bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying depression and anxiety in a 40‐year epidemiological investigation: the Stirling County study
Authors: Murphy Jane M. , Monson Richard R. , Laird Nan M. , Sobol Arthur M. , Leighton Alexander H.
Published: March 2006

As a longitudinal investigation, the ‘Stirling County study’ involves a 40‐year period beginning with the drawing of a sample in 1952 for a survey of psychiatric disorders. In 1970 a new sample was drawn and subjects from 1952 were followed, and in 1992 another new sample was drawn and all 1952 and 1970 subjects were followed. During these years, knowledge about psychiatric disorders has increased in the population at large; changes in everyday language about them have occurred and criteria for identifying them have been improved. This report describes adaptations of methods designed to overcome some of the problems inherent in such changes.

A revised computerized algorithm named DPAX‐2 (DP for depression and AX for anxiety) is described. The first version, DPAX‐1, deals with a core set of questions that have been asked in identical fashion throughout the study. Early investigations of validity indicated that DPAX‐1 appeared to be an adequate method for the period from 1952 through 1970. The revised version was constructed after data gathering for the 1990s phase of research documented that vocabulary changes had taken place. DPAX‐2 addresses these changes by having more questions about states of sadness and apprehension. It also takes into account improvements introduced as ‘supplements’ that come after the core questions in the interview schedule. These improvements were available in the data collected for 1970 but have not thus far been utilized in reports about longitudinal findings because of their absence from the 1952 data.

Evidence is presented that DPAX‐1 and DPAX‐2 were well correlated in 1970 and became considerably less so by 1992. This result, in conjunction with increased diagnostic sophistication in the responses of subjects to open‐ended questions in the 1990s, suggests that the common parlance, especially about depression, began to change after 1970. It was also mainly after 1970 when antidepressant medications began to be widely used, a fact that may have influenced awareness about depression and the language for describing it.

For comparison, depression and anxiety modules of the more recently developed Diagnostic Interview Schedule (DIS) were also part of the interview protocol in the 1990s. To explore validity, the Structured Clinical Interview for DSM‐IIIR (SCID) was administered to a subsample. Agreement with the SCID results was better for DPAX‐2 than for DPAX‐1. Agreement with SCID was somewhat higher for the DIS, but DPAX‐2 and the DIS showed almost equivalent sensitivity. In conclusion, the most satisfactory approach to studying the effects of ‘time's arrow’ in the Stirling County study will be to use DPAX‐1 for the period 1952 to 1970 and DPAX‐2 for the period 1970 to 1992. The level of articulation between the two versions will therefore be discernible at the middle phase of the study. Copyright © 1998 Whurr Publishers Ltd.
Generalized anxiety disorder, obsessive‐compulsive disorder and social phobia: sources of dissonance between ICD‐10 and DSM‐IV
Authors: Andrews Gavin , Slade Tim , Peters Lorna , Beard John
Published: March 2006

The present study examined the diagnostic concordance between ICD‐10 and DSM‐IV in generalized anxiety disorder (GAD), obsessive‐compulsive disorder (OCD) and social phobia. The Composite International Diagnostic Interview was administered to 1504 people, in a sample derived from community and clinic cases, and discrepant diagnoses were identified for ICD‐10 and DSM‐IV GAD, OCD and social phobia. The initial analysis yielded 243 positive GAD, 41 positive OCD, and 190 positive social phobia diagnoses on one or the other classification, yet only 54%, 64%, and 39% of these respective diagnoses were concordant on both classifications. After removing potential errors with the ICD‐10‐DCR criteria for GAD and in the way the Composite International Diagnostic Interview (CIDI) and scorer operationalized the diagnostic criteria there were 426 diagnoses in the three disorders of which 298 (70%) were concordant. The residual discordance reflects the magnitude of the difference between the two diagnostic systems and researchers should be aware of this when they are making cross‐national comparisons of prevalence rates. Copyright © 1998 Whurr Publishers Ltd.
Modelling the frequency of psychiatric admissions
Authors: McKenzie Dean P. , Mackinnon Andrew J. , Martindale Colin , Clarke David M.
Published: March 2006

The analysis of readmissions has important implications in psychiatric research, particularly in the areas of emergency‐room administration, diagnostic classification, treatment and policy planning. Although many studies have attempted to evaluate possible predictors of readmission, commonly employed statistical techniques generally ignore the fit of probability distributions of readmissions to the data. One type of probability distribution – the negative binomial – has previously been successfully fitted to readmission data and has been found to give a closer fit than a commonly employed distribution, the Poisson. Employing a form of generalized linear model – negative binomial regression – we extend these findings to another set of readmission data, using readily available statistical software. Copyright © 1998 Whurr Publishers Ltd.
To what degree does the Composite International Diagnostic Interview (CIDI) correctly identify DSM‐IV disorders? Testing validity issues in a clinical sample
Authors: Reed Victoria , Gander Franz , Pfister Hildegard , Steiger Axel , Sonntag Holger , Trenkwalder Claudia , Sonntag Annette , Hundt Wolfgang , Wittchen Hans‐Ulrich
Published: March 2006

This paper compares diagnoses of the DSM‐IV algorithms of the computer‐assisted version of the Munich‐Composite International Diagnostic Interview (M‐CIDI) with clinical diagnoses made by treating physicians using the standard LEAD procedure. A random sample of 68 patients being treated in three psychiatric and one neurological ward of the Max Planck Institute of Psychiatry were first examined with the CIDI, using the M‐CIDI/DSM‐IV algorithms. Diagnostic findings were then compared with lifetime and cross‐sectional diagnoses assigned by the treating physician, who was blind to the CIDI findings, taking into account all available symptom and diagnostic information from current and previous charts as well as his own assessments. Clinicians were encouraged to use the DSM‐IV manual to assign multiple lifetime diagnoses and not to focus exclusively on primary diagnoses. To explore agreements and disagreements further, all discrepant cases were subsequently discussed with the treating physicians. There was generally good concordance between clinicians and interview DSM‐IV diagnoses, with the exception of psychotic disorders (kappa: 0.21), dysthymia (0.54) and somatoform disorders (0.50), with kappa values for the remaining categories ranging from 0.63 (any panic disorder) to 0.96 (any depressive episode). It is concluded that the M‐CIDI, in clinical cases, provides valid diagnoses for almost all non‐psychotic disorders and is sensitive for all disorders but might have reduced specificity and predictive value in some anxiety and somatoform disorders. Copyright © 1998 Whurr Publishers Ltd.
Panic and agoraphobia: sources of dissonance between ICD‐10 and DSM‐IV
Authors: Andrews Gavin , Slade Tim
Published: March 2006

The present study examined the diagnostic concordance between ICD‐10 and DSM‐IV for panic and agoraphobia in a sample derived from clinic and community cases. The Composite International Diagnostic Interview was administered to 1504 people and discrepant diagnoses were identified for the three pairs of ICD‐10/DSM‐IV panic and agoraphobia disorders. The initial analyses produced 271 diagnoses in the three disorders yet only 103 (38%) of the diagnoses were concordant on both classifications. After possible errors in the CIDI and in the construction of the diagnostic criteria had been removed, there were 245 diagnoses in the three disorders of which 137 (56%) were concordant. The two classifications identify different groups of people but use similar names for the diagnoses, a fact that could interfere with the orderly accumulation and integration of knowledge from international research. Copyright © 1998 Whurr Publishers Ltd.
Measuring the sensitivity to change of the Role Functioning Scale through the utilization of the RCID index
Authors: Wieduwilt Kristin M. , Jerrell Jeanette M.
Published: March 2006

This study presents data on the sensitivity to change of the Role Functioning Scale (RFS) in assessing improvement in psychosocial functioning among persons with severe and persistent mental illness after exposure to different clinical interventions. The sample for this study was composed of 122 severely and persistently mentally ill clients who received outpatient services in one of three case‐management conditions as part of a randomized clinical trial. Utilizing the twofold criteria of the RCID index proposed by Jacobson and Truax (1991) evidence was found for the sensitivity of the RFS to detect statistically reliable and clinically significant changes in client functioning as a result of the treatment interventions. The global score of the RFS demonstrated highly significant treatment effects, as well as moderate to large effect sizes. Results from the current study, as well as those presented in previous psychometric studies of the RFS indicate that this measure can be used effectively in outcome studies of the severely and persistently mentally ill to assess treatment efficacy reliably and accurately. Copyright © 1998 Whurr Publishers Ltd.
The World Health Organization Composite International Diagnostic Interview short‐form (CIDI‐SF)
Authors: Kessler Ronald C. , Andrews Gavin , Mroczek Daniel , Ustun Bedirhan , Wittchen Hans‐Ulrich
Published: March 2006

Data are reported on a series of short‐form (SF) screening scales of DSM‐III‐R psychiatric disorders developed from the World Health Organization's Composite International Diagnostic Interview (CIDI). A multi‐step procedure was used to generate CIDI‐SF screening scales for each of eight DSM disorders from the US National Comorbidity Survey (NCS). This procedure began with the subsample of respondents who endorsed the CIDI diagnostic stem question for a given disorder and then used a series of stepwise regression analyses to select a subset of screening questions to maximize reproduction of the full CIDI diagnosis. A small number of screening questions, between three and eight for each disorder, was found to account for the significant associations between symptom ratings and CIDI diagnoses. Summary scales made up of these symptom questions correctly classify between 77% and 100% of CIDI cases and between 94% and 99% of CIDI non‐cases in the NCS depending on the diagnosis. Overall classification accuracy ranged from a low of 93% for major depressive episode to a high of over 99% for generalized anxiety disorder. Pilot testing in a nationally representative telephone survey found that the full set of CIDI‐SF scales can be administered in an average of seven minutes compared to over an hour for the full CIDI. The results are quite encouraging in suggesting that diagnostic classifications made in the full CIDI can be reproduced with excellent accuracy with the CIDI‐SF scales. Independent verification of this reproduction accuracy, however, is needed in a data set other than the one in which the CIDI‐SF was developed. Copyright © 1998 Whurr Publishers Ltd.
Multidimensional assessment of outcome in psychiatry: the use of graphical displays. The South‐Verona Project 2
Authors: Ruggeri Mirella , Riani Marco , Rucci Paola , Biggeri Annibale , Tansella Michele
Published: March 2006

In psychiatry, the assessment of outcome, to be relevant for clinical practice, should be multidimensional. This demands suitable statistical tools both to represent and to analyse the complex relationships between variables. This paper aims to provide guidelines for selecting graphical displays of multidimensional data that enable better capturing of the relationships between variables and summarize information available for individual cases as well as for groups of patients. Multivariate graphical techniques such as Chernoff faces, stars, parallel co‐ordinates and Andrews plots are applied to a set of data drawn from the South Verona Outcome Project, a naturalistic study based on a multidimensional model for the assessment of outcomes, routinely conducted at the Institute of Psychiatry of the University of Verona, Italy. The assessment includes global functioning, psychopathology, social disability, subjective quality of life, and satisfaction with services, number of service contacts and days of hospitalization.

The selected sequence of graphical displays allows a quick understanding of the multivariate data set not otherwise obtainable with numerical indexes and specifically enabled us to: (a) picture the characteristics of the data set on each single variable; (b) identify relationships between two or more variables; (c) identify peculiarities of individual patients and of group of patients. In psychiatry and in other areas of medicine a graphical approach to multidimensional data is a useful analytical tool for increasing the impact of outcome studies, in everyday clinical practice and in monitoring and evaluating of services. Copyright © 1998 Whurr Publishers Ltd.
Use of multiple informant data as a predictor in psychiatric epidemiology
Authors: Horton Nicholas J. , Laird Nan M. , Zahner Gwendolyn E.P.
Published: March 2006

Multiple informant reports of psychopathology are often collected in studies of psychiatric epidemiology. Previous reports have primarily focused on methods for handling multiple informant information when it is used to measure a psychiatric outcome in a regression model. Here we deal with methods for incorporating multiple informant reports as predictor variables (covariates) in regression modelling. In general, there is no single appropriate analytic strategy in this setting. Approaches seen in the literature include separate analyses by informant, inclusion of both reports in the model, or combination of the reports (using the ‘OR’ rule or use of concordant reports). Other approaches include use of measurement error models and latent class analysis. We review these approaches, discuss their relative advantages and disadvantages and illustrate them with an example where dichotomous reports of psychopathology are used to predict mental health service utilization in a community‐based sample. Copyright © 1999 Whurr Publishers, Ltd.
Criteria for early onset of action of an antidepressant from the clinical trial logistics point of view – methodological considerations
Authors: Niklson I.A.
Published: March 2006

Several authors have recommended various criteria for investigating the early onset of action (EOA) of an antidepressant. In this article some of the criteria that are most often mentioned were reviewed, considering clinical study design and logistics of the trial. The advantages and disadvantages of individual criteria are listed. Despite the existence of many recommendations, only a very limited number of them originate from scientific sources such as large databases. Moreover, some of the recommendations need to be viewed as suggestions as they do not originate from experience and data analysis. Individuals designing clinical trials to investigate EOA are left to try out different approaches, which are far from being internationally accepted and regulated. Copyright © 1999 Whurr Publishers, Ltd.
The development and initial validation of a telephone‐administered cognitive test battery (TACT)
Authors: Prince Martin J. , Macdonald Alison M. , Sham Pak C. , Richards Marcus , Quraishi Seema , Horn Isobel
Published: March 2006

Telephone interviews are increasingly recognized as a convenient assessment tool for epidemiological studies with geographically scattered samples, particularly where repeated assessments are to be made. We have compiled a telephone‐administered cognitive test battery (TACT) that aims to be sensitive enough to detect small but important degrees of early decline in cognitive function. The telephone‐administered cognitive test battery comprises tests of crystallized intelligence, logical memory, visuo‐spatial function, verbal fluency, and inductive reasoning. It incorporates a brief telephone assessment of cognitive status, the modified Telephone Interview for Cognitive Status (TICS‐m), already validated as a screening test for dementia. We carried out a preliminary pilot study on 98 volunteer twin subjects. The test was generally administered in less than 30 minutes. Most component test scores were normally distributed with no evidence of ceiling or floor effects. We tested for the effects of age and education, and estimated test–retest reliability. A second‐order factor analysis suggested that TACT measured three dimensions of cognitive function (1) logical memory, (2) crystallized intelligence and (3) the ability to learn and apply rules to abstract material under pressure of time. The last of these dimensions was the most influenced by age. The TACT is a convenient and efficient, yet comprehensive and demanding, measure of cognitive status with wide‐ranging applications in gerontological epidemiology, genetic epidemiology and health service evaluative research. Copyright © 1999 Whurr Publishers, Ltd.
Screening for mental disorders: performance of the Composite International Diagnostic – Screener (CID–S)
Authors: Wittchen H.‐U. , Höfler M. , Gander F. , Pfister H. , Storz S. , Üstün Bedirhan , Müller N. , Kessler R.C.
Published: March 2006

This paper introduces the Composite International Diagnostic – Screener (CID–S) for mental disorders, a 12‐item self‐report questionnaire that is based on core diagnostic questions from the Composite International Diagnostic Interview for the assessment of DSM‐IV and ICD‐10 disorders (CIDI) for use in two‐stage epidemiological designs. Data are reported relating to the performance of the CID–S in a two‐stage study of a random sample of 1095 respondents, using a wide range of DSM‐IV/CIDI diagnoses (somatoform, anxiety, depressive, other affective, and substance‐use disorders). In the first stage, all subjects filled out the screening instrument. Seven to 30 days later trained clinical interviewers administered the computer‐assisted full CIDI. The CID–S had an overall sensitivity of 85.3% (range for specific diagnoses 74.7% for alcohol use disorders to 100% for panic disorders) and negative predictive value (NPV) of 92.0% (range 91.0%–100%) for any current (12‐month) diagnosis and similar values for lifetime disorders (80.7%, NPV: 85.1%). Likelihood for a DSM‐IV diagnosis increased steadily from 10.5% among screen negatives, to 24.9% among those endorsing one screening item to 100% among those endorsing more than eight of the screening items. The performance of the individual CID–S items overall was good, except for three disorders: agoraphobia, somatoform disorders and substance use disorders. Overall, the CID–S was found to be a time‐efficient diagnostic screening tool for most mental disorders (except for some somatoform and substance use disorders), when used in a two‐stage design with a two to 12 week interval between investigations. Copyright © 1999 Whurr Publishers, Ltd.
Level of agreement between DIS and UM‐CIDI alcohol and marijuana use disorders: implications for research
Authors: Chilcoat Howard D. , Lucia Victoria C. , Breslau Naomi
Published: March 2006

By and large, recent epidemiological investigations of alcohol and drug use disorders are based on structured interviews, such as the Diagnostic Interview Schedule (DIS) and the Composite International Diagnostic Interview (CIDI), which are designed to be administered by trained lay interviewers. Little is known about the level of agreement between these instruments. To fill this gap, we compared responses from 971 young adults from an epidemiological sample, who were administered both the DIS and the University of Michigan CIDI (UM‐CIDI) in the same interview session. Level of agreement was estimated for responses to individual items, and for DSM‐IIIR abuse/dependence (A/D) diagnoses and symptoms for alcohol and marijuana. DIS/UM‐CIDI agreement for drug use disorders in the year preceding the interview was moderate for each disorder (alcohol A/D, kappa = 0.58; marijuana A/D, kappa = 0.68), although one‐year prevalences of alcohol and marijuana A/D were approximately 40% higher for the DIS compared to the UM‐CIDI. Despite the discrepancies, levels of comorbidity with other psychiatric disorders and associations with risk factors were similar for the DIS and UM‐CIDI. Copyright © 1999 Whurr Publishers Ltd.
The Center for Epidemiologic Studies Depression scale (CES‐D) in a mixed‐mode repeated measurements design: sex and age effects in older adults
Authors: Geerlings Sandra W. , Beekman Aartjan T.F. , Deeg Dorly J.H. , Tilburg Willem Van , Smit Jan H.
Published: March 2006

In order to obtain repeated measurements of depression in an efficient and relatively inexpensive design, a mixture of face‐to‐face interviews and mail questionnaires was employed. The aims of the study were to examine mode effects of face‐to‐face interviews versus mail questionnaires on depression scores and to test potential interactions between mode of data collection and sex and age of the respondents. In the study sample, which at the outset consisted of 327 depressed and 325 non‐depressed older adults (55–85 years) drawn from a larger random community based sample in the Netherlands, depression was measured in successive waves (cycles), using the Center for Epidemiologic Studies of Depression scale (CES‐D). With mode of data collection and sex and age of the respondents as independent variables, differences in CES‐D scores were analysed. The CES‐D scores were higher when collected by mail questionnaires than when face‐to‐face interviews were used. No systematic interactions between sex and age of the respondents with mode of data collection were found. For the scores based on mail questionnaires, a transformation is proposed, resulting in scores that are comparable to those obtained by interviews. In studying depression in older adults, more cost‐effective mail questionnaires may be used in addition to face‐to‐face interviews, provided that a transformation is performed before embarking on the analysis. Copyright © 1999 Whurr Publishers Ltd.
The validity of the associated symptom criteria for DSM‐IV generalized anxiety disorder
Authors: Turvey Carolyn L. , Stevens Denise E. , Merikangas Kathleen R.
Published: March 2006

In light of the poor reliability and discriminant validity of the DSM‐III‐R criteria for generalized anxiety disorder (GAD), extensive modifications were implemented in the development of the DSM‐IV criteria. This study compares the discriminant validity of the DSM‐III‐R and DSM‐IV criteria for GAD using data from a study of the familial aggregation of anxiety disorders and alcoholism. Based on information from a semi‐structured diagnostic interview, both the DSM‐III‐R and DSM‐IV associated symptom criteria were applied to characterize directly interviewed spouses and relatives of probands. The criterion‐related and discriminant validity of the DSM‐IV revised criteria were assessed according to the following clinical criteria: lifetime and concurrent comorbidity with depressive disorder and lifetime comorbidity with panic disorder. Subjects who met the DSM‐IV associated symptom with and without comorbid depression were then compared on rates of treatment, psychotropic medication use, impairment, age at onset and presence of a psychosocial stressor at onset. No differences were found in the discriminant validity of the DSM‐III‐R versus DSM‐IV definitions of GAD. It is postulated that the lack of difference in validity between the two diagnostic systems is due to the low prevalence of autonomic hyperactivity symptoms associated with GAD. Implications for the nosology of GAD and its relationship with other anxiety disorders are discussed. Copyright © 1999 Whurr Publishers Ltd.
Internal consistency and discriminant validity of the Structured Clinical Interview for Panic Agoraphobic Spectrum (SCI‐PAS)
Authors: Cassano G.B. , Banti S. , Mauri M. , Dell'Osso L. , Miniati M. , Maser J.D. , Shear M.K. , Frank E. , Grochocinski V. , Rucci P
Published: March 2006

This paper reports on the feasibility, acceptability and psychometric properties of the Structured Clinical Interview for Panic‐Agoraphobic Spectrum (SCI‐PAS). This interview was designed to assess the lifetime presence of symptoms and other clinical features considered to comprise the panic‐agoraphobic spectrum. The interview has 114 items grouped into nine domains. A total of 422 subjects, from 11 centres located throughout Italy, participated in this study. Data were collected from three groups of subjects: psychiatric patients meeting DSM‐IV criteria for panic disorder (n = 141), cardiovascular patients (n = 140), including 29 with post‐myocardial infarction, and university students (n = 141). The inter‐rater reliability and the internal consistency of the SCI‐PAS measures were assessed using the intra‐class correlation coefficient and the Kuder‐Richardson coefficient, respectively. Discriminant validity was assessed by comparing results in patients with panic disorder to those in the other groups. The interview required an average of 25 (±5) minutes to administer. Patients and clinicians found the scale to be highly useful, providing information not previously obtained. Internal consistency was good (>0.70) for six out of nine SCI‐PAS domains. The inter‐rater reliability was excellent (>0.70) for all the domains except for ‘other phobias’ (0.467). Patients with panic disorder scored significantly higher on each domain, and on the overall panic spectrum, than did the control subjects. In conclusion, the SCI‐PAS is a useful clinical interview, which can be administered in a reasonable period of time. This assessment further demonstrates good internal consistency, discriminant validity, and inter‐rater reliability. Copyright © 1999 Whurr Publishers Ltd.
Length of stay in a German psychiatric hospital as a function of patient and organizational characteristics – a multilevel analysis
Authors: Frick Ulrich , Rehm Jürgen , Krischker Stefan , Cording Clemens
Published: March 2006

Hierarchical linear modelling (HLM) was used to compare the influence of individual and organizational variables on patients' length of stay (LOS) in a large psychiatric hospital in Germany. Organizational variables used were characteristics of the different wards, such as capacity, staff workload, and diagnosis mix. About 28% of the variance in the final hierarchical model was explained by the wards (between‐wards variance) and about 13% by individual or ‘level‐1’ variables. Individual predictors with significant influence included age, diagnosis, level of social functioning and its improvement during therapy, medication, and discharge to complementary services or to subsequent outpatient treatment. Significant organizational variables influencing LOS were number of nursing personnel per bed day, average level of social functioning among patients of each ward, and proportion of patients with schizophrenic disorders treated in each ward.

The results are compared with other studies from the recent literature on LOS. General advantages of HLM in the comparisons of hospitals or other health care organizations are illustrated. It is concluded that HLM analysis should be employed regularly in quality management and cost‐containment studies of different healthcare providers. Copyright © 1999 Whurr Publishers Ltd.
Commentary on Höfler's proposed measure of specificity of an association of two disorders
Authors: Kraemer Helena Chmura
Published: March 2006

In this issue, Höfler has proposed a statistical method to determine the specificity of an association of two disorders (A and B) when A is also associated with a third disorder, C. Questions are raised concerning Höfler's approach. It is argued that the proposed measures suggest a problem that would be better addressed using other methods. Copyright © 1999 Whurr Publishers Ltd.
Gender differences in the relationship between early conduct problems and later criminality and substance abuse
Authors: Fergusson David M , Woodward Lianne J , Horwood L John
Published: March 2006

This paper develops a multiple group structural equation modelling approach for examining gender differences in developmental data. The approach is applied to data on the continuities between early conduct problems and later offending and substance use behaviour in an unselected birth cohort of 1265 New Zealand children studied to the age of 16. The principal conclusions of this analysis are that the model structures linking early conduct problems to later outcomes were similar for males and females, but that there were gender specific differences in test means, test variances and some regression parameters. The analysis supports the view that common theories may be applied to both males and females, but suggests that these theories need to be sufficiently flexible to permit some model parameters to vary with gender. Copyright © 1999 Whurr Publishers Ltd.
Consequences of the use of different classification systems: a comparison of the DSM‐III‐R and the ICD‐10 for depression
Authors: Ravelli Anneloes , Bijl Rob V , Brink Wim Van Den
Published: March 2006

This paper examines the consequences of applying two different psychiatric classification systems, DSM‐III‐R and ICD‐10. Focusing on depression, the prevalence rates, the sociodemographic, personality and family history determinants and the consequences (quality of life, use of care, need for care) are compared. Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a general population study among people 18–64 years of age. Depression was assessed by the Composite International Diagnostic Interview (CIDI). According to DSM‐III‐R, 15.7% of the population has suffered from depression at one point or another in their lives. For ICD‐10, this percentage was 20.3%. The differences in prevalence rates appear to stem primarily from differences in the inclusion criteria. The DSMIII‐R identifies a subset of more severe depressive categories and thereby produces lower prevalence rates, higher rates of comorbidity and stronger correlations between depression and its determinants and consequences. Copyright © 1999 Whurr Publishers Ltd.
Development and initial validation of the Parent–child Joint Activity Scale: a measure of joint engagement in activities between parent and pre‐school child
Authors: Chandani Kumari , Prince Martin James , Scott Stephen
Published: March 2006

A substantial body of literature links several specific dimensions of negative parenting to disruptive child behaviour. However, few population‐based studies have explored positive parenting practices in pre‐school children. The Parent–child Joint Activity Scale (PJAS), is a new self‐report instrument using parents as the informants for the assessment of parent–pre‐school child joint activities. Forty‐eight items were generated through a literature review and by eliciting opinions from professionals working with children, and parents of young children. A group of professionals and parents reviewed these items, to establish their content validity. Item analysis was carried out using a sample of 150 mothers of three‐ to four‐year‐old children. Finally, we selected 21 items for our scale which showed a good internal consistency and reliability. The concurrent validity of the scale was assessed against the amount of time that mothers spent in joint activity with their child, assessed in a semi‐structured interview called ‘Yesterday's Interview’. Validity was further established by contrasting scores on the new scale for two groups, nominated by their health visitors as characterizing high and low levels of parent–child joint activity. Finally, potential clinical applications and future research priorities are addressed. Copyright © 1999 Whurr Publishers Ltd.
Validity and reliability of the Structured Clinical Interview for Obsessive‐Compulsive Spectrum (SCI‐OBS) and of the Structured Clinical Interview for Social Phobia Spectrum (SCI‐SHY)
Authors: Dell'osso Liliana , Cassano Giovanni Battista , Sarno Nannina , Millanfranchi Alessandro , Pfanner Chiara , Gemignani Alfredo , Maser Jack D. , Shear M. Katherine , Grochocinski Victoria J. , Rucci Paola , Frank Ellen
Published: March 2006

This paper reports on the psychometric properties of the Structured Clinical Interview for Obsessive‐Compulsive Spectrum (SCI‐OBS) and the Structured Clinical Interview for Social Phobia Spectrum (SCI‐SHY). Interviews were administered to 135 patients with psychiatric disorders and 119 controls. During the same session, subjects were given the Mini International Neuropsychiatric Interview (MINI), the Liebowitz Social Anxiety Scale (LSAS), the Checklist for Obsessions and Compulsions and the Yale‐Brown Obsessive‐Compulsive Scale (Y‐BOCS). Patients and raters also answered specific questions on acceptability and usefulness of the interviews. Inter‐rater reliability was assessed by administering the interviews to 36 patients with psychiatric disorders and 12 controls. The internal consistency of all domains of the interviews was from moderate to substantial (Kuder‐Richardson coefficient >0.60). Discriminant validity was excellent. The concurrent validity of the SCI‐SHY versus the LSAS and of the SCI‐OBS versus the Checklist for Obsessions and Compulsions was satisfactory. However, no association was found between Y‐BOCS and the SCI‐OBS domains. Inter‐rater reliability was substantial. Both interviews were rated as meaningful and clear by most subjects. Raters' attitudes toward the utility of these interviews for understanding patients and their foreseeable use in their practice varied, but most were in favour of administering them as self‐report instruments. Copyright © 2000 Whurr Publishers Ltd.
Completed suicide among psychiatric in‐patients with depression in an Australian mental hospital
Authors: Shah Ajit , Ganesvaran Thirunavakarasu
Published: March 2006

Up to 45% of completed psychiatric in‐patient suicides have a diagnosis of depression. Twenty‐two completed psychiatric in‐patient suicides with depression, over a 21‐year period, in a large psychiatric hospital in Melbourne, Australia, were examined. The characteristics, including demographic and clinical data, for the completed suicides with depression were compared with a comparison group of ‘alive’ in‐patients with depression. Completed suicide among psychiatric in‐patients with depression was associated with male sex, suicidal thoughts during admission, and fluctuating suicidal ideation or continuous absence of suicidal ideation. Over 40% of completed suicides occurred whilst on approved leave and over 20% after absconding from the hospital. Violent methods (including jumping in front of trains, trams and road traffic, jumping of buildings, hanging and drowning) were used in over 65% of completed suicides. Psychiatric units should be developed away from readily available methods of suicide. In‐patients with suicidal thoughts during the admission and unstable suicidal ideation should be carefully observed to avoid absconding and suicide, and should be carefully assessed prior to granting of leave. Copyright © 2000 Whurr Publishers Ltd.
The Composite International Diagnostic Interview: feasibility and necessity of editing and interviewer training in general population surveys
Authors: Meyer Christian , Rumpf Hans‐Jürgen , Hapke Ulfert , John Ulrich
Published: March 2006

Current knowledge of the prevalence of psychiatric disorders in the general population is basically derived from highly standardized and fully structured interviews such as the Diagnostic Interview Schedule (DIS) and the Composite International Diagnostic Interview (CIDI), which were administered by psychiatric lay interviewers. The feasibility of the most recent German version of the CIDI, the Munich‐CIDI (M‐CIDI) was analysed with respect to unit and item non‐response. We also analysed the effects of editing and interviewer training, constituting quality assurance procedures that are inherent with the CIDI. A random sample of 4075 adults in a northern German region were interviewed by 56 psychiatric lay interviewers, using the M‐CIDI, enabling an assessment to be made of the most frequent DSM‐IV diagnoses over the whole lifespan. Editing was carried out by psychologists and was combined with weekly interviewer training and individualized feedback. Results show a negligible rate of interview‐induced unit non‐response (0.1% only partially completed interviews) and item‐non‐response due to refusal, except for illicit drug use (3%). Considerable item non‐response due to ‘don't know’ answers occurred in time‐related questions. Errors detected by editing led to data correction in 37% of all interviews. Alcohol, nicotine, and somatoform disorder sections were mainly affected on the level of items and diagnostic decision. Occurrence of errors decreased with increasing interviewer experience and training in CIDI administration, but was not associated with participants' characteristics such as age and educational level. Complex time‐related questions, allocation of physicians' diagnoses, and calculation of alcohol consumption index were most frequently subject to editing. We conclude that the application of editing may significantly influence the result of psychiatric epidemiological studies for some diagnostic categories. Findings are discussed on the background of future improvements of the CIDI. Copyright © 2000 Whurr Publishers Ltd.
The Inventory of Depressive Symptomatology (IDS): Clinician (IDS‐C) and Self‐Report (IDS‐SR) ratings of depressive symptoms
Authors: Rush A. John , Carmody Thomas , Reimitz Paul‐Egbert
Published: March 2006

This paper describes the rationale and methods entailed in developing the Inventory of Depressive Symptomatology (IDS) in both clinician‐rated (IDS‐C) and self‐reported (IDS‐SR) formats. Psychometric features of the both the IDS‐C and IDS‐SR are presented. These scales are compared to the Hamilton Rating Scale for Depression (HRS‐D) in the detection of symptom change in patients with major depressive (n = 184) or bipolar disorder (n = 141). The face validity and established psychometric features of the IDS‐C and IDS‐SR indicate that either may be useful in detecting symptom change, as well as in detecting residual symptoms in depressed patients. Further efforts to shorten each measure are indicated. Copyright © 2000 Whurr Publishers Ltd.
Subject and informant characteristics influence the reliability and validity of family history information: an analysis based on the generalized estimating equations approach
Authors: Heun Reinhard , Kockler Martin , Papassotiropoulos Andreas , Ptok Ursula , Fimmers Rolf
Published: March 2006

Family history information is a necessary surrogate for unavailable interview information in family studies. However, the reliability and validity of such information has rarely been assessed during the conduct of family studies. This paper presents a reanalysis of data on the reliability and validity of family history information for dementia and depression using the general estimation equations approach.

All available relatives of patients and controls were interviewed and questioned about the psychiatric morbidity of other family members. Interinformant reliability of this family history information was evaluated as well as factors influencing this information. The validity of family history was investigated by comparing the informant derived diagnoses with interview‐derived diagnoses. To account for possible lack of independence of family history provided by several family members on other family members, the generalized estimating equations (GEE) were used in statistical analysis.

The interinformant reliability for depression (kappa = 0.13) was low. It was fair for dementia (kappa = 0.34). The informants more frequently agreed about the diagnosis of dementia when the subject was older. The sensitivity of family history was 35.2% for dementia and 31.8% for depression. The specificity of family history information was generally above 97%. The sensitivity of family history increased significantly with the severity of both disorders. The sensitivity of the family history for dementia was higher when the informant was a first‐degree relative, when he was younger and when the index subject of the family suffered from dementia. The specificity of the family history was slightly reduced with higher age.

The observed low sensitivity of family history information leads to underestimation of psychiatric disorders. The informants provide more useful information on more severe disorders. The sensitivity of family history was higher in families with an affected index subject than in control families, so familial aggregation of dementia might be overestimated in studies using the family history method. Copyright © 2000 Whurr Publishers Ltd.
A standardized and reliable method to apply the Global Assessment of Functioning (GAF) scale to psychiatric case records
Authors: Mirandola M. , Baldassari E. , Beneduce R. , Italo A. , Segala M. , Tansella M.
Published: March 2006

The Global Assessment of Functioning (GAF) scale is widely used both in routine clinical practice and in research. However, its reliability has never been assessed when used to rate information in clinical records. The present study focuses on the development of a standardized method (an ongoing modelling process between raters) for establishing desired levels of inter‐rater reliability (IRR) in the application of the GAF to psychiatric case records. Fifty‐one patients at first‐ever contact with mental health services were included in the study. They were selected from a total sample of 662 first‐ever patients by using a systematic sampling. Three raters (resident psychiatrists at their third year of training) took part in a 12‐hour training programme, during which they were asked to assess the global psychological functioning of patients, taking into account information recorded in case records. The extent of agreement between raters was estimated by applying the ‘limits of agreement’ method and the ‘concordance correlation coefficient’. The training programme proved to be feasible, easy to administer and acceptable to psychiatrists in training with limited previous experience of using rating scales. Very high levels of concordance (all greater than 0.95) emerged between the three raters. The GAF, completed using information from case records included in the initial assessment form, appeared to be a reliable instrument, even when used by clinical psychiatrists in training. Copyright © 2000 Whurr Publishers Ltd.
New approach to translating instruments for cross‐cultural research: a combined qualitative and quantitative approach for translation and consensus generation
Authors: Sumathipala Athula , Murray Joanna
Published: March 2006

Translation is the very essence of ethnographic research. The current practice of translation and back translation of an instrument is considered by some as inadequate. We used a combined qualitative and quantitative method: a nominal group to translate and assess the extent of agreement (consensus measurement) on the appropriateness of the translation and resolve disagreement (consensus development).

A panel (n = 9) fluent in English and Sinhala, translated the 21‐item Bradford Somatic Inventory, independently of one another. Each member rated each individual translation independently, for conceptual and semantic equivalence based on predefined quantitative measures for consensus. Translations failing to reach consensus were discussed by the group for modifications and subjected to the process of consensus generation. Translations agreed to be inappropriate were excluded. Translations agreed as appropriate were subjected to ranking and the final selection.

The process of translation confirmed that only part of the original meaning could be expressed in local terms. This resulted in the loss of some connotations making the item too narrow, or conversely in having to expand the original meaning in the local language terms making the translated item broader.

No single participant produced a significantly different contribution to the final outcome than other participants. The range of contribution to the finally selected questionnaire was five to eight translations with median of seven. Therefore the likelihood of one individual producing a translation of an instrument with 100% probability of acceptance to a wider group is unrealistic.

A group is better placed to translate, modify or eliminate inadequate or ambiguous items and generate culturally appropriate translation with semantic and conceptual equivalents. The process we describe, to assess and guide translations by a group, is better than arbitrary decision making by one or more individuals handling the translations and back translations. The combined qualitative and quantitative approach provides a more rigorous, systematic and contextual approach to translations. Copyright © 2000 Whurr Publishers Ltd.
Successful treatment of major depression: the effects of positive and negative life events on time to remission
Authors: Tu Xin Ming , Sherrill Joel T. , Anderson Barbara , Ritenour Angela , Kupfer David J. , Frank Ellen
Published: March 2006

The relationships of stressful and of positive events to treatment response for depression have typically been studied separately using methods based on the rates of events and ultimate remission status. A novel data‐analytic approach was introduced that addresses the limitations of these ad hoc methods and provides more power for detecting effects of life events and other prognostic factors on treatment response.

Survival methodology with time‐varying covariates was used to delineate the simultaneous but separate effects of positive and negative aspects of life events occurring both prior to and during treatment among patients treated with interpersonal psychotherapy (IPT) alone or IPT followed with adjunctive fluoxetine or imipramine for recurrent unipolar depression.

Somewhat surprisingly, stressful events were not significantly related to response time, but neutral events during treatment were related to a prolonged time to remission both alone in univariate analysis and when considered along with other life‐event and prognostic covariates in multiple regression analyses. Positive events during treatment did not relate to remission, but those occurring on average 24 weeks prior to remission were associated with more rapid remission in univariate analysis. Other significant correlates of remission included endogeneity, which consistently related to more rapid remission.

Overall, these results underscore the importance of studying events, including seemingly neutral and temporally distal experiences, and support the use of the novel methodology in studying the impact of major life events and other prognostic factors on remission of depressive disorder. Copyright © 2000 Whurr Publishers Ltd.
Evaluating screening questionnaires using receiver Operating Characteristic (ROC) curves from two‐phase (double) samples
Authors: Bisoffi Giulia , Mazzi Maria Angela , Dunn Graham
Published: March 2006

The characteristics of psychiatric screening tests (for example, sensitivity, specificity, and AUC – the area under an ROC curve) are frequently assessed using data arising from two‐phase samples. Too often, however, the statistical methods that are used are incorrect. They do not appropriately account for the sampling design. Valid methods for the estimate of sensitivity, specificity and, in particular, the AUC, together with its standard error, are discussed in detail and a Stata macro for the implementation of these methods is provided. Simple weighting procedures are used to correct for verification biases arising from the two‐phase design, together with bootstrap or jackknife sampling for the calculation of valid standard errors. Copyright © 2000 Whurr Publishers Ltd.