[Chronic Somatic Conditions and Mental Health Problems in the General Population in Germany.]

[Chronic Somatic Conditions and Mental Health Problems in the General Population in Germany.]

Psychiatr Prax. 2013 Apr 5;
Maske UE, Busch MA, Jacobi F, Riedel-Heller SG, Scheidt-Nave C, Hapke U

Objective: To assess the association of chronic somatic diseases and mental health problems in the general population in Germany.Methods: The data (n = 22 050) derived from the representative cross-sectional telephone survey “Gesundheit in Deutschland aktuell (GEDA) 2010”. It included self-reported information on diagnosis of 19 chronic physical conditions for at least 18-year-old people. Mental health problems encompass self-reported diagnosis of depression and recent mental distress according to the Mental Health Inventory (MHI-5). Age-specific adjusted logistic regressions were calculated.Results: There was an association of chronic physical illness and mental health problems in all age groups. In 18 – 44 and 45 – 64-year-olds the association got stronger with each additional chronic disease. In all age groups mental health problems were most common in multimorbid subjects.Conclusion: Comorbid mental health problems should be accounted for particularly in multimorbid subjects of all ages. In younger patients mental health problems should be considered even if only one chronic disease is present. HubMed – depression


[The Childhood Trauma Screener (CTS) – Development and Validation of Cut-Off-Scores for Classificatory Diagnostics.]

Psychiatr Prax. 2013 Apr 5;
Glaesmer H, Schulz A, Häuser W, Freyberger HJ, Brähler E, Grabe HJ

Objectives: Childhood abuse and neglect are associated with worse physical and mental health outcomes. There is some evidence, that the CTS is a brief and valid screening tool. To support the application of the CTS for categorical diagnostics cut-offs will be identified and validated.Methods: Based on two large-scale population studies suitable cut-off-scores for the different dimensions of childhood abuse and neglect were identified due to comparable case identification rates in the CTS compared with the Childhood Trauma Questionnaire. The cut-off-scores were validated with respect to depression as an external criterion.Results: Suitable cut-off-scores were identified for all subscales in both samples. The cases and non-cases according to the cut-off-scores differed significantly regarding the severity of depressive symptoms and the prevalence of depression. Good to very good sensitivity and specificity of the CTS-items and the related subscales of the CTQ are shown, except for the dimension “physical neglect”.Conclusion: With the help of the cut-off-scores it is possible to use the CTS for categorical diagnostics, especially in large-scale studies with two-step diagnostic approaches. HubMed – depression


Disease-specific quality of life evaluation and its determinants in Cushing’s syndrome: what have we learnt?

Pituitary. 2013 Apr 7;
Badia X, Valassi E, Roset M, Webb SM

Cushing’s syndrome (CS) has a considerable negative impact on patient health-related quality of life (HRQoL). Two disease-specific instruments (the CushingQoL and the Tuebingen CD-25 questionnaire) are now available to assess the impact of the disease and its treatment on HRQoL. The purpose of this review was to summarize the characteristics of the studies which have used these two instruments to date and summarize their findings regarding (a) the determinants of disease-specific HRQoL in patients with CS and (b) the impact of treatment for CS on disease-specific HRQoL. A total of 7 studies were identified, 5 with the CushingQoL and 2 with the Tuebingen CD-25. Most were observational studies, though the CushingQoL had been used in one randomized clinical trial. In terms of clinical factors, there was some evidence for an association between UFC levels and disease-specific HRQoL, though the presence and strength of the association varied between studies. There was also some evidence that a more recent diagnosis of CS could lead to poorer HRQoL, and that length of time with adrenal insufficiency may also affect HRQoL. There was no evidence for an impact on disease-specific HRQoL of etiology or of the clinical signs and symptoms associated with CS, such as bruising, rubor, and fat deposits. One factor which did have a significant negative effect on HRQoL was the presence of depression. No clear picture emerged as to the effect of demographic variables such as age and gender on HRQoL scores, though there was some evidence for poorer HRQoL in female patients. As regards treatment, the two interventions studied to date (transsphenoidal surgery and pasireotide) both showed significant gains in HRQoL, with moderate to large effect sizes. This type of review is useful in summarizing knowledge to date and suggesting future research directions. HubMed – depression


Validation and cross-cultural adaptation of the Self-Assessment Disability Scale in patients with Parkinson’s disease in Serbia.

J Neurol. 2013 Apr 7;
Gazibara T, Stankovic I, Tomic A, Svetel M, Tepavcevic DK, Kostic VS, Pekmezovic T

The symptoms of Parkinson’s disease (PD) worsen over time affecting performance and causing disability. The purpose of this study was to translate the Self-Assessment Disability Scale in patients with Parkinson’s disease (SADS-PD) into the Serbian language and assess its validity and reliability. From January to July 2012, 114 consecutive PD patients were recruited at the Neurology Clinic in Belgrade. The inclusion criteria were: ability to walk independently for at least 10 m, ability to stand for at least 90 s. The exclusion criteria were: cognitive impairment, the presence of other major neurologic, psychiatric, visual, audio-vestibular, and orthopedic disturbances. The 25-item SADS-PD was translated according to internationally-accepted methodology. The internal consistency of the scale was evaluated using Cronbach’s alpha coefficient. Test-retest reliability was evaluated using Kendall’s concordance coefficient for total scores. To evaluate construct validity, an exploratory factor analysis (principal component analysis, varimax rotation) was performed. Cronbach’s alpha coefficient was 0.984. Kendall’s concordance coefficient was 0.994. Duration of the disease, Hoehn & Yahr (H&Y) stage, Unified Parkinson’s Disease Rating Scale (UPDRS) motor score, history of falls, Hamilton’s Depression and Anxiety Rating Scales (HDRS and HARS) scores were significantly correlated with the total SADS-PD score. On factor analysis 25 items in the SADS-PD questionnaire were separated in two clusters with total matrix variance of 79.7 %. The psychometric properties of the cross-culturally adapted SADS-PD questionnaire (Serbian version) have outstanding validity and reliability as an instrument for evaluation of the extent of disability in patients with PD. HubMed – depression



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