Sample Of Psychiatric Patients Research Articles

Die deutsche Version des Childhood Trauma Questionnaire (CTQ): Erste Befunde zu den psychometrischen Kennwerten

Given the relevance of child maltreatment for the development and treatment of many mental disorders, the objective of our study was the psychometric evaluation of the German version of the Childhood Trauma Questionnaire (CTQ). In a sample of psychiatric patients (N=1 524) the established factor structure (i.e. sexual, physical and emotional abuse as well as physical and emotional neglect) was replicated by means of confirmatory factor analysis. The internal consistency of all scales (apart from physical neglect) was high (Cronbachs α ≥ 0.89). Correlations between the CTQ and self-report measures for posttraumatic stress, dissociation and general psychopathology were low to moderate. The psychometric properties of the German version of the CTQ were similar to the American original; it proved to be a reliable and valid screen for the retrospective assessment of child maltreatment.

PW01-234 - Severity of adicction and PSY-5 traits in adolescents with substance use disorders

The objective of this study was to examine the association of different personality traits on severity of addiction indexes and patterns of drug use level, in a sample of adolescent psychiatric patients with Substance Use Disorders (SUD), based on the dimensional model of Personality Psychopathology Five (PSY-5) of the MMPI-A.MethodThe Teen Addiction Severity Index (T-ASI), the MMPI-A, and an inventory of drug use pattern were administered to 73 psychiatric patients (M=16.0, SD=1.18 years old; 51% male).ResultsRho Spearman correlations showed significant associations between Disconstraint (DISC) and T-ASI indexes of drug and social problems (rho= .342, p= .003, and rho= .320, p= .006) and also between DISC in relation to level of cannabis use and other drugs than cocaine and amphetamines (rho= .334, p= .004, and rho= .274, p= .023). The dimension of Psychoticism (PSYC) and Aggressiveness (AGGR) showed slight association with cannabis use (rho= .236, p= .045, and rho= .247, p= .035). The Negative emotionality (NEGE) and Introversion (INTR) showed a moderate association with the T-ASI index of psychiatric problems (rho= .265, p=0.023, and rho=.256, p= .029) but not with drug problems.ConclusionsThe DISC trait could represent a good indicator of risk for drug related problems. High scores in PSYC and AGGR are slightly associated to increase level of cannabis use. While psychiatric complaints are associated with NEGE and INTR traits.

P02-131 - Violence risk assessment in two forensic samples using the HCR-20 in Lithuania

ObjectivesProfessional risk assessment provides estimates of future risk in terms of nature, frequency and severity as well as may determine treatment services required of an offender under parole or probation supervision. This study examined the predictive validity of the HCR-20 (Webster, Douglas, Eaves, & Hart, 1997) in a Lithuanian forensic context.MethodsThis research includes a sample of criminal offenders and a sample of forensic psychiatric patients (a total of 118 participants). The HCR-20 was coded on the basis of file information.ResultsThe mean HCR-20 scores were: Total score = 14.96 (SD = 6.56), H-scale = 8.42 (SD = 3.61), C-scale = 2.57 (SD = 2.16), R-scale = 3.89 (SD = 2.55). ROC analyses of the HCR-20 subscales showed AUC's of .72 for the H Scale, .69 for the C Scale and .58 for the R Scale.ConclusionsThe HCR-20 total score and final risk judgments were significantly more accurate in predicting violent recidivism (p < .05). Results indicate the predictive ability of the instrument may be maximized when judgments of final risk are used rather than an actuarial approach wherein individual risk factors are summed.

An exploration of criminal thinking styles among civil psychiatric patients

Several studies have found a relationship between psychiatric illness and criminal behaviour. Despite this, few studies have examined the presence of criminal thinking among civil psychiatric patients. The aim of this study is to explore the patterns and correlates of criminal thinking, using the Psychological Inventory of Criminal Thinking Styles (PICTS), in a sample of civil psychiatric patients. The PICTS (Layperson Edition) and the Brief Psychiatric Rating Scale (Anchored Version; BPRS) were administered to 76 civil psychiatric patients. PICTS scores were compared with those of offenders from a previously published study. Bivariate tests were conducted between selected PICTS scales, BPRS factors, demographic and criminal history variables. Stepwise multiple regressions were performed to assess those variables that predicted the general criminal thinking, proactive and reactive composite scales of the PICTS. Independent samples t-tests revealed that five PICTS thinking styles were significantly higher in the psychiatric sample compared with the comparison sample of criminal offenders. Bivariate correlations revealed that the PICTS proactive composite scale was significantly related to and predicted by substance abuse and arrest history. CONCLUSIONS/CLINICAL IMPLICATIONS: Thinking styles which are typically associated with criminality were found in this sample of civil psychiatric patients. Cognitive remediation strategies targeting these may help to prevent criminal activity in psychiatric patients.

Psychological mindedness in relation to personality and coping in a sample of young adult psychiatric patients

Psychological mindedness (PM) is a relevant but rarely studied construct in clinical psychology. The aim was to examine the relationships among PM, personality, and coping in young adults with psychological difficulties. Sixty-three young women and 32 young men who were admitted for intake at a Dutch mental health institute completed relevant questionnaires. PM showed positive associations with the putatively adaptive personality characteristics of extraversion, openness, agreeableness, and conscientiousness and a negative correlation with neuroticism. In addition, PM was associated with problem-focused coping independently of the effect of personality characteristics. PM seems to be related to adaptive person characteristics in young adults with psychological difficulties. Longitudinal studies are needed to examine the issue of causality.

Prevalence of Hepatitis B, Hepatitis C, and HIV Infections Among Patients in a Psychiatric Hospital in Greece

Prevalence of Hepatitis B, Hepatitis C, and HIV Infections Among Patients in a Psychiatric Hospital in Greece

Childhood Sexual Abuse is Associated With Physical Illness Burden and Functioning in Psychiatric Patients 50 Years of Age and Older

To examine the association of childhood sexual abuse (CSA) with cumulative illness burden, physical function, and bodily pain (BP) in a sample of male and female psychiatric patients >or=50 years of age. Previous research on the health consequences of sexual abuse has focused on nonpsychiatric samples of younger-age adults, especially women. The health implications of abuse for mixed-gender samples of older psychiatric patients have not been explored. Participants were 163 patients with primary mood disorders. Sexual abuse histories were collected via patient self-report, as was BP. The measure of medical illness burden was based on chart review. Clinical interviewers rated physical function, using the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) scales. Linear and logistic regressions examined the association between CSA and health outcomes. As hypothesized, severe childhood sexual abuse was associated with higher cumulative medical illness burden, worse physical function, and greater BP. Comparisons of regression coefficients revealed that severe CSA's influence on illness burden is roughly comparable to the effects of adding 8 years of age. For ADL impairment and BP, the effects are comparable to adding 20 years of age. Strong relationships exist between CSA and medical illness burden, function, and pain among psychiatric patients >or=50 years of age. These relationships cannot be ascribed to shared method variance. Early detection of patients' abuse histories could inform targeted interventions to prevent or decelerate the progression of morbidity in this high-risk group.

The German version of the Toronto Structured Interview for Alexithymia: factor structure, reliability, and concurrent validity in a psychiatric patient sample

Background Recently, the Toronto Structured Interview for Alexithymia (TSIA) was developed to supplement the self-assessment of alexithymia and/or offer a different method of measuring the alexithymia construct. The aim of this study was to evaluate the psychometric properties of a German language translation of the TSIA in a psychiatric patient sample. Methods Translation and back-translation were performed until a high agreement of cross-language equivalence was obtained between the German and the original English language version of the TSIA. The TSIA and the German language version of the 20-Item Toronto Alexithymia Scale were administered to 237 psychiatric patients at the departments of psychiatry and psychotherapy in Germany and Switzerland. Videotapes of some of the interviews were recorded for the assessment of interrater reliability. Results The German version of the TSIA and its 4 scales correlated significantly with the German version of the 20-Item Toronto Alexithymia Scale and its 3 factor scales, providing support for concurrent validity of the interview. Confirmatory factor analyses supported the hierarchical, 4-factor structure obtained with the original English version, with 4 lower-order factors nested within 2 higher-order latent factors. Acceptable levels of internal reliability and interrater reliability were also demonstrated. Conclusion The TSIA is a valid and reliable measure for assessing alexithymia, at least in clinical samples. The TSIA, together with a self-report alexithymia scale, allow for a multimethod approach to assessing alexithymia.

Forensic psychiatric patients among immigrants in Denmark – Diagnoses and criminality

The purpose of this study is to analyse a sample of immigrant forensic psychiatric patients and to compare them with Danish patients. Of the 326 forensic patients in Copenhagen, 111 were immigrants or descendants of immigrants. The sample was broken down according to area of origin, age, gender and ethnic status. The data have been analysed by Poisson regression with the background population as an offset variable. Of the patients of non-Danish ethnicity, a significantly higher ratio was diagnosed with schizophrenia and a lower ratio was diagnosed with personality disorders compared with Danes. Iranians accounted for a higher ratio than did other minority groups, whereas patients from Western Europe/USA were not different from Danes. The higher ratio of forensic schizophrenic patients of non-Danish ethnicity cannot be explained by social factors or substance abuse. Migration increases the age-adjusted risk (ARR) of becoming schizophrenic (ARR=2.7). We found the ARR of becoming a male forensic schizophrenic patient among immigrants/descendants to be 2.8, i.e. the same as that caused by migration as such. Violence and schizophrenia are associated, and this explains the fact that the ratio of immigrants/descendants having committed violence exceeds that of Danes. Non-violent crimes are more equally distributed among ethnic groups and seem to be associated with common criminogenic factors. Arson is mainly committed by older schizophrenic patients of Danish ethnicity. The risk of an individual immigrant and Danish schizophrenic patient exhibiting criminal behaviour is the same. Schizophrenia is a crimonogenic factor in violence, but not in non-violent crimes. The differences between the various ethnic groups could be related to selection caused by both immigration and emigration.

Chronic fatigue syndrome and DSM-IV personality disorders

Objective Personality is an important factor in the research of the chronic fatigue syndrome (CFS). Although some studies report a high rate of personality disorders—around the 40% level—in samples of patients with CFS, the generalizability of these findings can be questioned. The present study evaluates the prevalence of Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR) personality disorders in a sample of female CFS patients and in two control groups. Method The ADP-IV questionnaire (Assessment of DSM Personality Disorders IV) was used to assess the DSM-IV-TR personality disorders at a dimensional and categorical level in a sample of 50 female CFS patients and in two matched control samples of Flemish civilians ( n=50) and psychiatric patients ( n=50). Results The results indicate a striking lack of statistical significant differences between the CFS sample and the Flemish control group at the level of dimensional Trait scores, number of criteria, and prevalence rates of personality disorder diagnoses. Unsurprisingly, higher scores at these levels were obtained within the psychiatric sample. The prevalence of an Axis II disorder was 12% in the Flemish and CFS samples, whereas the psychiatric sample obtained a prevalence of 54%. Conclusion The prominent absence of any significant difference in personality disorder characteristics between the female Flemish general population and the CFS samples seems to suggest only a minor etiological role for personality pathology, as defined by the DSM-IV Axis II, within CFS.

Additional evidence for a quantitative hierarchical model of mood and anxiety disorders for DSM-V: The context of personality structure.

Recent progress toward the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders includes a proposed quantitative hierarchical structure of internalizing pathology with substantial, supportive evidence (D. Watson, 2005). Questions about such a taxonomic shift remain, however, particularly regarding how best to account for and use existing diagnostic categories and models of personality structure. In this study, the authors use a large sample of psychiatric patients with internalizing diagnoses (N = 1,319) as well as a community sample (N = 856) to answer some of these questions. Specifically, the authors investigate how the diagnoses of obsessive-compulsive disorder (OCD) and bipolar disorder compare with the other internalizing categories at successive levels of the personality hierarchy. Results suggest unique profiles for bipolar disorder and OCD and highlight the important contribution of a 5-factor model of personality in conceptualizing internalizing pathology. Implications for personality-psychopathology models and research on personality structure are discussed.

Family caregiver quality of life in multiple sclerosis among Kuwaitis: a controlled study

BackgroundResearch interest in the quality of life (QOL) of persons with multiple sclerosis (MS) has been spurred by the need to broaden outcome measures. Far less of this interest has been directed at the family caregivers, who bear most of the burden of care. The objectives of the study were: First, to compare the subjective QOL of family caregivers of persons with relapsing remitting and progressive MS, with those of a matched general population sample and caregivers of diabetes and psychiatric patients. Second, to assess the relationship of QOL with caregiver attitudes to MS and patient's variables.MethodsConsecutive MS clinic attendees were assessed with the 26 – item WHOQOL Instrument, and for depression and disability. Similarly, caregivers independently rated their own QOL as well as their impression of patients' QOL and attitudes to patients' illness.ResultsThe 170 caregivers, mean age 35.7 years, had no significant diagnostic differences in QOL domain scores and attitudes to MS. Caregivers had significantly lower QOL than the general population control group for five out of six domains and the general facet (P < 0.01), but higher QOL than the patients. When the scores were corrected for patients' depression and disability, caregivers had similar QOL with the general population group for four domains. Using corrected scores, MS caregivers had lower scores than diabetic and psychiatric caregivers in the physical, psychological and social relations domains. Majority expressed negative attitudes to MS. Caregiver QOL was more affected by their fear of having MS than their feelings about the illness and caregiving role. Caregiver attitudes had mostly no significant impact on their proxy ratings of patients' QOL. The significant predictor of caregivers' overall QOL was their impression of patients' QOL.ConclusionCaregivers need specific attention if they are less educated, unemployed, afraid of having MS and caring for patients with longer duration of illness and less education. In particular, attention to patients' depression and disability could improve caregivers' QOL. Caregivers need specific programs to address fear of having MS, negative attitudes to illness and their unmet needs.

Violence in psychosis: Estimating the predictive validity of readily accessible clinical information in a community sample

ObjectiveThis study sought to assess the validity of different combinations of readily available clinical information in predicting assaults by patients with psychosis, predominantly in the community. The combinations of information were: a) age and sex, b) age, sex and history of criminality/violence c) age, sex, history of violence and drug use and d) age, sex, history of violence, drug use and personality disorder. Method708 subjects were followed for 2 years. Assaults were measured using multiple sources of information. Prediction validity was measured using the area under the receiver operating curves (AUC) and the number needed to detain (NND). A simple prediction tool was developed. ResultsThe AUC values using the four combinations of information were a) 0.65, b) 0.70, c) 0.71, and d) 0.73. Prediction based on combination b), c), and d) implied a NND of 3. A rule based on c), the most accessible information, is suggested as a simple screening tool. ConclusionsReadily available clinical information allowed the prediction of assault over 2 years, in a sample of general psychiatric patients with psychosis, with a level of predictive accuracy comparable to that described using more detailed risk assessment tools. The information used in the predictive model was: age, sex, having committed an assault in the last 2 years (self-report) and having used any drug in the last year (self-report).

Substance Abuse-Related Mortality Among Middle-Aged Male VA Psychiatric Patients

Substance Abuse-Related Mortality Among Middle-Aged Male VA Psychiatric Patients

Psychopathic personality traits and life-success

Psychopathy is an important personality construct, particularly within forensic settings. However, the first comprehensive description of psychopathic personalities was based on non-criminal, civil psychiatric patient samples. Case reports included highly maladaptive individuals but also suggested that milder traits can be found in persons with considerable success in life. More recent studies suggested that the interpersonal traits of psychopathy might be of advantage to achieve professional success but less successful in other important domains of life. This study aimed to investigate the hypothesis that some features of psychopathy are related to life-success in a community sample of 304 men at age 48. This hypothesis was not confirmed. Despite strong similarities with narcissistic personality disorder traits which have been demonstrated to have beneficial effects on life-success, the interpersonal domain was not related to “status and wealth” or “successful intimate relationships”. Impulsiveness and antisocial behavior negatively predicted “status and wealth”, and affective deficiency was negatively associated with both aspects of a successful life. It is concluded that psychopathic traits do not contribute to a successful life and that the findings cast doubt on the existence of the successful psychopath.

In This Issue

In This Issue

Psychache and Suicide: A Preliminary Investigation

Shneidman's Psychological Pain Assessment Scale (PPAS; 1999) was administered to 88 psychiatric patients. Both current and worst-ever psychache were significantly higher in those patients judged by a psychiatrist, on the basis of a structured clinical interview, to be at risk of suicide. However, current and worstever psychache were not associated with having attempted suicide in the past. Thus, for the present sample of psychiatric patients, the PPAS appears to be more sensitive to current suicidality than to past suicidality. Further, there are validity issues with the PPAS, with the need for multi-item measures and probably a multifactor measure.

Suicide among Discharged Psychiatric Inpatients in the Department of Veterans Affairs

The objective of this study was to explore correlates of the use of firearms to commit suicide. A national sample of psychiatric patients discharged from Department of Veterans Affairs medical centers was followed from the time of discharge until December 1999. The study explores state-level measures as correlates of overall suicide and suicide by firearm, controlling for individual sociodemographic characteristics and psychiatric diagnosis. The outcomes of interest were completed suicide and suicide by firearm. Patients who were male, Caucasian, and who had a diagnosis of substance abuse or post-traumatic stress disorder were significantly more likely to use a firearm than another means to commit suicide. Multivariable models indicated that veterans living in states with lower rates of gun ownership, more restrictive gun laws, and higher social capital were less likely to commit suicide with a firearm. Gun ownership rates, legislation, and levels of community cohesiveness are significantly associated with the likelihood of psychiatric patients committing suicide with a gun.

Medicare Part D Prescription Drug Benefits and Administrative Burden in the Care of Dually Eligible Psychiatric Patients

Medicare Part D Prescription Drug Benefits and Administrative Burden in the Care of Dually Eligible Psychiatric Patients

Avaliação das habilidades de vida independente e comportamento social de pacientes psiquiátricos desospitalizados

INTRODUÇÃO: Este estudo teve como objetivo avaliar o comportamento social e as habilidades de vida independente de um grupo de pacientes psiquiátricos antes de sua saída do hospital e 2 anos após a sua transferência para as residências terapêuticas. MÉTODO: Estudo de corte transversal, realizado em duas etapas distintas, antes e depois, utilizando-se, como instrumentos, as escalas Independent Living Skills Survey e Social Behavior Scale. RESULTADOS: A maioria dos pacientes era do sexo masculino (58,7%), com médias de idade e tempo de internação iguais a 57,5±11,8 anos e 29,8±10,2 anos; 54,6% tinham diagnóstico de esquizofrenia; 25,3%, de deficiência mental; e o restante, de categorias várias. Houve melhora significativa no comportamento social e no grau de autonomia dos pacientes (p &lt;0,05) ao se comparar os escores dos pacientes nas escalas, nas fases 1 e 2. As variáveis que mais se associaram com o escore de evolução foram idade, tempo de internação e nível inicial de funcionamento dos pacientes. DISCUSSÃO: As limitações no funcionamento social e no grau de autonomia dos pacientes, na primeira fase do estudo, não foram incompatíveis com a convivência na comunidade. Os pacientes apresentaram evolução satisfatória no comportamento social e nas habilidades cotidianas ao longo de 2 anos, de acordo com os escores de evolução medidos pelas duas escalas.