Accuracy in detecting major depressive episodes in older adults using the Swedish versions of the GDS-15 and PHQ-9

Objectives: The purpose of this study was to evaluate the diagnostic accuracy at different cut-off values for the Swedish versions of the 15-item Geriatric Depression Scale (GDS-15) and Patient Health Questionnaire (PHQ-9) compared with a structured clinical psychiatric interview in older adults. Methods: Community-dwelling participants (N = 113) aged 65 years or older completed the Swedish versions of the GDS-15 and PHQ-9 and were then interviewed using the Mini International Neuropsychiatric Interview (MINI) to establish the presence or absence of current major depressive episodes (MDEs). Areas under the curve (AUC) were calculated for each scale, as well as the sensitivity, specificity, and Youden’s index for different cut-off values. Results: Seventeen participants met the criteria for MDEs. The AUC was 0.97 for the GDS-15 and 0.95 for the PHQ-9. A cut-off of ≥6 on the GDS-15 yielded a sensitivity of 94%, a specificity of 88%, and a Youden’s index of 0.82. A cut-off of ≥5 on the PHQ-9 yielded a sensitivity of 100%, a specificity of 81%, and a Youden’s index of 0.81. The proposed cut-off of ≥10 on the PHQ-9 produced excellent specificity of 95% but a lower sensitivity of 71%. Conclusions: This study indicates that the Swedish versions of the GDS-15 and PHQ-9 have comparable accuracy as screening instruments for older adults with MDEs. However, the proposed cut-off of 10 on the PHQ-9 might be too high when applied to older individuals in Sweden, and further investigations in larger samples in different healthcare settings are warranted.

ПСИХОЛОГІЧНА СУТНІСТЬ ФЕНОМЕНА ЕМОЦІЙНО-ЗНАЧУЩІ ВЗАЄМИНИ

У статті презентовано результати теоретичного та емпіричного дослідження змістовного наповнення поняття емоційно-значущих взаємин. Проаналізовано основні положення сучасної психологічної науки щодо розуміння визначеного феномена та окреслено складові такого виду стосунків. Результати дослідження отримано за допомогою анкети, яка складається з трьох смислових блоків. По першому блоку запитань на тему «Уявлення про феномен емоційно-значущих взаємин» виявлено, що асоціаціями до нашого ключового поняття є: кохання, любов, взаєморозуміння, повага, підтримка, довіра, вірність, взаємність та щирість, це вказує на те, що респонденти вбачають у емоційно-значущих взаєминах найкращі риси, які притаманні міжособистісним стосункам. Другий блок нашого опитування стосувався психологічного наповнення та складових емоційно-значущих взаємин. Найпоширеніші відповіді було згруповано у 5 категорій і отримали наступне наповнення емоційно-значущих взаємин в їх ієрархії: турбота, трепетне ставлення; схожі ціннісні орієнтації, емоційний відгук; достатній рівень комунікації; відвертість, довіра; повага та взаєморозуміння. Третій блок запитань стосувався руйнівних тенденцій та чинників, що визначають динаміку емоційно-значущих взаємин. Доведено, що вони можуть бути емоційно виснажливими, адже в них був виявлений цілий ряд атрибутів, які дестабілізують стосунки між партнерами. Проте третина респондентів свідомо заперечують таку можливість, а половина допускає лише в окремих випадках Це свідчить про те, що в основі уявлень про останні присутні почуття з позитивною модальністю. У випадку наявності деструкції вони мають носити іншу назву. Отримані результати емпіричного дослідження дали можливість консатувати, що емоційно-значущі взаємини це – близькі взаємини зазвичай між партнерами, яким притаманна здатність втілювати в собі емоційно-ціннісне ставлення та викликати почуття в іншого через призму його життєвого досвіду. Література Ананьев, Б.Г. (2008). Личность, субъект деятельности, индивидуальность. Москва : Директ-Медиа. Богомолова, Н.Н., Бодалев, А.А., & Гительмахер, Р.Б. (2005). Основы социально-психологической теории. Учебное пособие. Москва : Изд-во Междунар. пед. академии. Березовська, Л., & Ямчук, Т. (2020). Психологія міжособистісних взаємин подружньої пари. Вісник Національного університету оборони України, 56(3), 5–13. https://doi.org/10.33099/2617-6858-2020-56-3-5-13 Берн, Е. (2016). Ігри, у які грають люди. Харків : Книжковий клуб «Клуб сімейного дозвілля». Бодалев, А.А. (2007).Формиравание понятия о другом человеке как личности. Издательство Ленинградского унивеситета. Бодалев, А. А. (2004). О взаимосвязи общения и отношения. Вопросы психологии, 1, 122–127. Британника, I.E. (2007). Encyclopædia britannica. Британская энциклопедия. Режим доступу: https://en.wikisource.org/wiki/Index:EB1911_-_Volumedjvu Вильям, Дж. (2011). Психология. Москва : Педагогика Гірняк, А.Н., & Глова, І.М. (2019). Передумови формування гармонійної міжособистісної взаємодії в молодій сім’ї. IV Міжнародна науково-практична конференція «Україна в умовах реформування правової системи: сучасні реалії та міжнародний досвід» (м. Тернопіль, 5–6 квітня 2019 р.), Т. 2. (с. 133–135). Тернопіль : Економічна думка. Режим доступу: http://uf.wunu.edu.ua/wp-content/uploads/2020/03/TEZI-YUF-2019-T.-2.pdf#page=133 Гозман, Л.Я., & Ажгихина, Н.И. (2008). Психология симпатий. Москва : Знание, 1(5). Грей, Дж, (2017). Мужчины с Марса, женщины с Венеры. София. Журавльова, Л.П., & Коломієць, Т.В. (2013). Структурно-динамічна модель мезовиміру міжособистісної взаємодії. Освіта регіону, 4(34), 275–279. Жмайло, І.М. (2013). Міжособистісні взаємини як соціально-психологічна проблема. Проблеми сучасної психології, 22, 146–154. Зинченко, В.П., & Моргунов, Е.Б. (2004). Человек развивающийся. Очерки российской психологии. Москва : Тривола. Изард, К.Е. (2009). Эмоции человека. Москва : Изд-во МГУ. Коломієць, Н. (2018). Теоретичний аналіз поняття взаємодія. Психолого-педагогічні проблеми сільської школи, 58, 112–119. Режим доступу: http://library.udpu.org.ua/library_files/psuh_pedagog_probl_silsk_shkolu/58/14.pdf Коломинський, Я.Л. (2003). Соціальна психологія шкільного класу: наук-метод. посібник для педагогів та психологів.Минськ : ООО «ФУА інформ». Кроник, А.А., & Кроник, Е.А. (2010). В главных ролях: вы, мы, он, ты, я. Москва : Мысль. Ломов, Б.Ф. (2013). Методологические и теоретические проблемы психологии. Москва : Directmedia. Мясищев, В.Н. (2015). Психология отношений. Воронеж : Модэк. Орбан-Лембрик,Л.Е. (2013). Соціальна психологія. Київ : посібник Академвидав. Обозов, Н.Н. (2010). Возрастная психология: юность и зрелость.Санкт-Петербург : СаиВеда. Рубинштейн, С.Л. (2016). Бытие и сознание. Санкт-Петербург : Питер. Шадських, Ю.Г., & Піча, В.М. (2006). Психологія: Короткий навчальний словник: терміни і поняття.Львів : Магнолія. Шнейдер, Л.Б. (2009). Психология семейных отношений. Москва : Апрель-Пресс, ЭКСМО-Пресс. Fromm E. (2003). The Art of Loving: A Study of the Nature of Love. New York : Harper and Brothers. Mead, G.H. (2004). The philosophy of the present. Amherst :Prometheus Books. Sullivan, H. (2002). The Psychiatric Interview (Norton Library). New York :WW Norton & Co Plutshik, R., 2006. Psycholophysiology of individual differences with special reference to emotions. Annual New York : Acad Sciense.

Sensory Deprivation and Psychiatric Disorders: Association, Assessment and Management Strategies

Background: Sensory deprivation (SD) is a widely prevalent condition that leads to various health-related consequences and is also an important cause of disability worldwide. Earlier, SD experiments were used as research modalities to alter human behavior. In recent years, the focus has shifted to understand how SD can affect the mental health of individuals (with congenital or acquired sensory impairments). This narrative review focuses on the current understanding about the association of SD and psychiatric disorders. Methods: A comprehensive literature search was done PubMed, Scopus, PsycINFO, and Google Scholar and in the cross-references of relevant articles. Keywords included “sensory deprivation,” “blindness,” “deafness,” “mental illness,” “psychiatric disorders,” “prevalence,” “assessment,” and “management” in various combinations. Only original articles (abstract and full text) published in English till October 2020 were included. Results: The prevalence of anxiety, depression, dementia, suicidality, and psychosis in persons with SD is higher than the general population (highest being in persons with dementia with comorbid SD). Several mechanisms/hypotheses have been proposed to explain these associations. Assessment of SD includes a thorough history taking, with adequate awareness about the difficulties faced during a psychiatric interview in this population. Modifications in the psychometric assessment procedures are warranted. Management depends on a multi-disciplinary approach that includes proper referral to specialties, pharmacological management (depending on diagnosis as well as taking care of ototoxic/ocular side-effect profile of the drugs), and nonpharmacological supportive measures. Conclusions: SD is a complex condition, and evidence suggests that persons with SD have higher psychiatric morbidity. A comprehensive assessment, along with holistic management approach is warranted.

Metabolic syndrome among young adults at high and low familial risk for depression

Background Our study examined whether the early-onset depression phenotype among young adults (probands) is associated with the metabolic syndrome (MetS) and its components, and if MetS characterizes unaffected but high-risk siblings of probands. Methods We studied three groups of young adults (Mage = 25 years, s.d. = 3.84 years): probands with histories of childhood onset depression – i.e. early-onset phenotype – (n = 293), their unaffected siblings (high-risk siblings, n = 273), and healthy controls (n = 171). Participants completed a full psychiatric interview, physical and laboratory assessments, and self-rating scales. MetS was defined using the criteria of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001). Results Early-onset depression phenotype and being a high-risk sibling were associated with higher MetS composite scores relative to that of controls, but did not differ from one another. With regard to MetS components: Probands and siblings had similarly larger waist circumference and lower HDL than did controls, while siblings and controls had lower triglyceride levels than did probands but did not differ from one another. Groups did not differ on glucose levels and SBP. Conclusions Our study extends the literature on the association between MetS and depression and underscores the importance of depression phenotypes: failure to account for the clinical heterogeneity of depression may partly underlie the inconsistent findings regarding its relation to MetS. The results also suggest that, in depression-prone populations, MetS may predate and possibly function as a risk factor for eventual depression.

Assessment of Sexual Functions among Male with Substance Use Disorders

Background: Recent epidemiological and clinical studies confirmed the presence of a strong association between substance use disorders and sexual dysfunctions. Studies have demonstrated that prevalence of sexual dysfunctions among addict was about 30 %the most common problem among male substance abuse patients were Erectile Dysfunction (ED) and delayed ejaculation Methods: This cohort comparative study was conducted on of 376 males aged between 18 – 50 years who were substance abusers including tramadol, cannabis and poly substance related and addictive disorders. All participants were subjected to psychiatric interview which was done using SCID-5-CV structured clinical interview for DSM-5 disorders. Psychometric, biochemical, medical and drug history evaluations were also performed. Results: Our results show comparison between four groups (opiates-cannabis-poly substance abuse and control group according to severity of drug abuse, psychiatric evaluation and according to sexual functions. There were statistically significant differences between groups in sociodemographic data mainly in occupational and educational history. There also were statistically significant differences between groups in terms of drug use, psychiatric assessment, assessment of sexual activity, hormonal assessment of the studied population and quality of life assessment. Conclusions: Long term drug use has a statistically significant negative effect on all domains of male sexual functions. Also average daily dose and severity of addiction are significantly correlated to sexual dysfunctions in patients with tramadol abuse. This is done through an alteration in sex hormone and alters feedback regulations of the pituitary on the hypothalamus.

Psychiatric Symptoms of Children and Adolescents With Mitochondrial Disorders: A Descriptive Case Series

Background: Mitochondrial disorders (MD) are a group of clinically heterogeneous genetic disorders resulting from dysfunction of the mitochondrial respiratory chain. Cognitive impairment is a common feature in adults with MD and psychiatric symptoms are associated with MD in up to 70% of the adult population. The aim of this study is to describe the psychiatric profile in children and adolescents with MD by focusing on the description of psychiatric symptoms.Methods: A cohort of 12 children and adolescents was prospectively recruited between February 2019 and February 2020 in the Reference Center for Mitochondrial Disorders of Angers (France). Participants and their parents completed an anamnestic form to provide socio-demographic data and completed the Global Assessment of Functioning scale, the Brief Psychiatric Rating Scale, the Child Depression Inventory, the Revised Children's Manifest Anxiety Scale, and the Conner's Rating Scale to evaluate the inattention/hyperactivity symptoms as well as the Quality of Life scale.Results: Four children (33.3%) were diagnosed with depressive symptoms. With regarding to anxiety, 6 children (50%) reported anxiety issues during the psychiatric interview and 3 children (25%) were suffering from anxiety according to the RCMAS scale. Compared to other children with chronic illnesses, the individuals in our cohort reported a lower overall quality of life score and lower scores in physical and social subscales.Conclusion: Our study shows that MD can lead to psychiatric disorders in children and adolescents, in particular anxiety and depression, as well as poor quality of life. This highlights the need for regular psychiatric assessments in individuals with developing brains, such as children and adolescents. We do not, however, have data regarding the neuropsychological profile of this population.

Measuring Knowledge, Attitudes, and Barriers to Medication Adherence in Potential Bariatric Surgery Patients

Background Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery. Methods The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations. Results Attitude to adherence was associated with alexithymia (β = ˗2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = −2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale. Conclusion We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done.

Association Between Obsessive-Compulsive Symptom Dimensions in Mothers and Psychopathology in Their Children

Background: The non-clinical presentation of obsessive–compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children.Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL).Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). “Aggression/violence” was the most frequent symptom dimension (32.2%), followed by the “symmetry/ordering” (16.4%) and the “sexual/religious” dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p &lt; 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p &lt; 0.001), internalizing (p &lt; 0.001), externalizing (p &lt; 0.001), and OCS subscale scores (p &lt; 0.001) on the CBCL.Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.