Emotional State Questionnaire Research Articles

Effects of paroxetine on emotional functioning and treatment awareness: a 4-week randomized placebo-controlled study in healthy clinicians

The objective of our study was to evaluate the effects of paroxetine on emotional functioning in three arms: double-blind paroxetine (DBPX), single-blind paroxetine (SBPX), and double-blind placebo (DBPO). Healthy psychologists and psychiatrists were elected for their ability to analyze with correct sensibility changes in their emotions. Thirty nonanxious, nondepressed participants working as psychiatrists (N = 18) or psychologists (N = 12) were randomly assigned to receive an ambulatory treatment with paroxetine (DBPX N = 10, SBPX N = 10) or placebo (DBPO N = 10). Paroxetine was administered for 4 weeks at 20 mg/day. Emotional functioning was evaluated with the Emotional State Questionnaire (ESQ), a self-questionnaire designed to assess four emotional dimensions: "recognition," "expression," "internal emotional experience," and "social context." Changes in emotional measures from baseline to D0, D7, D14, D28, and D42 were compared between treatment groups. Analyses of ESQ showed in DBPX a significant decrease from baseline to D28 in internal emotional experience as compared to SBPX and DBPO groups. A different influence of gender between treatment groups on emotional recognition was observed. This is the first study assessing the impact of a 4-week paroxetine treatment on emotional functioning in healthy psychiatrists and psychologists. The DBPX group was distinguishable from both SBPX and DBPO groups by a decrease in internal emotional experience, suggesting that two factors could be involved in the clinical response to paroxetine: a decrease in emotional feeling and treatment awareness.

Conceptualisation et validation factorielle d’un questionnaire mesurant le profil émotionnel : Emotional State Questionnaire (ESQ)

The objective of this study is to evaluate the validity of a new self questionnaire: the "ESQ" (Emotional State Questionnaire).This novel instrument possesses a number of original attributes: first of all, it is designed to assess a general emotional profile, in opposition to other similar scales which can only be applied to the emotional reactions provoked by specific stimuli. Secondly, this scale is composed of several emotional dimensions. The ESQ has been constructed according to four components: recognition, expression, internal emotional experience and social context. The first three dimensions were selected because of their wide use through behavioral experiments. Indeed, contrary to most scales used in this field, which only assess the emotional experience, we wanted to propose an instrument also able to assess the subject's impression of his own capacities to encode and decode emotions. We hypothesized that these three dimensions could not be dissociated from a fourth dimension, the social context, which therefore also figures in this scale. The emotions explored were the five fundamental emotions indicated by Izard (fear, happiness, sadness, disgust and surprise) to which we added a neutral feeling that we considered as a basic emotion.To establish this instrument, a first conceptual phase was conducted by a group of experts. These experts all worked in the psychological field. They proposed the scale on the base of their clinical experience and after study of the literature. The scale was then validated in a population of 218 healthy volunteers, aged between 15 and 88 years. Subjects were not included if they presented depression (score above 16 in the Beck Depression Scale) or pathological anxiety (score above 5 in the Spieberger State Anxiety Inventory). The psychometric characteristics tested were: the item analysis, the item-dimension correlation, the factor analysis and the internal consistency reliability.The population studied was equally distributed according to gender (sex ratio: 0.97), the mean age was of 36.2 2 +/- 16.1 years. Acceptability was good with less than 5% of data missing. The analysis of items revealed no floor or ceiling effect and a low correlation between items. Item-dimension correlation ranged from 0.23 to 0.62, with most scores above 0.4. The items were always better correlated to their dimension than to other dimensions, except for one item. The 4 dimensions (recognition, expression, internal emotional experience and social context of emotions) explained 42% of the total variance. Finally, the scale showed good internal consistency with Cronbach coefficients, equal or above 0.84 for the total score, the recognition and the expression dimensions. This coefficient reached 0.77 for the feeling dimension but only 0.58 for the social context dimension.All together, results showed satisfactory characteristics in regard of the complexity of the notion measured. However, an important drawback is the lack of an external instrument to assess convergent validity. This instrument can be of great interest in the emotional characterization of healthy volunteers. More-over, if validated in psychiatric populations, this scale could be most useful in psychopathological assessment and also in comparison with behavioral evaluations of emotion.

Screening for depression in primary care

Depression has become one of the most prevalent mental disorders. Depressive disorders or significant depressive symptoms have been found in up to 25% of patients visiting general or family practitioners. Thus family doctors frequently meet depressive patients in their everyday work, and the importance of timely evidence-based diagnostics and treatment of the disorder has increased. The diagnosis of depression often presents difficulties, as it is time consuming and requires more clinical investigation. The recognition of depression on the primary care level could be improved by the availability of relevant diagnostic devices. Structured psychiatric interviews, e.g. Composite International Diagnostic Interview (CIDI), are reliable diagnostic instruments but these are too time consuming for family doctors and too elaborate for the routine use in primary care. Therefore, short self-rate questionnaires are proposed as screening devices of potential depressive patients in primary care. Self-rate instruments also enable the recognition of persons with minor depressive symptoms who form one of the risk groups for clinical depression. There is good evidence that screening improves the accurate identification of depressed patients in primary care settings. Self-rate instruments vary in the number of symptoms, by duration of the symptoms and by the scale of evaluation. The combination of symptoms in the self-rate instruments is also variable and it is still not clear which combination is best for the differentiation of healthy persons from depressive ones. The most commonly used screening measures for adults in primary care settings include the Beck Depression Inventory, the Zung Self-Depression Scale, the General Health Questionnaire (GHQ) and Patient Health Questionnaire-9 (PHQ-9). Screening by asking two simple questions about the mood and anhedonia was studied in order to facilitate the recognition of depression and it was discovered that these questions were as effective as using longer instruments. The aim of such type of studies was to provide as short and informative screening method of depression as possible which would be easier for patients and faster for GPs. In Estonia a screening scale for depression and anxiety, the Emotional State Questionnaire (EST-Q), which performs well on psychiatric patients and general population, has been developed. Nowadays a later modified version EST-Q2 is used. One purpose of the present study was to research the suitability of EST-Q2 screening scale depression subscale for screening of depression in general practice. The second purpose was to find out the combination of symptoms allowing the GPs to differentiate patients with depression from patients with other biomedical or psychosocial problems.

Symptoms of anxiety and depression in Estonian medical students with sleep problems

High emotional stress in medical students has been observed in many studies. Our aim in this article was to assess the prevalence of symptoms of anxiety and depression among Estonian medical students and to find relationships between sleep complaints and emotional symptoms. The study group consisted of 413 medical students, ages 19-33 years, at the University of Tartu. Each was asked to complete two questionnaires: the Emotional State Questionnaire (EST-Q), containing 28 questions, and the Questionnaire on Sleep and Daytime Habits, with 25 questions. The anxiety and depression subscales from the EST-Q were applied. From the study group, 21.9% students had symptoms of anxiety, and 30.6% had symptoms of depression. The frequency of anxiety and depressive symptoms was higher in females. In regression and multiple regression analysis, we determined which sleep problems were related to emotional symptoms. The associations were different for men and women. In women, anxiety remained significantly related to waking up because of nightmares and feeling tired in the morning; depressive symptoms were related to difficulties in getting to sleep at night, waking up because of nightmares and nocturnal eating habits, daytime sleepiness, and sleepiness during school lessons. In men, significant relations were clear only for depression: difficulties in falling asleep at night before an exam and subjective sleep quality. The study demonstrated that a high percentage of medical students had emotional symptoms. We found that some sleep problems indicated underlying symptoms of anxiety and depression.

Symptoms of depression in the Estonian population: prevalence, sociodemographic correlates and social adjustment

Objective: The current study presents data on the prevalence of depressive symptoms in the Estonian population and examines associated sociodemographic factors and subjective aspects of social adjustment. Method: The data came from the Estonian Health Interview Survey where 4711 persons aged 15–79 were interviewed. This study included 4677 respondents who answered the Emotional State Questionnaire (EST-Q), a self-rating scale of depression and anxiety. Data on the sociodemographic factors and domains of social adjustment were derived from structured interviews. Results: Depressive symptoms were observed in 11.1% of the respondents. Depressiveness was more common among women, in older age groups, among those not married, in ethnic groups other than Estonians, in lower income groups, and among the unemployed and economically inactive respondents. Depressive subjects were less satisfied, had a more pessimistic prognosis about the future and lower self-rated health. A low level of perceived control was a significant correlate of depression. The association of depressiveness with poor subjective social adjustment remained significant even after controlling for objective circumstances. Limitations: Depression was identified by a self-rate questionnaire, therefore results can not be generalized to clinical depression without caution. Conclusion: Depressive symptoms in the Estonian population were strongly related to socioeconomic functioning. Results emphasize that subjective social adjustment and perceived control are important characteristics of depression and should be considered in assessment and treatment.

Development and psychometric properties of the Emotional State Questionnaire, a self-report questionnaire for depression and anxiety

Anxiety and depression are dimensions of emotional state that can be validly assessed with self-report measures. This article introduces a new self-report questionnaire for depression and anxiety (Emotional State Questionnaire (EST-Q)) and presents data on its reliability and validity. The items of the EST-Q were derived from diagnostic criteria of DSM-IV and ICD-10. Thirty-three items were rated on a five-point frequency scale. The questionnaire was administered to 194 inpatients with depressive and anxiety disorders and to a population sample of 479 subjects. According to the results of factor analysis, five subscales were formed: Depression, Anxiety, Agoraphobia‐Panic, Fatigue, and Insomnia. EST-Q and subscales showed acceptable internal consistency (a 0.69‐0.88). Significant differences in subscales between patients and population and across diagnostic groups confirmed the discriminant validity of the instrument. Depression, Anxiety, and Agoraphobia‐Panic subscales distinguished corresponding diagnostic groups. Fatigue and Insomnia appeared to assess nonspecific psychopathology dimensions characteristic of several psychiatric disorders. • Agoraphobia, Anxiety, Depression, Questionnaires.