Clinical Psychiatric Interview Research Articles

Usefulness of the Beck depression inventory in the diagnosis of depressive disorders in multiple sclerosis

Depression is one of the most prevalent psychiatric conditions in adulthood, reaching figures of around 20%. The methodologies used to study depression are varied, and range from a self-administered test to structured psychiatric assessment. Several studies of patients with multiple sclerosis (MS) have been conducted in the last 20 years, and figures of around 35% have been found for depressive symptoms, while depressive disorders are less frequent, at approximately 21%. The aim of this study is to evaluate the usefulness of patient self-reported scales such as the Beck depression inventory (BDI) for identifying depressive symptoms in patients with MS, and to analyse their correlation with the diagnosis of clinical depression or depressive disorder using the psychiatric clinical interview based on the criteria of the Diagnostic and statistical manual of mental disorders, fifth edition. This is a multicentre descriptive cross-sectional study of patients with MS and depressive symptoms. The BDI and the Hamilton depression rating scale (HDRS) were used, and the patients with the highest scores underwent psychiatric assessment. A total of 191 patients were included; 81 of these (40.5%) had depressive symptomatology in the pathological range according to the BDI (cut-off point of 14), and 20 had a severe score (above 28). Nineteen patients with severe depressive symptoms according to both scales were selected and finally evaluated by a psychiatrist, who also assessed five patients who according to the neurologist had severe depressive symptoms despite a BDI score of almost 28, but did not reach that level. The suspected major depressive disorder was confirmed in only four (21%) cases with BDI scores indicative of severe symptoms. There is no correlation between the severity score as evidenced by the BDI and the psychiatric assessment. A major depressive disorder was diagnosed in 16 (66.6%) of the 24 patients with BDI > 26 evaluated by psychiatry. A score above 26 on the BDI enables identification of 75% of cases of depressive disorder without subtyping. The correlation between the HDRS and the BDI was statistically significant (r = 0.8; p < 0). The BDI is a useful screening test for identifying patients with depressive symptoms; in specific terms, a score above 26 is probably indicative of a depressive disorder that may benefit from psychiatric assessment.

Psychometric properties of the Persian version of Conners Early Childhood ADHD Questionnaire-Parents’ Form in Iranian children aged 3-6 years

Background. Attention deficient-hyperactivity disorder (ADHD) is the most prevalent psychiatric diagnosis in preschool children. The present study aimed to translate and determine the validity and reliability of the Persian version of Conners Early Childhood Attention Deficit-Hyperactivity Disorder Questionnaire–Parents’ Form in Iranian children aged 3-6 years. Methods. We included 1,013 pediatrics aged &lt;6 years in 2017-18 in Tabriz, Iran. In the first step, the questionnaire was translated into Persian using the re-translation method. Then, the content validity of the questionnaire was evaluated by ten specialists. Finally, the concurrent validity of the questionnaire was simultaneously compared with the children’s Strengths and Difficulties Questionnaire (SDQ). ROC curve was used to determine the best cut-off point, and sensitivity and specificity were measured to determine the questionnaire’s diagnostic value compared to the clinical psychiatric interview. The test-retest method was used to determine reproducibility using the intra-class correlation coefficient (ICC). The internal consistency was also evaluated with Cronbach’s alpha test. Results. Of all the 1,013 participants, 569 (56.2%) were female. The overall modified kappa agreement and concurrent validity coefficients were 0.76 and 0.70, respectively. The sensitivity and specificity of the questionnaire was estimated 86.8% and 79.4%, respectively. The ICC was calculated at 0.90, and the questionnaire’s internal consistency was calculated at an overall Cronbach’s alpha coefficient of 0.88. Conclusion. The Persian version of Conners Early Childhood Attention Deficit-Hyperactivity Disorder Questionnaire–Parents’ Form exhibited proper reliability and validity for screening the Iranian pediatric population. Practical Implications. The emerged validated tool from the present study can be used in the first-line health system in the public and private sectors for physician and non-physician healthcare providers, especially family physicians in primary health care.

Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population

ObjectivesThe Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in...

Clinical characteristics of bipolar 1 disorder in relation to interleukin-6: a cross-sectional study among Egyptian patients

BackgroundStrong evidence in the literature points to the role of pro-inflammatory cytokines in bipolar disorder (BD) pathophysiology. Interleukin-6 (IL-6) is a pro and anti-inflammatory cytokine that was repeatedly found higher in bipolar patients than in healthy controls. However, studies on the phasic differences of IL-6 in bipolar type I (BP-I) were limited. This study aims to explore the phasic differences of serum IL-6 levels in BP-I during euthymia, depression, and mania and their association with the disease’s clinical characteristics in a sample of Egyptian BP-I patients. Thirty currently euthymic, 24 currently depressed, 29 currently manic BP-I patients, and 20 healthy subjects were recruited. Serum IL-6 levels were compared among BP-I groups and then between each group and a group of 20 healthy controls. Serum IL-6 levels (pg/ml) were measured with a sandwich enzyme-linked immunosorbent assay (ELISA). Depression and mania symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS), respectively. Clinical characteristics were evaluated through a semi-structured clinical psychiatric interview, and cognitive status was tested using the Montreal Cognitive Assessment (MoCA).ResultsSerum IL-6 levels were significantly higher in each bipolar phase than in healthy subjects. In the BP-I patients, IL-6 levels were lower in patients with a current manic episode than in patients with a current depressive episode (P < 0.05) or who were currently euthymic (P < 0.001). Moreover, IL-6 levels correlated inversely with the YMRS score (rs = − 0.29; P < 0.05). Compared to patients without psychotic features, patients with psychotic features had decreased serum IL-6. Moreover, IL-6 levels were lower in inpatients compared to outpatients.ConclusionsBP-I disorder is associated with an inflammatory state. The decreased levels of IL-6 during manic episodes, affective episodes with psychotic features, and their inverse correlation with the severity of mania symptoms indicate a possible anti-inflammatory role of IL-6 in mania and psychotic symptoms pathogenesis.

Neurodevelopmental disorders and comorbidity in young adults attending a psychiatric outpatient clinic

“Missed” cases with neurodevelopmental disorders (NDDs) within adult psychiatry services have attracted increasing attention in the last decade. Key questions have been what the prevalence of NDDs (particularly attention-deficit/hyperactivity disorder/ADHD and autism spectrum disorder/ASD) is, and what the clinical and gender characteristics of those with NDD in adult psychiatry are. All first-time attenders at an adult psychiatry clinic serving 18–25 years old were invited to take part in the study regardless of cause of concern. Participation in the study included diagnostic in-depth evaluation performed by experienced adult psychiatrists. Clinical diagnoses (DSM-IV-TR and DSM-5 criteria) were based on all available information (clinical psychiatric interview, clinical observation, and self-rating questionnaires). Almost two thirds (63%) of the study group met criteria for ADHD or ASD. Most of the patients with NDD (particularly the "NDD females") had not been diagnosed in childhood. Twelve percent of the females included had been given an ADHD diagnosis in childhood. In the current study we found that 48% of the females had ADHD. The high male:female NDD ratio reported among children, was not obvious in our NDD group. The results underscore the importance of screening for NDD in adult psychiatric services regardless of referral reason.

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

ObjectivesThe 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.MethodsCommunity-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.ResultsSeventeen 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%.ConclusionsThis 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.

Who will guard the guardians? Cross-sectional study on prevalence of psychiatric morbidity, quality of life, and coping skills in caregivers of children with thalassemia major.

Background:Patients of thalassemia major require frequent hospitalization. Caregivers are more affected than the patient themselves as they better appreciate the magnitude of illness and treatment, resulting in increased risks for psychiatric illness.Aims and Objectives:The purpose of the study was to assess the prevalence of psychiatric morbidity in the caregivers of patients with thalassemia major. The study also examined the quality of life of the caregivers, their coping strategies, and its association with sociodemographic variables.Methodology:A cross-sectional study with 100 caregivers, recruited by convenience sampling technique, attending the thalassemia daycare center, was carried out over 12 months in a tertiary care hospital. They were administered a semistructured proforma along with General Health Questionnaire 12 (GHQ 12), WHO-Quality of Life-BREF (WHO-QOL-BREF), and Coping Inventory for Stressful Situations 21 scale. The GHQ 12 was used for screening and those scoring three or more underwent a clinical psychiatric interview. Those who were diagnosed with psychopathology were ascribed diagnosis as per ICD-10. Descriptive analysis was done. Associations were studied using Fischer's exact test. Comparison of quality of life with blood transfusion variables was done using Mann–Whitney U test.Results:The prevalence of psychiatric morbidity amongst the caregivers was found to be 35% with depressive episode (22%) being the most common. Psychiatric morbidity was found to have a significant association with both, the frequency (P = 0.037) and total number of blood transfusions (P = 0.012). Coping was found to have a strong association with psychiatric morbidity (P = 0.001) and employment (P = 0.009).Conclusions:Caregivers of children with thalassemia major face psychological burden like depression or anxiety, for which treatment is not sought. Improved psychological health of the caregivers will ensure better care of the child and guarantee better adherence to the treatment.

TMAO (trimethylamine n-oxide) as a potential biomarker of individual severe stress perception in posttraumatic stress disorder (PTSD)-vulnerable patients after acute myocardial infarction

Abstract Background Acute myocardial infarction is not only a somatic disease but potentially triggers psychological effects, too. Post-traumatic stress disorder (PTSD) is a common stress-related disorder. It is characterized by numerous symptoms, such as flashbacks, intrusions, nightmares and severe anxiety, as well as uncontrollable, intense and disturbing thoughts and feelings related to the traumatic experience. However, with regard to the development of PTSD, individual stress perception might be crucial since not every serious traumatic experience leads to PTSD. To date, almost no biological correlates of an individual's perception of stress have been identified as being associated with the long-term development of PTSD. Objective The aim of the study was to determine whether blood levels of TMAO vary immediately after AMI (1) in patients with or without depression, and (2) in patients with AMI induced PTSD symptomatology (subsyndromal PTSD and full PTSD). Furthermore, we investigated whether TMAO is a potential biomarker that might be useful in the prediction of PTSD symptomatology in the long term. Method A total of 114 AMI patients were assessed with standardized clinical psychiatric interviews based on the Hamilton Depression Scale (HAMD-17) after admission to the hospital and 6 months later. In addition, the CAPS-5 was used to explore PTSD symptoms (subsyndromal PTSD and full PTSD) 6 months after AMI. To assess patients' TMAO status, serum samples were collected at hospitalization and 6 months after AMI. Results Study participants with post-myocardial infarction PTSD symptomatology (subsyndromal PTSD and full PTSD) had significantly higher TMAO levels immediately after AMI than patients without PTSD symptoms (ANCOVA: TMAO (PTSD x time), F = 4.544, df = 1, p=0.035). In contrast, depressive symptomatology 6 months after AMI had no influence on TMAO levels (TMAO (depression x time), F = 0.083, df = 1, p=0.774). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO becomes a significant predictor of PTSD symptomatology. Conclusions An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increased gut permeability to trimethylamine (TMA), the precursor of TMAO. Thus, elevated TMAO might be a biological correlate for stress that is associated with vulnerability to PTSD and might help to identify patients at increased risk. Funding Acknowledgement Type of funding sources: None.

AGGRESSIVE BEHAVIOR AND SUICIDE PROBABILITY IN ADOLESCENT MALES

Background: Aggressive behavior and probability of suicide in adolescents are increased in last decades this affects most communities in our world increasing and socio-economic burden and stress health care facilities. Objective: To compare suicide probability and aggressive behavior in rural and urban areas and relation between probability of suicide and aggressive behavior in adolescents. Patients and Methods: Total sample of this study was 295 male student,105 student from Zorkan secondary school at Zorkan Village, Tala Center, El-Menofeya Governorate and 190 students from Khalil Agha secondary school in Bab El-Sheria Cairo Governorate selected in random manner. All participants were subjected to suicide probability scale, semi-structured clinical psychiatric interview and socioeconomic standard form during the period from December 2019 to April 2020. Results: This study revealed that there was a high suicide risk in the sample divided into three groups: group of mild risk (46.1%), group of moderate risk (25.1%) and group of sever risk (11.9%), Suicide risk increased in urban sample than rural sample in statistical significant degree, There was a positive correlation between suicide risk and aggressive behavior in statistical significant degree, Prevalence of psychiatric disorders was(11.53%) in the total sample, (11.58%) in urban sample and (11.435%) in rural sample, Prevalence of depression in rural sample was (8.57%) and (7.89%) in urban sample while prevalence of generalized anxiety disorder in rural sample was (2.86%) and in urban sample was (2.635%), Prevalence of obsessive- compulsive disorder in urban sample was (1.05%) and no cases in rural sample, there was a positive correlation between suicide probability, aggressive behavior and psychiatric morbidity in a significant degree in the sample as a whole. Conclusion: Suicide probability and aggression in adolescents was increased in urban areas in Egypt than in rural areas also the increasing rate of aggressive behavior increased the rate of probability of suicide in adolescents.

Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up

COVID-19 outbreak is associated with mental health implications during viral infection and at short-term follow-up. Data on psychiatric and cognitive sequelae at medium-term follow-up are still lacking. During an ongoing prospective cohort study, the psychopathological and cognitive status of 226 COVID-19 pneumonia survivors (149 male, mean age 58) were prospectively evaluated one and three months after hospital discharge. Psychiatric clinical interview, self-report questionnaires, and neuropsychological profiling of verbal memory, working memory, psychomotor coordination, executive functions, attention and information processing, and verbal fluency were performed.Three months after discharge from the hospital, 35.8% still self-rated symptoms in the clinical range in at least one psychopathological dimension. We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up. Sex, previous psychiatric history, and the presence of depression at one month affected the depressive symptomatology at three months. Regardless of clinical physical severity, 78% of the sample showed poor performances in at least one cognitive domain, with executive functions and psychomotor coordination being impaired in 50% and 57% of the sample.Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted self-rated depressive symptomatology and cognitive impairment at three-months follow-up; and changes of SII predicted changes of depression during follow-up. Neurocognitive impairments associated with severity of depressive psychopathology, and processing speed, verbal memory and fluency, and psychomotor coordination were predicted by baseline SII.We hypothesize that COVID-19 could result in prolonged systemic inflammation that predisposes patients to persistent depression and associated neurocognitive dysfunction. The linkage between inflammation, depression, and neurocognition in patients with COVID-19 should be investigated in long-term longitudinal studies, to better personalize treatment options for COVID-19 survivors.

Thought Suppression in Primary Psychotic Disorders and Substance/Medication Induced Psychotic Disorder.

Introduction: First episode-psychosis (FEP) represents a stressful/traumatic event for patients. To our knowledge, no study to date has investigated thought suppression involved in FEP in a Romanian population. Our objective was to investigate thought suppression occurring during FEP within primary psychotic disorders (PPD) and substance/medication induced psychotic disorders (SMIPD). Further, we examined the relationship between thought suppression and negative automatic thoughts within PPD and SMIPD. Methods: The study included 30 participants (17 females) with PPD and 25 participants (10 females) with SMIPD. Psychological scales were administered to assess psychotic symptoms and negative automatic thoughts, along a psychiatric clinical interview and a biochemical drug test. Results: Participants in the PPD group reported higher thought suppression compared to SMIPD group. For the PPD group, results showed a positive correlation between thought suppression and automatic thoughts. For the SMIPD group, results also showed a positive correlation between thought suppression and automatic thoughts. Conclusions: Patients with PPD rely more on thought suppression, as opposed to SMIPD patients. Thought suppression may be viewed as an unhealthy reaction to FEP, which is associated with the experience of negative automatic thoughts and might be especially problematic in patients with PPD. Cognitive behavioral therapy is recommended to decrease thought suppression and improve patients’ functioning.

Study of Depression in Attention Deficit Hyperactive Disorder Subtypes in sample of children patients

Abstract: Background: Attention deficit hyperactivity disorder (ADHD) has three subtypes : hyperactive, inattentive and mixed types each of them has role in development and presence of depression. So the purpose of this study to detect the association between each subtype and presences of depressive disorder. This study comparative study done on ADHD patients took place at the outpatient child and adolescent psychiatric clinic at Al-Hussien University Hospital in Cairo, were recruited from January to June 2017. The children was assessed at first by Psychiatric semi-structured clinical interview then Complete medical and neurological examination, The Arabic version of MINI Kid were applied on children with ADHD. Results: The total sample size at time of study was 96 child only 64 child which fit the inclusion criteria then they divided into three groups depending on the type of ADHD according to mini kid scale. Group 1 hyperactive type was 18.7%, Group 2 inattentive type was 56.3% and Group 3 mixed type was 25%. Male sex was more predominant, depression was more prevalent in inattentive type of ADHD in all the sample while inside each group depressed patients present in hyperactive group more than non-depressed patients. There was positive correlation between age and presence of depression in hyperactive type, while there was a negative correlation with the other two groups. Conclusion: ADHD subtypes affect development of depression as found that The inattentive participants more susceptible for depression. Moreover, Age may be risk factor for depression in hyperactive type.

Anxiety, depression and perceived stress among breast cancer patients: single institute experience

BackgroundStatistics reveal that the number of women diagnosed with breast cancer is increasing in Egypt. It is seen as a terrifying disease due to its high mortality rate and its impacts on the self-image and the sexual relationship. Many of its patients experience psychological reactions and may have psychiatric morbidities. The present study aimed to identify the prevalence and associated psychosocial factors of anxiety, depressive disorders, and perceived stress among breast cancer patients in Menoufia university hospitals. This cross-sectional study was conducted in the Clinical Oncology Department, Menoufia University. Sixty patients were subjected to questionnaires for socio-demographic data, structured psychiatric clinical interview to screen for psychiatric diagnoses, Beck Depression Inventory (BDI-II) for measuring the emotional, cognitive and motivational symptoms of depression, Manifest Anxiety Scale to assess the degree of anxiety, and Perceived Stress Scale (PSS-10) to assess stress level.ResultsThe prevalence of depressive symptoms, anxiety symptoms, and perceived stress were 68.6%, 73.3%, and 78.1% respectively. Moderate to severe anxiety, depression, and stress were more prevalent among advanced disease patients, patients who underwent surgery, married patients, patients who were living in rural areas, illiterate, and those without satisfactory income but without statistically significant difference except for the effect of occupation on the anxiety state as unemployed patients had significantly higher prevalence of moderate to severe anxiety (100%) than employed patients p = 0.003.ConclusionDepressive disorders, anxiety, and perceived stress are common psychiatric disorders among the studied breast cancer patients. Understanding these common psychiatric disorders and associated stress can help to plan for their management.

Improved quality of life and reduced depressive symptoms in medical students after a single-session intervention.

Objective:Anxiety and depression are prevalent among medical students. Brazilian medical students have higher levels of depression and lower quality of life than their U.S. counterparts, and no preventive intervention exists for this risk group in Brazil. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral treatment protocol for neuroticism, was recently adapted into a single-session, preventive intervention. This study tested the impact of this protocol on psychiatric symptoms and quality of life in Brazilian medical students.Methods:In this open trial, the intervention protocol was translated and adapted to Brazilian Portuguese. Medical students over 18 years of age without psychotic symptoms, severe depressive episodes, or acute psychiatric risk were included, undergoing a psychiatric clinical interview (Mini-International Neuropsychiatric Interview [MINI]) and evaluation at baseline and at 7 and 30 days after a single-session UP that included experimental avoidance, quality of life, self-esteem, empathy, and anxiety symptom scales. A new evaluation was performed 90 days after the intervention.Results:Sixty-two students participated. Ninety days after the intervention, there were significant reductions in the number of students who met the criteria for social anxiety disorder (p = 0.013) or panic disorder (p = 0.001). There were also significant improvements in depressive symptoms (Beck Depression Inventory, p < 0.001) and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire, p < 0.001).Conclusion:UP improved anxiety and depressive symptoms in medical students. The single-session group format could reduce costs and facilitate application. Future placebo-controlled studies are necessary to confirm these findings.

Development of the Korean Practice Parameter for Adult Attention-Deficit/Hyperactivity Disorder.

Objectives:Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals.Methods:The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review.Results:According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners’ Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching.Conclusion:The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

Comparison of Attention-Deficit/Hyperactivity Disorder Practice in Adults According to a Training Background in Child Psychiatry.

Objectives:Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD.Methods:A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry.Results:In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP.Conclusion:Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.

Impairment of Quality of Life Associated With Lifetime Diagnosis of Post-traumatic Stress Disorder in Women - A National Survey in Italy.

Introduction:The aim of the study was to measure the lifetime prevalence of Post-Traumatic Stress Disorder (PTSD) among women of an Italian community sample, the comorbidity of PTSD with mood and anxiety disorders and the burden attributable to PTSD in worsening the Quality of Life (QoL).Methods:Community survey on a sample of 1961 adult women randomly selected. Tools: psychiatric clinical interview ANTAS partially derived from the SCID-DSM-IV, administered by psychologists or medical doctors; Short Form Health Survey (SF-12); Mood Disorder Questionnaire (MDQ).Results:Lifetime prevalence of PTSD in women was 1.3%, (1.4% in<45 years aged, 1.3% in >44 years aged; p=0.8). In order of risk of comorbidity, PTSD was associated with: Bipolar Spectrum Disorders (MDQ+), Panic Disorders (PD) and Major Depressive Disorder (MDD). People with PTSD showed an SF-12 mean score lower than women of the same sample without PTSD (standardized by gender and age), with a mean difference (attributable burden) of 3.9±0.9 similarly to MDD and Eating Disorders and higher than PD. Among the analyzed nonpsychiatric diseases, Multiple Sclerosis and Carotid Atherosclerosis showed a higher burden in impairing QoL than PTSD; Wilson’s Disease showed a similar burden and Celiac Disease was found less impairing on QoL than PTSD.Conclusion:The attributable burden in worsening women’ perceived QoL due to a lifetime diagnosis of PTSD was found comparable to those caused by MDD, Eating Disorders or by neurological condition such as Wilson’s Disease. The comorbidity of PTSD with Bipolar Spectrum Disorders was remarkable, even further studies are needed to clarify the direction of causality.

Self-efficacy and acceptance of disability following mild traumatic brain injury: A pilot study

Recovery from mild traumatic brain injury (mTBI) and regaining emotional equilibrium afterward can take much longer than the typical three months. Recent works attribute persisting complaints to psychological factors, primarily the negative perception of mTBI. However, research has yet to demonstrate how self-beliefs concerning capability are linked to perception and ability to accept injury. The objective of this study was to investigate how perceived general self-efficacy (GSE) and acceptance of disability (AD) relate to emotional outcome following mTBI. Thirty individuals aged 21–57, all of whom were at least three-month post diagnosis of mTBI, underwent a psychiatric clinical interview assessing depression, post-traumatic stress disorder (PTSD), and quality of life (QoL), and completed self-report scales to evaluate psychological factors. Scores on AD, depression, and QoL for most life domains were significantly lower and worse than among the normative population. Pearson coefficients indicated significant correlations between psychological factors and emotional outcome. Mediation analysis showed a significant role of AD in mediating the correlation between GSE and depression/general QoL, irrespective of PTSD. Low self-efficacy accentuates negative perception of the injury which, in turn, leads to poor emotional outcomes post mTBI. Therefore, AD should become the focus of therapeutic interventions.

Effectiveness of Providing Cognitive-behavioral Group Therapy for Both Children and their Parents Separately in the Treatment of Childhood Major Depressive Disorder: A Pilot Study

Background: Three social learning mechanisms were hypothesized to influence the development of depressogenic cognitive styles: modeling of parents’ negative cognitive styles; direct learning from negative parental inferential feedback regarding the stressful events in the child’s life; and indirect learning from negative parenting practices. In this study, I proposed an approach addressing psychopathology in parents as well as their children through providing cognitive behavioral therapy for both, separately, in treatment of childhood Major depressive disorder. This study’s objective is to evaluate the effectiveness of this approach. Method: Cognitive behavioral group therapy was provided separately to seven children diagnosed with Major depressive disorder, and their parents in 12 weekly 1-hour sessions. Parents’ sessions were parallel to children sessions, focused on learning the same skills and techniques taught in the children’s groups, targeting modifying negative cognitive styles of parents as well as children. Psychiatric clinical interview by specialized child psychiatrists and Parent-rated Mood and Feelings Questionnaire (PMFQ) were used pre- and post-treatment to evaluate depressive symptoms. Results: At the end of the treatment, all children no longer met criteria for major depressive disorder. There were statistically significant reductions in scores of parent-rated Mood and Feelings Questionnaire, which also demonstrated that none of the children no longer had a score indicative of depressive disorder. Conclusion: This study suggested that providing cognitive behavioral group therapy for both children and their parents, separately, is an effective approach for childhood major depressive disorder treatment.

Self-Monitoring and Self-Efficacy Increase with a Smartphone Application: A Technical Approach to Treating Bipolar Disorder?-Study Protocol for a Clinical Validation Trial

Background: Bipolar disorder (BD) is characterized by mood fluctuations, which are often recognized late by those who are affected. Symptom monitoring via smartphone seems to be an inexpensive and feasible method to detect these fluctuations earlier. The aim of an application (app) for smartphones is to record individual activity patterns (e.g. physical activity, sleep-wake rhythm, digital communication) as characteristic for mood swings in individuals with BD. Methods: We developed the UP! app for Android smartphones, which collects subjective mood daily and continuous data about movement, exercise, sleep duration and intensity of digital communication via GPS and sensors. This pilot trial will include 24 individuals with BD and 24 healthy controls (HC) without a mental disorder. The main aim of this study is to assess the app’s validity to detect mood fluctuations and illness episodes in comparison to a clinical psychiatric interview, validated questionnaires and a fitness tracker. A second aim is to determine whether changes in activity patterns, measured with the app, can detect early warning symptoms of depressive and/or manic episodes. The third aim is the evaluation of users’ acceptance of the app. The recruitment of participants (planned n=48) is ongoing. Discussion: Behavior patterns recognition via smartphone could present an innovative, technological tool for the early detection of BD episodes and could be valuable for long-term research. Registration Details: The trial is approved by the ethics committee of the Medical University Graz, Austria (29-290 ex 16/17). The trial is registered at ClinicalTrials.gov as NCT03275714.