Cross-Cutting Symptom Measure Research Articles

Personality Traits And Non Suicidal Self Injury In University Students

The study aimed to assess the relationship of personality traits (neuroticism, extraversion, agreeableness, conscientiousness and openness to experiences) with Non Suicidal Self Injury (NSSI) in University students. It was hypothesized that there is likely to be significant positive relationship of neuroticism with NSSI while significant negative relationship of extraversion, agreeableness, conscientiousness, and openness to experiences with NSSI was assumed [1]in University students. The sample comprised of three hundred university students who full filled DSM-5 criteria of NSSI (M=19.97, SD=1.62). The assessment measures used were: Demographic Form, The DSM-5 Level 1 Cross-Cutting Symptom Measure (APA-2013), The Big Five Personality Inventory (John & Srivastava, 1999) and The Alexian Brothers Assessment of Self-Injury (Washburn et al., 2015).The finding revealed significant positive relationship of neuroticism and NSSI while significant negative relationship of agreeableness, extraversion and conscientiousness with NSSI in University students. The study have implications for early detection, tailored interventions and prevention of NSSI.

Using recursive partitioning to predict presence and severity of suicidal ideation amongst college students

Objective Predicting the presence and severity of suicidal ideation in college students is important, as deaths by suicide amongst young adults have increased in the past 20 years. Participants We recruited college students (N = 5494) from ten universities across eight states. Method Participants answered three questionnaires related to lifetime and past month suicidal ideation, and an indicator of suicidal ideation in a DSM-5 symptom measure. We used recursive partitioning to predict the presence, absence, and severity, of suicidal ideation. Results Recursive partitioning models varied in their accuracy and performance. The best-performing model consisted of predictors and outcomes measured by the DSM-5 Level 1 Cross-Cutting Symptom Measure. Sexual orientation was also an important predictor in most models. Conclusions A single measure of DSM-5 symptom severity may help universities understand suicide severity to promote targeted interventions. Though further work is needed, as similar scaling amongst predictors could have influenced the model.

How much or how often? Examining the screening properties of the DSM cross-cutting symptom measure in a youth population-based sample.

The DSM Level 1 Cross-Cutting Symptom Measure (DSM-XC) allows for assessing multiple psychopathological domains. However, its capability to screen for mental disorders in a population-based sample and the impact of adverbial framings (intensity and frequency) on its performance are unknown. The study was based on cross-sectional data from the 1993 Pelotas birth cohort in Brazil. Participants with completed DSM-XC and structured diagnostic interviews (n = 3578, aged 22, 53.6% females) were included. Sensitivity, specificity, positive (LR+), and negative (LR-) likelihood ratios for each of the 13 DSM-XC domains were estimated for detecting five internalizing disorders (bipolar, generalized anxiety, major depressive, post-traumatic stress, and social anxiety disorders) and three externalizing disorders (antisocial personality, attention-deficit/hyperactivity, and alcohol use disorders). Sensitivities and specificities >0.75, LR+ > 2 and LR- < 0.5 were considered meaningful. Values were calculated for the DSM-XC's original scoring and for adverbial framings. Several DSM-XC domains demonstrated meaningful screening properties. The anxiety domain exhibited acceptable sensitivity and LR- values for all internalizing disorders. The suicidal ideation, psychosis, memory, repetitive thoughts and behaviors, and dissociation domains displayed acceptable specificity for all disorders. Domains also yielded small but meaningful LR+ values for internalizing disorders. However, LR+ and LR- values were not generally meaningful for externalizing disorders. Frequency-framed questions improved screening properties. The DSM-XC domains showed transdiagnostic screening properties, providing small but meaningful changes in the likelihood of internalizing disorders in the community, which can be improved by asking frequency of symptoms compared to intensity. The DSM-XC is currently lacking meaningful domains for externalizing disorders.

The role of interpersonal trauma and substance use in mental health: A large population-based study

Both interpersonal trauma (IPT) and substance use are linked to mental health problems, however their interplay is understudied. This study will investigate the relationship between IPT, substance use and mental health in a large population-based sample.Participants included 3756 individuals, mainly young university students using a snowball sampling method. History of IPT was collected retrospectively using the Traumatic Experiences Checklist. Substance use was examined using the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test. Mental health symptoms were assessed by the DSM-5 Level 1 Cross-Cutting Symptom Measure. Moderation analyses were performed investigating the relationship between IPT, substance use, and mental health symptoms.Participants exposed to IPT had a higher prevalence of substance use (cannabis, alcohol, tobacco) and had more severe mental health problems than people without IPT. Substance use was associated with a blunted increase of depression, anxiety, and anger in trauma victims. A history of abuse was more strongly linked to substance use than neglect. Moderation analyses further revealed that cannabis use increased psychotic symptoms and psychotic symptoms increased cannabis use in participants with high levels of IPT.Our findings indicate that substance use worsens psychotic symptoms in IPT victims whilst dampening other mental health symptoms.

DSM-5 self-rated level 1 cross-cutting symptom measure (CCSM1): Proposal for a three-factors model and implications for the assessment of at-risk situations

ObjectiveThe aim of this paper is to study the measurement of the DSM5 self-rated transversal symptoms level 1 (CCSM1) from a dimensional perspective in line with current models of psychopathology in three factors: internalization, thought disorders, externalization. MethodBased on the 670 non-clinical protocols we collected, we verified that the VSS is composed of three factors. We studied the 3-factor composition with half of the sample and confirmed this composition with the other half. To show that these three factors were more relevant than the original 13 dimensions, we compared the results to three clinical groups and, after a cluster analysis, we investigated the intensity and frequency of people at risk across the original dimensions. ResultsWhile the 13 initial dimensions of the CCSM1 do not completely differentiate this sample from the clinical groups, the three high-order dimensions are discriminating. Clustering confirms these results when comparing the least and most affected subjects and allows us to see that these three HODs have significant impacts on the observation of cases at risk of clinical disorders in this non-clinical sample. DiscussionTo be further validated, these three HODs should be studied in relation to tools that assess internalization, thought disorders or externalization.

Validity of the revised Diagnostic and Statistical Manual of Mental Disorders-5 cross-cutting symptom measure as implemented in community mental health settings

BackgroundThe purpose of this study was to validate the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) Cross-Cutting Symptom Measure (CCSM) as a screening tool for a wide variety of disorders within busy community outpatient mental health settings. MethodParticipants (N = 851) were referred for coordinated specialty care services (mean age = 20.26 years (SD = 2.97); 82.5 % Caucasian, 7.5 % African American, 0.7 % Native American, 0.7 % Pacific Islander, 0.8 % Asian, 7.8 % Multiracial; 15.1 % Latinx; 53.1 % female, 45.5 % male, 1.4 % other gender). ResultsAt optimal cut-score, specificity ranged from 57 to 77 % for depression, anxiety, substance use and psychosis domains; sensitivity ranged from 63 to 72 %. Scores for depression, anxiety, substance use and psychosis domains differed significantly by groups with and without diagnoses. Correlations among domains were larger where expected (r = 0.52, depression-suicidal ideation), and relatively smaller where expected (r = 0.28, suicidal ideation-inattention). Depression, anxiety, substance use and psychosis domains evidenced incremental validity for their respective diagnoses (change in explained variance, 3–15 %). Psychometric features of CCSM were broadly supported. LimitationsCriterion measures did not have inter-rater reliabilities as this is generally prohibitive in clinic settings. ConclusionThe CCSM could provide a first step in screening for multiple disorders; however, it cannot replace structured interviews for making diagnoses related to these conditions.

Implementing the DSM-5 parent/guardian-rated level 1 cross-cutting symptom measure child 6-17 in a community mental health clinic.

Despite their relevance to assessment and clinical decision-making in behavioral health, measurement tools are still rarely used in clinical settings. With an increase in undiagnosed and untreated mental health problems in children and adolescents, a southeastern US Community Health System was the ideal setting for the implementation of a behavioral health assessment tool. This quality improvement project was conducted to address the question: "Among mental health clinicians at the Community Health System, will the use of the DSM-5 parent/guardian-rated level 1 cross-cutting symptom measure 6-17 (CCSM) improve diagnosis and treatment choices of children with mental health conditions, over a 4-week period?" A convenience sample was recruited from among behavioral health counselors working at various out-patient clinics and school-based counseling sites in the Community Health System. After nurse-led training on use of the CCSM, including a PowerPoint intervention and individual coaching sessions, the five clinical participants were encouraged to use the CCSM screening tool on their patients presenting for mental health assessment. Knowledge of the tool was assessed using a pre- and post-training survey. Completed screening tools were collected from participants over the 4-week duration of the project. A chart audit comparing the project period with the previous year showed an increase in diagnosis and treatment in 6-17 year-old patients at the outpatient clinic. This project demonstrated the usefulness of the CCSM for behavioral health assessment in the child/adolescent population at the Community Health System and supported use of the intervention in other clinics.

BEHAVIORS OF NON SUICIDAL SELF INJURY IN UNIVERSITY STUDENT

Aim of study was to assess behaviors of Non Suicidal Self Injury (NSSI) in University Students. Research design was correlational. Assessment measures used were: DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult, Alexian Brothers Assessment of Self-Injury (ABASI) and Inventory of Statement about Self Injury (ISAS). Sample comprised of hundred students of 19 to 24 years who were diagnosed with of Non Suicidal Self Injury (NSSI). The results indicated that hitting one self, hair pulling and interference in wound healing were more commonly used methods of Non Suicidal Self Injury (NSSI). Moreover, it was found that mostly students use more than one method of Non Suicidal Self Injury (NSSI). Furthermore, the results revealed that indirect methods of Non Suicidal Self Injury (NSSI) were taking over dose of some medicine, smoking, drug use and restricted food intake. . It could be concluded that students who engage in more than one method of Non Suicidal Self Injury (NSSI) are at greater risk of suicide. Early identification and intervention can be helpful in prevention of Non Suicidal Self Injury (NSSI).

P104 Exploring the heterogeneity of psychiatric symptom profiles in sleep clinic patients using a cross-cutting dimensional approach

Abstract Introduction Individuals attending sleep services commonly present with comorbid psychiatric symptoms. This study reports our ongoing effort to characterise presenting psychiatric symptom profiles of individuals seeking treatment at a sleep clinic and classify heterogenous subgroups within a large sample. Method Data were collected at a university-based multidisciplinary sleep clinic via opt-out consent. Prior to treatment, individuals completed the Cross-Cutting Symptom Measure (CCSM), which provides a transdiagnostic symptom profile by measuring 13 domains of mental health (e.g., anger, anxiety, depression, psychosis, mania, memory). Additional questions on demographics and the Morningness-Eveningness Questionnaire Reduced (rMEQ) were also administered. Results 1263 participants (52.9% male; age M±SD= 43.53±16.06) completed the CCSM and were analysed. Latent class analysis revealed 3 distinct profiles: Low-Symptom subgroup (n=655, 51.9%) reported mild affective and somatic symptoms; Psychopathology subgroup (n=342, 27.1%) reported moderate to severe psychopathology including psychosis, dissociation, and suicidality, in conjunction with severe affective, obsessive-compulsive, and somatic symptoms, and significant interference with memory and personality functioning; Affective-Disturbance subgroup (n=266, 21.1%) reported moderate affective and somatic symptoms, and some interference with memory and personality functioning. The three subgroups did not differ significantly on key demographics or the rMEQ. Discussion There was heterogeneity in psychiatric symptoms experienced by sleep clinic patients. Affective and somatic disturbances were common across subgroups whilst severe psychopathology appeared in a sizeable (one in four) proportion of patients. These findings solidified the need for careful assessment of a wide range of psychiatric symptoms to inform treatment planning in sleep services.

Examining the factor structure of the DSM-5 Level 1 cross-cutting symptom measure.

The DSM-5 Level 1 Cross-Cutting Symptom Measure (DSM-XC) was developed by the American Psychiatric Association as a transdiagnostic mental health symptom survey. Despite its promise as a screening tool, few studies have assessed its latent dimensionality or provided guidance on interpreting responses. We examined the factor structure of the DSM-XC in a convenience sample of participants with varying degrees of psychopathology. Participants (n=3533) were enrolled in an online study on the mental health impact of COVID-19 (NCT04339790). We used a factor analytic framework with exploratory and confirmatory analyses to evaluate candidate factor solutions. Convergent validity analysis with concurrent study measures was also performed. Six-factor and bifactor candidate solutions both had good fit and full measurement invariance across age, sex, and enrollment date. The six-factor solution resulted in constructs labeled as: mood, worry, activation, somatic, thought, and substance use. A general psychopathology factor and two residual factors (mood and anxiety constructs) explained the variance of the bifactor solution. Our analysis supports that the DSM-XC is a multidimensional instrument spanning many mental health symptoms. We provide scoring solutions for two factor structures that capture broader constructs of psychopathology. Use of a convenience sample may limit generalizability of findings.

Validation of the DSM-5 Level 1 Cross-Cutting Symptom Measure in a Community Sample

The shift toward transdiagnostic and dimensional approaches to diagnosing mental disorders has created a need for assessment tools that efficiently measure a range of mental health symptoms and their severity. The present study aimed to evaluate the psychometric properties and diagnostic utility of the DSM-5 Level 1 Cross-Cutting Symptom Measure (CCSM), developed by the American Psychiatric Association as a brief transdiagnostic measure of mental health symptoms, in community-dwelling adults. Participants (N = 482) completed symptom measures corresponding to CCSM domains and self-reported diagnostic criteria were used to establish DSM-5 diagnoses. The results showed CCSM domains had significant validity correlations with longer measures of the same or similar mental health constructs and overall symptom severity was associated with functional impairments and current treatment status. Several domains demonstrated moderate diagnostic efficiency for corresponding DSM-5 diagnoses. The recommended thresholds for depression, anxiety, and substance use domains showed strong sensitivity (≥ 0.83) but low specificity (range = 0.60-.73), whereas the personality functioning threshold showed low sensitivity (0.51) and excellent specificity (0.92). These results suggest CCSM domains are internally consistent and valid measures of psychopathology. Further, these findings indicate the CCSM shows promise as a screening tool for specific DSM-5 disorders in community samples.

A machine-learning model to predict suicide risk in Japan based on national survey data.

ObjectiveSeveral prognostic models of suicide risk have been published; however, few have been implemented in Japan using longitudinal cohort data. The aim of this study was to identify suicide risk factors for suicidal ideation in the Japanese population and to develop a machine-learning model to predict suicide risk in Japan.Materials and MethodsData was obtained from Wave1 Time 1 (November 2016) and Time 2 (March 2017) of the National Survey for Stress and Health in Japan, were incorporated into a suicide risk prediction machine-learning model, trained using 65 items related to trauma and stress. The study included 3,090 and 2,163 survey respondents >18 years old at Time 1 and Time 2, respectively. The mean (standard deviation, SD) age was 44.9 (10.9) years at Time 1 and 46.0 (10.7) years at Time 2. We analyzed the participants with increased suicide risk at Time 2 survey. Model performance, including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity, were also analyzed.ResultsThe model showed a good performance (AUC = 0.830, 95% confidence interval = 0.795–0.866). Overall, the model achieved an accuracy of 78.8%, sensitivity of 75.4%, specificity of 80.4%, positive predictive value of 63.4%, and negative predictive value of 87.9%. The most important risk factor for suicide risk was the participants' Suicidal Ideation Attributes Scale score, followed by the Sheehan Disability Scale score, Patient Health Questionnaire-9 scores, Cross-Cutting Symptom Measure (CCSM-suicidal ideation domain, Dissociation Experience Scale score, history of self-harm, Generalized Anxiety Disorder-7 score, Post-Traumatic Stress Disorder check list-5 score, CCSM-dissociation domain, and Impact of Event Scale-Revised scores at Time 1.ConclusionsThis prognostic study suggests the ability to identify patients at a high risk of suicide using an online survey method. In addition to confirming several well-known risk factors of suicide, new risk measures related to trauma and trauma-related experiences were also identified, which may help guide future clinical assessments and early intervention approaches.

Preliminary Validation Study of the Korean Version of the DSM-5 Level 2 Cross-Cutting Symptom Measure: Depression and Irritability for Parents of Children Aged 6-17 Years.

ObjectivesThis study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure—Patient-Reported Outcomes Measurement Information System (PROMIS)–Depression and the Irritability for parents of children aged 6–17 years.MethodsParticipants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8–15 years of age. The participants’ mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure— PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children.ResultsThe reliability coefficient of the PROMIS Depression scale (Cronbach’s α) was 0.93. The correlation coefficient with the KCBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability.ConclusionOur results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6–17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

Methadone Contrasted with Acetaminophen Codeine Plus Clonidine: An Inpatient Pilot Study

Introduction: The mainstay of pharmacological management of opioid dependence is opioid substitution treatment. Methadone is a long-acting opioid agonist, which is used for detoxification and maintenance of opioid-dependent people. Objective: Objective of the present evaluation included a comparison between methadone and acetaminophen codeine plus clonidine for management of opioid withdrawal symptoms. Methods: All patients of an acute ward of a psychiatric hospital, who met dual diagnosis of primary psychiatric disorder plus opioid use disorder, were selected as accessible sample for the current evaluation. Duration of assessment was around eleven months and the study was performed according to a single-blind plan. Among 96 patients, cases, who were using methadone, before their recent admission in hospital, continued their substitution treatment according to the recommended dosage and formulation till release (n = 42). The remaining group of patients, had been given acetaminophen codeine plus clonidine, as substitution treatment, during their inpatient management (n = 54). The primary outcome measures were the ‘Cross-Cutting Symptom Measure’ and the ‘Subjective Opiate Withdrawal Scale’, which were scored at baseline, week 1 and week 2. The study was performed according to the ‘per-protocol’ analysis, and the assessor was blind with respect to the said protocols. Results: While the mean total score of primary outcome measures decreased significantly in both groups, the between-group analysis did not show any significant difference between these two groups in a head-to-head analysis. Conclusion: Acetaminophen codeine plus clonidine was as good as methadone for management of opioid withdrawal symptoms in inpatient setting.

The Psychological Impacts of COVID-19 Pandemic among Emerging Adults: An Observational Cross-Sectional Study.

(1) Background: COVID-19 has had psychological impacts, particularly anxiety, depression, anger, and suicidal ideation, on the world’s populace, including young persons who were prone to mental health disorders even before the pandemic. We described the psychological impacts of COVID-19 among emerging adults aged 18–30 years in Saudi Arabia. (2) Methods: A cross-sectional survey was done among a randomly sampled population in Saudi Arabia between July 2020 and May 2021 using the DSM-5 Self-rated Level 1 Cross-Cutting Symptom Measure and Ask Suicide Questionnaire. Logistic regression was used to assess participant characteristics associated with reporting symptoms of mental disorders under each of the 13 domains that would warrant further investigation. (3) Results: Approximately, 91% of participants experienced different mental health symptoms; these participants are more likely to be young, female students, those who had a history of being diagnosed with a mental disorder, and those diagnosed or treated for COVID-19. (4) Conclusion: This study strongly showed an increased prevalence of mental health symptoms among young persons during the COVID-19 pandemic. Addressing the mental health burden among young persons in time using simple, self-administered screening tools linked to interventions will prevent dire consequences in the future.

Strokes of Strength: An Expressive Arts-based Intervention with Adolescents

In order to explore how adolescents who have been affected by traumaticexperiences would respond to an expressive arts-based intervention, amodule was designed, implemented and its effect on certain behavioraland emotional constructs was evaluated. The sample included 10 femaleadolescents between the ages of 12 and 17 who underwent a 2-month longgroup expressive arts therapy in their institutional home, namely, PrayasJuveline Aid Centre, New Delhi, India. The tools which were used toassess the changes in the pre – post intervention scores in self – reportedbehavioral and emotional difficulties were: The Youth Self Report Form(YSR Form 11-18, CBCL; ASEBA, 2001) and the ‘Severity of Post –Traumatic Stress Scale’ (NSESSS; APA, 2013). The tools used to assessthe changes in the pre – post intervention ratings of the caregiver were,the ‘DSM – 5 Parent / Guardian Rated Level 1 Cross Cutting SymptomMeasure’ (APA, 2013) and the ‘Caregiver’s Observation Checklist:Children at – risk’ (WCCL, 2013). The results revealed that 4-weekexpressive arts -based intervention elicited a statistically significantdifference in the self – reported behavioural and emotional difficultiesby the participants. The verbatim reports, diary excerpts and paintings ofthe participants were qualitatively analysed. In future, there is room toinvestigate how an intervention with a longer duration and a representativesample would explain the effectiveness of expressive – arts-based therapywith such populations.

Differences in Patient and Parent Informant Reports of Depression and Anxiety Symptoms in a Clinical Sample of Transgender and Gender Diverse Youth.

Purpose: We assessed characteristics of patients at a pediatric gender clinic and investigated if reports of mental health concerns provided by transgender and gender diverse (TGD) youth patients differed from reports provided by a parent informant on their behalf. Methods: This cross-sectional study included 259 TGD patients 8 to 22 years of age attending a pediatric gender clinic in the southeast United States from 2015 to 2020. Pearson correlations and paired sample t-tests compared patient-reported mental health concerns at patient intake with those provided by a parent informant. Clinical symptom severity was assessed with standardized T-scores. Level 2 Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress-Depression Scale and Level 2 PROMIS Emotional Distress-Anxiety Scale assessed depression and anxiety symptoms of patients. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure was used with parents. Results: Patients had a mean age of 14.9 at first visit, with most identifying as White (85.5%), non-Hispanic (91.1%), and as a boy or man (63.6%). Half had moderate-to-severe depression (51.2%) or anxiety (47.9%) symptoms. There was a moderate, positive correlation between patient-reported and parent-reported depression symptoms, with no correlation for anxiety symptoms. Informant type differences were statistically significant (patients reporting greater depression and anxiety symptoms). Conclusions: TGD youth patients reported more severe depression and anxiety symptoms compared with parent informants. Despite moderate agreement on depression symptoms, parents did not accurately detect their child's anxiety symptoms. These discrepancies highlight a need for interventions which increase parental recognition of child mental health status.

Evaluation of the construct reliability and validity of the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Chinese version in maintenance hemodialysis patients.

ObjectiveThe study aim was to assess the construct reliability and validity of the internal structure of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Self-Rated Level 1 Cross-Cutting Symptom Measure (CCSM)-Chinese version in maintenance hemodialysis (MHD) patients, and to clarify whether the CCSM is suitable for patients with psychological issues.MethodsParticipants were 190 MHD patients. Structural equation modelling was used to establish a measurement model to confirm the reliability and validity of the internal structure of the CCSM-Chinese version, and to compare it with the Chinese version of the Symptom Checklist-90 (SCL-90).ResultsOf the 13 CCSM domains, 8 showed stability and validity in the initial screening of psychological symptoms. Although the Chinese version of the SCL-90 is widely used, the measurement model of the 8-domain CCSM was a better fit than the SCL-90 (CCSM: chi-square = 35.668, chi-square/degrees of freedom [CMIN/df] = 1.877; root mean square error of approximation [RMSEA] = 0.061; adjusted goodness of fit index [AGFI] = 0.931 vs. SCL-90: chi-square = 89.159, CMIN/df = 2.972; RMSEA = 0.084; AGFI = 0.879).ConclusionThe Chinese version of the CCSM is a useful rapid screening tool to detect psychological symptom risk in MHD patients.

A Study of the Reliability and Validity of the Korean Version of DSM-5 Symptom Measure-Inattention and Anger for Parent and Guardian of Child Age 6 to 17.

ObjectivesThis study was conducted to investigate the reliability and validity of the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure–inattention [Swanson, Nolan and Pelham, version IV (SNAP-IV)] and anger [Patient-Reported Outcome Measurement Information System (PROMIS) Anger] for parents and guardians of children aged 6–17 years.MethodsWe included 104 children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD), ADHD with anxiety and depression, depressive disorder, anxiety disorder, and tic disorder with somatic symptoms (ADHD=41, depression=9, anxiety=14, ADHD+anxious depression=11, tic+somatic symptoms=29). Their ages ranged from 8 years to 15 years. The participants’ mothers completed the SNAP-IV, PROMIS Anger scale, Korean version of the IOWA Conners Rating Scale (K-IOWA), and Korean ADHD Rating Scale (K-ARS) so that the reliability and validity of the SNAP-IV and PROMIS Anger scales, which are DSM-5 scales for assessing inattention and anger of children and adolescents, could be examined.ResultsThe reliability coefficient of SNAP-IV (Cronbach’s α) was 0.94. The correlation coefficients between SNAP-IV, K-IOWA inattention, and K-ARS inattention scores ranged from 0.73 to 0.86. The mean SNAP-IV scores of the ADHD and the ADHD+anxious depression groups were significantly higher than those of the anxiety and the tic+somatic symptoms groups. The reliability coefficient of the PROMIS Anger was 0.91. The correlation coefficient between PROMIS Anger and K-IOWA oppositional/defiant scores was 0.75. The PROMIS Anger mean score of the ADHD+anxious depression group tended to be higher than that of the other groups.ConclusionThese results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure–inattention and anger for parent and guardian of child age 6–17 might be a reliable and valid test and may be useful for screening children and adolescents with ADHD.

Negative effects of accompanying psychiatric disturbances on functionality among adolescents with chronic migraine

BackgroundChronic migraine is a condition with gradually increasing prevalence among adolescents which causes severe headaches resulting in functionality loss. Factors contributing to migraine becoming chronic and negatively affecting quality of life in adolescence are still unclear. Parallel with these, we aimed to examine the effect of psychiatric symptoms on headache severity and functionality loss among adolescents with chronic migraine.MethodsWe evaluated features of 50 adolescents who were diagnosed with chronic migraine according to International Classification of Headache Disorders-3 for the first time in their lives by an experienced neurologist. Sociodemographic and clinical data were collected and Pediatric Migraine Disability Assessment Score, Visual Analogue Score and DSM-5 Level 1 Cross-Cutting Symptom Measure Scores (CCSM-5) were evaluated. Semi-structured psychiatric interviews were done to those who scored higher than cut-off scores on CCSM-5. Healthy control group was constituted of cases which had similar age and sex distribution to case group.ResultsMajority of the case group was female (%78). There was a positive correlation between headache severity and computerized tomography history in emergency department. All of the psychiatric symptom scores were significantly higher in case group except for psychotic symptoms; but attention problems and manic symptoms clusters did not have significant difference according to the thresholds of CCSM-5. Receiving a psychiatric diagnosis did not affect frequency, severity or duration of headaches. There were also no relationship between depression/anxiety diagnosis and severity of headache/functionality loss.ConclusionFindings suggest that; more rational treatment methods with lesser functionality loss should be developed by adopting multidisciplinary and prospective approach via psychiatric screening for adolescents with chronic migraine.