Illness Profile Research Articles

Gender differences, family size and fertility rate among patients with bipolar disorder: A study from India

This study aimed to estimate the gender differences, family size and fertility rate among patients with Bipolar disorder (BD). 219 patients diagnosed with BD, who were married for at least 3 years and aged more than 25 years were assessed clinically for the course of illness as per the NIMH-life chart. Fertility and infertility were assessed based on the information on number of living children, abortions and medical termination of pregnancies. Significantly higher proportion of male patients had comorbid substance dependence while females had significantly higher prevalence of physical comorbidity. Additionally, female participants reported significantly higher mean number of depressive episodes per year of illness and suicidal attempts. When marriage was considered as a life event and its association with onset or relapse of illness was evaluated, about one-fourth (23.3%) of the study sample reported relapse of illness at the time of marriage or immediately following the marriage. About one-fourth (24.7%) of the couple with one of the partner having bipolar disorder had no living children even after four years of their marriage. To conclude, this study suggests that there are certain gender differences with regard to the clinical profile and longitudinal course of illness of BD.

A Logic Model of Neuronal-Glial Interaction Suggests Altered Homeostatic Regulation in the Perpetuation of Neuroinflammation.

Aberrant inflammatory signaling between neuronal and glial cells can develop into a persistent sickness behavior-related disorders, negatively impacting learning, memory, and neurogenesis. While there is an abundance of literature describing these interactions, there still lacks a comprehensive mathematical model describing the complex feed-forward and feedback mechanisms of neural-glial interaction. Here we compile molecular and cellular signaling information from various studies and reviews in the literature to create a logically-consistent, theoretical model of neural-glial interaction in the brain to explore the role of neuron-glia homeostatic regulation in the perpetuation of neuroinflammation. Logic rules are applied to this connectivity diagram to predict the system's homeostatic behavior. We validate our model predicted homeostatic profiles against RNAseq gene expression profiles in a mouse model of stress primed neuroinflammation. A meta-analysis was used to calculate the significance of similarity between the inflammatory profiles of mice exposed to diisopropyl fluorophostphate (DFP) [with and without prior priming by the glucocorticoid stress hormone corticosterone (CORT)], with the equilibrium states predicted by the model, and to provide estimates of the degree of the neuroinflammatory response. Beyond normal homeostatic regulation, our model predicts an alternate self-perpetuating condition consistent with chronic neuroinflammation. RNAseq gene expression profiles from the cortex of mice exposed to DFP and CORT+DFP align with this predicted state of neuroinflammation, whereas the alignment to CORT alone was negligible. Simulations of putative treatment strategies post-exposure were shown to be theoretically capable of returning the system to a state of typically healthy regulation with broad-acting anti-inflammatory agents showing the highest probability of success. The results support a role for the brain's own homeostatic drive in perpetuating the chronic neuroinflammation associated with exposure to the organophosphate DFP, with and without CORT priming. The deviation of illness profiles from exact model predictions suggests the presence of additional factors or of lasting changes to the brain's regulatory circuitry specific to each exposure.

Demographic and clinical characterization of human visceral leishmaniasis in the State of Pernambuco, Brazil between 2006 and 2015.

Human visceral leishmaniasis (HVL) primarily occurs in regions that present socioeconomic, health, and environmental vulnerability. In Pernambuco, Brazil, this neglected zoonosis has expanded in magnitude as well as geographically, and efforts to manage HVL have been insufficient to contain its spread. The objective of this study was to describe the epidemiological profile of human illness due to HVL during 2006 to 2015 in Pernambuco State. This study was conducted using secondary data collected from the Health Information System. During the study period, Pernambuco accounted for 2.4% of HVL cases in Brazil, with 49.6% of these concentrated in the macroregions of São Francisco Valley and Araripe. The percentage of municipalities that reported cases at the beginning of the study period increased from 21.1% (n = 39) to 43.8% (n = 81) by the end of the period. Cases were found predominantly among males, brown-skinned individuals, children aged 1-4 years, and individuals with incomplete 1st to 4th grade education. Coinfection with HIV was present in 5.6% of cases. Incidence was 9.7 cases per 100,000 inhabitants, and lethality was 12.3%. HVL has shown worrying expansion and evolution, in addition to high lethality, in Pernambuco. The only study of its kind in the past decade, it was evident from this study that despite efforts to contain this disease, HVL in Pernambuco exhibits patterns similar to those described in previous studies. Based on our results, we suggest reassessing the current prevention and control measures in the state.

Parent Perspectives on Health and Functioning of School-Aged Adolescents With Disabilities.

Youth living with disabilities are at risk of experiencing poor health outcomes. Coordinated school health programs have an opportunity to help youth with disabilities and their families through health education, health services, and community engagement. The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) as a framework to analyze factors related to health conditions. We used the ICF to examine parental perceptions of health and function among students with disabilities living in rural and urban areas. We surveyed parents (N = 71) using the parent-report versions of the Pediatric Outcomes Data Collection Instrument and Child Health and Illness Profile. From this group, parents were asked to volunteer to participate in in-depth, individual interviews (N = 18). The interviews were audio-recorded and transcribed verbatim. Researchers used the ICF linking rules to analyze and code the transcriptions. Emergent themes were assigned numerical ICF codes. There were more similarities than differences among rural and urban families. Children living with disabilities face significant environmental barriers regardless of context. Schools can facilitate education to improve the quality of life of parents and families of children with disabilities. School authorities should consider the many environmental barriers both urban and rural these families face in the community. The ICF can be used as a framework for program planning for community-based, health education for this population.

Postrzeganie środowiska psychospołecznego szkoły i funkcjonowanie w niej uczniów zdrowych i z chorobami przewlekłymi

The article presents the results of a survey on the perception of the psychosocial school environment and school functioning of lower secondary school students with and without chronic conditions. Students of grades 1–3 (N = 4,058) from randomly selected 234 public lower secondary schools from all voivodships participated in the survey. In this group 3,232 (80%) students were healthy and 798 (20%) had different chronic conditions. The anonymous “Health and school” questionnaire was used as the instrument for data collections with questions from HBSC study (Health Behaviour in School-aged Children) and from CHIP–AE Questionnaire (Child Health and Illness Profile: Adolescent Edition). Based on Urie Bronfenbrenner’s ecological model, dimensions of psychosocial school environment were analysed on the individual level (microsystem) and the social relations level (mesosystem). It was found that healthy students, in comparison with those with chronic conditions, perceived school environment and their functioning at school better. They have: a larger sense of school belonging, higher level of school competencies and achievements, larger sense that their grades are adequate to the results, a higher social position in the class and a higher level of support from peers, teachers and parents. Students with chronic conditions have higher level of workload, stress and problems associated with the school, and they also spend more time on homework. These students (about 20% of the population of school age) have special educational needs which depend on the specificity and the course of the disease. Identification of difficult areas in the functioning of chronically ill students in the school and knowledge of their perception of their school’s psychosocial environment will allow teachers to provide them with appropriate support.

Injury and illness profiles during the 2014 South African Ironman triathlon


 Background: There is a need for ongoing scrutiny of injury and illness profiles of ultra-distance athletes. This study aimed to record the medical history, illness and injuries of athletes receiving medical attention during the 2014 Ironman South Africa (IMSA) triathlon, and to investigate the temporal presentation of medical encounters. 
 Methods: This was a retrospective, cross-sectional study. All athletes who required medical attention at the main medical tent and all of the medical posts or mobile units along the route were included in this study A total of 2 331 athletes started the race. Data included age, gender, time and stage of the race when medical attention was required, pre-race medical history and medication use, illness and injuries treated, special investigations performed, and weather conditions. 
 Results: Overall, 179 athletes (7.7%) required medical attention. The incidence of medical encounters was 7.8%. A significantly higher percentage of younger participants encountered medical problems (P = 0.04). Most patient encounters (80.1%) occurred after the race. The median duration of treatment was 26 minutes. Medication was used by 35.1% of patients during the race. The most common medical encounters were exertion-related (71.2%), gastro-intestinal (16.4%), dermatological (11.9%), musculoskeletal (9.6%) and cardiorespiratory conditions (2.4%). 
 Conclusion: Medical encounters occurred more frequently in later stages of the race. Most medical conditions were exertion-related. Potential higher risk may be associated with medication use, recent illness, and in younger participants. Temporal stacking of medical personnel, planning of resources according to expected conditions, preventative measures for high-risk behaviour, and on-going data collection with comparable methodology are recommended.

Cancer risk in patients with alopecia areata: a nationwide population‐based matched cohort study

Alopecia areata (AA) is an organ‐specific autoimmune disorder. Defective immune system related disorders are prone to increase the risk of cancer formation. However, the association among AA and variety of cancer types had never been studied. A nationwide population‐based matched cohort study was conducted to evaluate the cancer risk in patients with AA. Records from Taiwan National Health Insurance Research Database were analyzed. Cases of AA from 1997 to 2013 and cancers registered in the catastrophic illness profile from the same time period were collected. The standard incidence ratio (SIR) of each cancer was calculated. In total, 2099 cancers among 162,499 patients with AA and without prior cancers were identified. The overall cancer risks in AA patients were slightly decreased, especially among male subjects (SIR: 0.89). Refer to individual cancer, the cancer risk of nonmelanoma skin cancer (NMSC) (SIR: 0.59), upper GI cancer (SIR: 0.70), liver cancer (SIR: 0.82), uterine, and cervix cancer (SIR: 0.84) were significantly lower in patients with AA. In contrast, AA patients were inclined to have lymphoma, breast cancer, kidney, and urinary bladder cancer with the SIR of 1.55, 2.93, and 2.95, respectively. Age stratified analyses revealed female AA patients younger than 50 years old have even higher risk of breast cancer (SIR: 3.37). Further sensitivity analysis showed similar results after excluding major autoimmune disorders. Cancer risk in AA patients is organ specific, and it is not associated with the underlying autoimmune disorders in patients with AA.

On the issue of choosing psychodiagnostic methods of measuring and scoring of cognitive deficit in case of schizophrenia.

The article is dedicated to the search of more accurate psychodiagnostic methods and methods of evaluation that can help to define the degree of manifestation of cognitive deficiency among patients suffering from various schizophrenic disorders. The notions of cognitive deficiency and cognitive profile are analysed; we understand them as the correlation between intact and damaged components of cognitive processes and their diagrammatic representation. The authors prove that it is essential to provide a detailed scale of cognitive deficiencies detectable in case of schizophrenic disorders and to design universal algorithms that could translate the results of traditional content analysis of cognitive disorders into quantitative indicators. The article is based on the authors' experiments. We examined 128 patients, among whom 76 were suffering from paranoid schizophrenia (F20 according to ICD) and 52 were suffering from schizotypal disorder (F21 according to ICD). In evaluation of cognitive deficiency, we used both traditional methods devised in Russia and foreign tests that are seldom used by medical psychologists in their daily practice. We have analysed the difference in doing the cognitive tests between the groups of patients with different forms of schizophrenia and also suffering from it for different periods (up to 5y and more than 5y). On the basis of the quantitative indicators, a cognitive profile of each particular illness was compiled. As a result, we have defined different varieties of cognitive deficiency depending on the symptoms and dynamics of the disease. The authors have provided a detailed description of the structure and dynamics of the cognitive deficiency in case of different forms of schizophrenia and compiled cognitive profiles based on those data.

Aetiology and clinical spectrum of acute undifferentiated febrile illness in hospitalized children

Introduction: Acute fever of 2 weeks duration with non-specific signs and symptoms is known as acute undifferentiated febrile illness (AUFI). Owing to non-specific presentation, it remains a diagnostic challenge. Hence the present study focuses on etiology and clinical profile of undifferentiated febrile illness. Methodology: All children aged 2-12 years admitted with fever of 5-15 days duration, for which no cause was found after a thorough history and clinical examination were included from July 2015 to June 2016 prospectively. History, examination findings, investigations and the treatment details were recorded. Data analyzed using SSPS software. Results: Total sample size was 263. The mean age was 6.7 ± 3.4 years. Most common symptoms were cough and vomiting. The most common diagnosis arrived at was Scrub typhus (22.4%) followed by Dengue (11%), Enteric fever (11%), Co- infections (6.1%), Urinary tract infections (3%)and Lower respiratory tract infections (2.3%). Fever was still undiagnosed in 116 children (44.1%). No malarial infection was noted. Conclusion: Non-malarial infections are common in this part of the country in children with AUFI.

Correlations Between Clinical Trial Outcomes Based on Symptoms, Functional Impairments, and Quality of Life in Children and Adolescents With ADHD

Objective: To assess relationships between treatment-associated changes in measures of ADHD symptoms, functional impairments, and health-related quality of life in children and adolescents with ADHD. Method: Pearson correlation coefficients were calculated post hoc for changes from baseline to endpoint in outcomes of one randomized, placebo- and active-controlled trial of lisdexamfetamine (osmotic-release methylphenidate reference) and one of guanfacine extended-release (atomoxetine reference). Results: Changes in ADHD Rating Scale IV (ADHD-RS-IV) total score generally correlated moderately with changes in Child Health and Illness Profile−Child Edition: Parent Report Form (CHIP-CE:PRF) Achievement and Risk Avoidance (r ≈ .4), but weakly with Resilience, Satisfaction, and Comfort (r ≈ .2); and moderately with Weiss Functional Impairment Rating Scale–Parent (WFIRS-P) total score (r ≈ .5). CHIP-CE:PRF Achievement and Risk Avoidance correlated moderately to strongly with WFIRS-P total score (r ≈ .6). Conclusion: The ADHD-RS-IV, CHIP-CE:PRF, and WFIRS-P capture distinct but interconnected aspects of treatment response in individuals with ADHD.

Study of Clinical Profile of Acute Febrile illness with Thrombocytopenia

Study of Clinical Profile of Acute Febrile illness with Thrombocytopenia

Health-related quality of life in non-paraplegic (ambulatory) children with myelomeningocele.

Evaluation of the effects of ventriculoperitoenal shunt and incontinence presence on health-related quality of life of ambulatory myelomeningocele patients. The study group included 35 myelomeningocele patients, between 5 and 18years old (mean age=9.6), who were neonatally operated. All patients were ambulatory. The Child Edition of the Child Health and Illness Profile (CHIP-CE) used to evaluate the patient group. Seventeen patients were using clean intermittent catheterization and nine patients had ventriculoperitoneal shunt. The CHIP-CE has five domains, and in satisfaction, resilience and achievement domains, significant lower scores were obtained from our study group. In terms of clean intermittent catheterization use, we got significantly lower scores on satisfaction, resilience and achievement domains (p<0.05). According to the presence of ventriculoperitoneal shunt, we found lower scores in satisfaction, resilience, risk avoidance and achievement domains but the differences were not significant (p>0.05). No significant difference was spotted according to gender and age. Continence problems have important effects on life quality of myelomeningocele patients. Incontinency should always be considered as a major variable in health-related quality of life evaluations.

Gene Polymorphisms of Glutathione S-Transferase T1/M1 in Egyptian Children and Adolescents with Type 1 Diabetes Mellitus.

Objective:Oxidative stress plays an important role in the pathogenesis of type 1 diabetes mellitus (T1DM). To evaluate the association of glutathione S-transferase mu 1 (GST M1) and glutathione S-transferase theta 1 (GST T1) polymorphisms with development of T1DM and disease-related risk factors.Methods:Measurement of fasting glucose, serum creatinine, lipid profile, and glycosylated hemoglobin (HbA1c), as well as evaluation of GST T1 and M1 genetic polymorphisms using polymerase chain reaction were done in 64 diabetic children and 41 controls.Results:The diabetic group had significantly higher fasting glucose, HbA1c, and cholesterol levels. GST T1 null genotype was more frequent in the diabetic than the control group with 4.2-fold increased risk of T1DM (odds ratio=4.2; 95% confidence interval=1.6-11.5; p=0.03). Significant positive associations were found with lipid profile, HbA1c, and duration of illness but not with age, age at onset, and body mass index.Conclusion:Gene polymorphisms of the enzyme GST are associated with development of T1DM and disease-related risk factors.

Injury And Illness Profiles During The 2014 South African Ironman Ultra-distance Triathlon

PURPOSE: High physiological demands on ultra-endurance triathletes and potentially serious medical complications require scrutiny of illness and injury profiles. Accurate data are required for planning of medical services. The aims of the study were to record medical history, illness and injuries of athletes receiving medical attention during the 2014 Ironman South Africa (IMSA) triathlon, and to investigate the temporal presentation of medical encounters, to optimise deployment of medical services for IMSA events. METHODS: A retrospective, cross-sectional study of all medical encounters and associated factors during the 2014 IMSA was conducted. RESULTS: The incidence of medical encounters was 7.8%. A significantly higher percentage of younger participants encountered medical problems (p=0.04). The majority of patient encounters (80.1%) occurred after completion of the race, and 49.2% of patient encounters occurred during the last eight hours of the event. The median duration of treatment was 26 minutes (2-126 minutes). Medication was used by 35.1% of patients during the race, and 36.2% in the three preceding days. The most common medical encounters were exertion-related (71.2%), followed by gastro-intestinal (16.4%), dermatological (11.9%), musculoskeletal (9.6%) and cardiorespiratory conditions (2.4%). CONCLUSION: Medical encounters occurred more frequently in later stages of the 2014 IMSA, as recorded elsewhere. The majority of medical conditions were exertion-related. Potential higher risk has been associated with medication use, recent illness, and in younger participants. Temporal stacking of medical personnel and resources, planning of resources according to expected conditions, preventative measures for high-risk behaviour, and on-going data collection are recommended.

The Injury and Illness Profile of 23055 Participants in a 94.7km Cycle Race - Cross-Sectional Study

INTRODUCTION: The Momentum 94.7 Cycle Challenge is an annual recreational long distance cycling event in South Africa. Medical support at such an event is imperative, with little known regarding the risk of acute traumatic injuries and acute medical illness. PURPOSE: To describe the incidence and patterns of acute injury and medical illness and difference between sexes during a mass community cycling race. METHODS: A descriptive study of the 2014 Momentum 94.7 Cycle Challenge, documenting the incidence of acute traumatic injuries and acute non-traumatic medical illness in 23055 race starters (males=17520, females=5236, not specified=299) during the 94.7km distance. RESULTS: An incidence (per 1000 starters) of 38.69 (females=38.39, males=36.52) for all medical illness; with an incidence of 11.88 (females=16.42, males=10.73) for adverse medical events and of 1.3 (females=2.67, males=0.86) for serious adverse events, were reported. The incidence of non-traumatic medical complaints was 32.48 (females=31.32, males=33.39) and of traumatic injuries was 3.99 (females=7.07, males=3.14). Females had a higher risk of sustaining traumatic injuries (p<0.001), central nervous system (p=0.0062) and eye complaints (p=0.0107). The musculoskeletal system had the most complaints, 80.7%. Males 10-16yrs (p=0.0013) and females 23-39yrs (p=0.0336) and >50yrs (p=0.0002), had a higher risk for traumatic injuries. CONCLUSIONS: A reported ratio of 1:26 (females=1:26, males=1:28) of all starters developed medical complaints; with 1:84 cyclists (females=1:61, males=1:93) that developed adverse events and did not finish the race; and 1:769 participants (females=1:374, males=1:1163) developing serious adverse events that required hospitalisation. The majority of admissions for traumatic injuries were followed by cardiovascular complaints. A wide spectrum of medical complaints can be expected during mass recreational sport events, with a higher risk for females to sustain traumatic injuries, and encounter central nervous system and eye complaints. The majority of disorders involved the musculoskeletal system. Information regarding the pattern and type of medical encounters can prove useful during planning and management of similar future events.

Is prior suicide attempt a reliable indicator of short-term suicide risk amongst patients admitted to an acute suicide inpatient intervention unit in India?

IntroductionTraditionally past suicide attempt is considered a strong reliable factor in predicting an immediate or short-term suicide risk. Considering the complex interplay of different variables associated with suicide, the absence of past attempts may not prove to be of lesser risk for a consequent attempt.AimTo compare sociodemographic and clinical correlates within high-risk suicidal patients who have made a recent suicide attempt in the presence versus absence of past suicide attempts.MethodsRetrospective review of patient's records admitted to intensive care unit, applied suicide intervention and supportive treatment (ASIST) between 1st January 2015 and 31st May 2016 was conducted. Data was extracted for all consecutive admissions to ASIST, of adults (16 to 60 years) male patients with high risk for suicide.ResultsOut of 109 at risk inpatients, 31% were recent attempters without past attempts and 13.5% were recent and past attempters. Rest included past attempters without recent attempt and non-attempters. Except for poor coping skills, which were significantly higher (Chi2= 13.97; P = 0.001) in the group consisting recent and past attempters, all other relevant sociodemographic and illness related correlates were comparable across these groups.ConclusionSuicide risk may be associated with multiple factors. Apart from past attempts, a faulty coping style can be associated with risk for further attempts. Other correlates like age, marital status, employment and illness profile did not follow the traditional pattern in our study which makes them equally important while addressing suicide risk in Indian men.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Social networks and social functioning level among occupational therapy workshops and community-based support centers users.

Community-Based Support Centers (CSC) and Occupational Therapy Workshops (OTW) have been functioning for over 20 years in Poland. However, the effectiveness of their rehabilitation programs as well as the users profile has not been examined yet. The aim of the study was to determine social functioning level and support network effectiveness of CSC and OTW users. Research tools: GAS (Global Assessment Scale), social network and social support assessment, Social Functioning Scale, Sociodemographic Questionnaire. Results show that investigated groups (except for participants' age) show no significant differences in sociodemographic variables and illness profile. Significant differences were found in the aspect of number and quality of support networks and the functioning level. Analyzed support institutions have different aims and offer different support programs which show differences in support networks and social functioning level. It can result from that the goal of OTW is to activate its users and assist them with their reintegration into the labor market, whereas CSCs are oriented on users' current issues and hospitalization prevention. It is important to have knowledge of these specifics during referring a person to such service.

The Functional Impact of Sleep Disorders in Children With ADHD

Objective: Children with ADHD display higher rates of sleep problems, and both sleep disorders and ADHD have been shown to affect functioning in childhood. The current study examines the frequency and relationship between sleep problems and ADHD, and their impact on quality of life (QoL) and functional impairment. Method: Parents of 192 children with ADHD (M = 10.23 years) completed measures regarding their child’s ADHD symptoms (Swanson, Nolan and Pelham [SNAP]), sleep disorders (Pediatric Sleep Questionnaire [PSQ]), QoL (Child Health Illness Profile [CHIP-PE]), and functioning (Weiss Functional Impairment Rating Scale–Parent Report [WFIRS-P]). Results: Common sleep complaints in participants were insomnia, excessive daytime sleepiness (EDS), and variability in sleep schedule. Regression analysis indicated that sleep problems and ADHD symptoms independently predicted lower levels of QoL (ΔR2 = .12, p < .001) and social functioning (ΔR2 = .12, p < .001). Conclusion: The results suggest that ADHD may coexist with somnolence and that both conditions have a significant impact on a child’s functioning and QoL.

Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis.

Structural brain imaging studies in obsessive-compulsive disorder (OCD) have produced inconsistent findings. This may be partially due to limited statistical power from relatively small samples and clinical heterogeneity related to variation in illness profile and developmental stage. To address these limitations, the authors conducted meta- and mega-analyses of data from OCD sites worldwide. T1 images from 1,830 OCD patients and 1,759 control subjects were analyzed, using coordinated and standardized processing, to identify subcortical brain volumes that differ between OCD patients and healthy subjects. The authors performed a meta-analysis on the mean of the left and right hemisphere measures of each subcortical structure, and they performed a mega-analysis by pooling these volumetric measurements from each site. The authors additionally examined potential modulating effects of clinical characteristics on morphological differences in OCD patients. The meta-analysis indicated that adult patients had significantly smaller hippocampal volumes (Cohen's d=-0.13; % difference=-2.80) and larger pallidum volumes (d=0.16; % difference=3.16) compared with adult controls. Both effects were stronger in medicated patients compared with controls (d=-0.29, % difference=-4.18, and d=0.29, % difference=4.38, respectively). Unmedicated pediatric patients had significantly larger thalamic volumes (d=0.38, % difference=3.08) compared with pediatric controls. None of these findings were mediated by sample characteristics, such as mean age or scanning field strength. The mega-analysis yielded similar results. The results indicate different patterns of subcortical abnormalities in pediatric and adult OCD patients. The pallidum and hippocampus seem to be of importance in adult OCD, whereas the thalamus seems to be key in pediatric OCD. These findings highlight the potential importance of neurodevelopmental alterations in OCD and suggest that further research on neuroplasticity in OCD may be useful.

Validation of the Korean Version of the Clinical Assessment Interview for Negative Symptoms.

ObjectiveClinical Assessment Interview for Negative Symptoms (CAINS) has recently been developed to improve measurement of negative symptoms in schizophrenia. We performed a multi-center study to validate the Korean version of the CAINS (CAINS-K) and explore potential cultural variation.MethodsOne hundred eighty schizophrenia patients diverse in demographic and illness profile were recruited from four centers in Korea. Along with the CAINS-K, the Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for Schizophrenia (CDSS), a self-report measure of behavioral inhibition and activation (BIS/BAS) and neurocognitive tasks were administered to verify external validities.ResultsThe CAINS-K showed high internal-consistency (0.92) and inter-rater reliability (0.77). Exploratory Factor Analysis replicated a two-factor structure of the original scale including motivation/pleasure and expression deficits dimensions. Korean patients tended to report lower pleasure compared to American patients in the prior study. The CAINS-K showed an adequate convergent validity with the SANS, negative symptoms of the BPRS, and BAS. A divergent validity was supported as the CAINS-K showed zero or only weak correlations with other symptoms of the BPRS, depression from the CDSS, and neurocognitive tasks.ConclusionThe CAINS-K demonstrated high internal consistency and adequate external validities, and is expected to promote studies on negative symptoms in Korean patients with schizophrenia.