by five assessors after they were trained in the application of the 14-item BFCSI, 23-item BFCRS and DSM-5 to assess catatonia in new admissions. Krippendorff α was used to compute the IRR, and Spearman’s correlation was used to determine concordance between screening tools. The study was performed at a 35-bed acute mental health unit in Dora Nginza Hospital, Nelson Mandela Bay Metro. Participants were mostly involuntary admissions under the Mental Health Care Act of 2002 and between the ages of 13 and 65 years and older. ResultsThe majority (8, 80%) were 35 years or less and males (8, 80%). At least six (60%) of the ten participants were found to have catatonia based on the BFCSI/BFCRS and DSM-5 criteria. The BFCRS (complete 23-item scale) had the greatest level of inter-rater agreement with an α=0.798, while the DSM-5 had the lowest level of inter-rater agreement with an α=0.565. The highest correlation coefficients were observed between the BFCRS and BFCSI. ConclusionThe BFCSI and BFCRS were found to be sensitive tools for screening for catatonia with high IRR and high correlation coefficients, while the DSM 5 showed some deficiencies in screening for catatonia with low IRR and lowest correlation with the other two tools.

2021 ◽  
Author(s):  
Zuksiwa Zingela ◽  
Louise Stroud ◽  
Johan Cronje ◽  
Max Fink ◽  
Stephan van Wyk

Abstract BackgroundClinical assessment of catatonia includes the use of diagnostic systems, like the Diagnostic and Statistical Manual 5 (DSM-5) and International Classification of Disease Manual 10 (ICD-10), or screening tools such as the Bush Francis Screening Instrument (BFCSI)/Bush Francis Catatonia Rating Scale (BFCRS) and Braunig’s Catatonia Rating Scale. In this study, we describe the inter-rater reliability (IRR), utilizing the BFCSI, BFCRS and DSM-5 to screen for catatonia. MethodData from 10 participants recruited as part of a larger prevalence study were used to determine IRR by five assessors after they were trained in the application of the 14-item BFCSI, 23-item BFCRS and DSM-5 to assess catatonia in new admissions. Krippendorff α was used to compute the IRR, and Spearman’s correlation was used to determine concordance between screening tools. The study was performed at a 35-bed acute mental health unit in Dora Nginza Hospital, Nelson Mandela Bay Metro. Participants were mostly involuntary admissions under the Mental Health Care Act of 2002 and between the ages of 13 and 65 years and older.ResultsThe majority (8, 80%) were 35 years or less and males (8, 80%). At least six (60%) of the ten participants were found to have catatonia based on the BFCSI/BFCRS and DSM-5 criteria.The BFCRS (complete 23-item scale) had the greatest level of inter-rater agreement with an α=0.798, while the DSM-5 had the lowest level of inter-rater agreement with an α=0.565. The highest correlation coefficients were observed between the BFCRS and BFCSI.ConclusionThe BFCSI and BFCRS were found to be sensitive tools for screening for catatonia with high IRR and high correlation coefficients, while the DSM 5 showed some deficiencies in screening for catatonia with low IRR and lowest correlation with the other two tools.


Author(s):  
Zukiswa Zingela ◽  
Louise Stroud ◽  
Johan Cronje ◽  
Max Fink ◽  
Stephan van Wyk

Abstract Background Clinical assessment of catatonia includes the use of diagnostic systems, such as the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) and the International Classification of Disease, Tenth Revision (ICD-10), or screening tools such as the Bush Francis Catatonia Screening Instrument (BFCSI)/Bush Francis Catatonia Rating Scale (BFCRS) and the Braunig Catatonia Rating Scale. In this study, we describe the inter-rater reliability (IRR), utilizing the BFCSI, BFCRS, and DSM-5 to screen for catatonia. Methods Data from 10 participants recruited as part of a larger prevalence study (of 135 participants) were used to determine the IRR by five assessors after they were trained in the application of the 14-item BFCSI, 23-item BFCRS, and DSM-5 to assess catatonia in new admissions. Krippendorff’s α was used to compute the IRR, and Spearman’s correlation was used to determine the concordance between screening tools. The study site was a 35-bed acute mental health unit in Dora Nginza Hospital, Nelson Mandela Bay Metro. Participants were mostly involuntary admissions under the Mental Health Care Act of 2002 and between the ages of 13 and 65 years. Results Of the 135 participants, 16 (11.9%) had catatonia. The majority (92 [68.1%]) were between 16 and 35 years old, with 126 (93.3%) of them being Black and 89 (66.4%) being male. The BFCRS (complete 23-item scale) had the greatest level of inter-rater agreement with α = 0.798, while the DSM-5 had the lowest level of inter-rater agreement with α = 0.565. The highest correlation coefficients were observed between the BFCRS and the BFCSI. Conclusion The prevalence rate of catatonia was 11.9%, with the BFCSI and BFCRS showing the highest pick-up rate and a high IRR with high correlation coefficients, while the DSM-5 had deficiencies in screening for catatonia with low IRR and the lowest correlation with the other two tools.


2019 ◽  
Vol 91 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Leonhard A Bakker ◽  
Carin D Schröder ◽  
Harold H G Tan ◽  
Simone M A G Vugts ◽  
Ruben P A van Eijk ◽  
...  

ObjectiveThe Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is widely applied to assess disease severity and progression in patients with motor neuron disease (MND). The objective of the study is to assess the inter-rater and intra-rater reproducibility, i.e., the inter-rater and intra-rater reliability and agreement, of a self-administration version of the ALSFRS-R for use in apps, online platforms, clinical care and trials.MethodsThe self-administration version of the ALSFRS-R was developed based on both patient and expert feedback. To assess the inter-rater reproducibility, 59 patients with MND filled out the ALSFRS-R online and were subsequently assessed on the ALSFRS-R by three raters. To assess the intra-rater reproducibility, patients were invited on two occasions to complete the ALSFRS-R online. Reliability was assessed with intraclass correlation coefficients, agreement was assessed with Bland-Altman plots and paired samples t-tests, and internal consistency was examined with Cronbach’s coefficient alpha.ResultsThe self-administration version of the ALSFRS-R demonstrated excellent inter-rater and intra-rater reliability. The assessment of inter-rater agreement demonstrated small systematic differences between patients and raters and acceptable limits of agreement. The assessment of intra-rater agreement demonstrated no systematic changes between time points; limits of agreement were 4.3 points for the total score and ranged from 1.6 to 2.4 points for the domain scores. Coefficient alpha values were acceptable.DiscussionThe self-administration version of the ALSFRS-R demonstrates high reproducibility and can be used in apps and online portals for both individual comparisons, facilitating the management of clinical care and group comparisons in clinical trials.


2017 ◽  
Vol 41 (S1) ◽  
pp. S607-S607
Author(s):  
L. González ◽  
B. Pecino ◽  
C. Gomez ◽  
M. Anibarro ◽  
C. Ortigosa

IntroductionAdjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.ObjectivesThe aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.MethodsThe study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.ResultsThe data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.ConclusionsAdjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (3) ◽  
pp. 159-164 ◽  
Author(s):  
J. Cowman ◽  
P. Whitty

ObjectiveThere is a dearth of information relating to the prevalence of housing needs among psychiatric in-patients in Ireland. Most of the information we have to date emerged as a result of attempts to plan for the closure of old psychiatric hospitals and inappropriate community residences. This study sought to identify the prevalence of housing needs among in-patients in the acute psychiatric unit in Tallaght Hospital.MethodsEach week, over a 12-month period, nursing managers and/or key nurses who knew the patients well were asked for numerical data. Information was collected on the numbers of in-patients with accommodation needs, number of delayed discharges due to accommodation needs and number of discharges to homeless accommodation in the previous week.ResultsOn average, 38% of in-patients had accommodation related needs at any one time. Most (98%) of delayed discharges had accommodation related needs. Delayed discharge in-patients with accommodation needs accounted for 28% of all inpatients and for 72% of all inpatients with accommodation related needs.ConclusionsAccommodation need among psychiatric in-patients is underreported. Housing need data should be routinely collected and effective interagency strategies developed to address housing needs.


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