Standardized Screening Questionnaire Research Articles

Preoperative coagulation tests: A narrative review of current guidelines

IntroductionHemostasis tests are traditionally requested for all patients requiring any surgical act or invasive diagnostic-therapeutic procedure to prevent hemorrhagic complications. The aim of this study is to assess the necessity of requesting standard pre-procedure hemostasis tests. MethodologyA narrative literature review was conducted using the PubMed data-base. Search terms included «Hemostasis» or «Blood coagulation» in combination with «Preoperative care», «Preoperative period», or «Preoperative procedure». Additionally, a targeted search was performed to find recommendations from international societies related to the topic. ResultsA total of 233 articles were found, 17 were pre-selected, and after full-text evaluation, 14 relevant articles were identified. The targeted search yielded an additional 12 articles.The request for tests should be individualized according to the clinical history. Standardized screening questionnaires for hemostasis disorders are useful and complement the aforementioned approach. Factors such as age, ASA classification, bleeding potential-complexity of the procedure, and anesthetic technique may influence their request. DiscussionThe incidence of hemostasis disorders in the general population is very low, and these can mostly be detected through clinical history. Thus, it is the clinical history that should guide the need for laboratory test requests. ConclusionsPreoperative hemostasis tests should not be indiscriminately requested for all patients needing an intervention or invasive diagnostic-therapeutic procedure, but rather when there are doubts about their hemostatic competence or as advised by the nature of the procedure they are undergoing.

Comparing standard screening questionnaires of canine behavior for assessment of cognitive dysfunction.

Canine cognitive dysfunction (CCD) is a common, yet underdiagnosed neurodegenerative disease affecting older dogs. Treatment is most effective when started early, so identifying mild cognitive decline in the earlier stages of the disease is considered important. To compare the results of three different standard screening questionnaires [Canine Dementia Scale (CADES), Canine Cognitive Assessment Scale (CCAS), and Canine Cognitive Dysfunction Rating Scale (CCDR)] for CCD diagnosis. Trainability, pain sensitivity, and fear were additionally assessed with the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) in order to evaluate associations between the three dementia scales and behavior. An online survey containing all the mentioned questionnaires was designed for and distributed among owners of elderly dogs. Data from 597 dogs were analyzed. Overall, the scores of the three CCD questionnaires correlated well with each other, especially those of the CADES and CCAS. The CADES was more sensitive in identifying dogs with already mild to moderate cognitive impairment, while the others classified them as still undergoing normal aging. CCD scores increased for all questionnaires with age with spatial orientation being a key feature in CCD development. Trainability assessed with the C-BARQ decreased significantly with severity of CCD signs, while pain sensitivity increased. Fear and anxiety was pronounced in animals with mild but not with severe CCD. These associations based on the C-BARQ were more clearly observable in relation to CADES and CCDR than CCAS. The choice of screening questionnaire impacts the evaluation of cognitive status and severity of CCD. Thresholds for severity classification differ significantly and may have an impact on reliable assessment. Further longitudinal studies are required to determine which of the questionnaires investigated in this study is best suited for early detection of CCD.

Implementation of Listening Visits with Parents of Preterm Infants in an Italian Neonatal Intensive Care Unit.

To assess the feasibility of implementing Listening Visits (LV) in an Italian neonatal intensive care unit (NICU). This feasibility implementation of LV included empathic listening and problem-solving sessions provided by a psychologist to 26 parents of hospitalized preterm newborns. Using the RE-AIM implementation framework, three facets of feasibility were assessed: reach, adoption, and implementation. It is feasible to integrate LV into the NICU: 76% of families were willing to try LV (reach). Listening Visits recipients reported high satisfaction. Twelve of the 16 families (75%) received six or more LV sessions (adoption), with mothers attending more sessions. Implementation fidelity, defined here as the percentage of LV recipients that received at least four sessions, was 94% among mothers and 30% among fathers. The LV intervention for parental support during the NICU stay is feasible and deemed helpful by parents. Parents were motivated to participate even though their levels of depression, stress, and anxiety were not high. In addition to the use of standardized screening questionnaires, parental requests and clinical team indications should be included in the decision-making for the provision of parental support services.

Improved accuracy and efficiency of primary care fall risk screening of older adults using a machine learning approach.

While many falls are preventable, they remain a leading cause of injury and death in older adults. Primary care clinics largely rely on screening questionnaires to identify people at risk of falls. Limitations of standard fall risk screening questionnaires include suboptimal accuracy, missing data, and non-standard formats, which hinder early identification of risk and prevention of fall injury. We used machine learning methods to develop and evaluate electronic health record (EHR)-based tools to identify older adults at risk of fall-related injuries in a primary care population and compared this approach to standard fall screening questionnaires. Using patient-level clinical data from an integrated healthcare system consisting of 16-member institutions, we conducted a case-control study to develop and evaluate prediction models for fall-related injuries in older adults. Questionnaire-derived prediction with three questions from a commonly used fall risk screening tool was evaluated. We then developed four temporal machine learning models using routinely available longitudinal EHR data to predict the future risk of fall injury. We also developed a fall injury-prevention clinical decision support (CDS) implementation prototype to link preventative interventions to patient-specific fall injury risk factors. Questionnaire-based risk screening achieved area under the receiver operating characteristic curve (AUC) up to 0.59 with 23% to 33% similarity for each pair of three fall injury screening questions. EHR-based machine learning risk screening showed significantly improved performance (best AUROC = 0.76), with similar prediction performance between 6-month and one-year prediction models. The current method of questionnaire-based fall risk screening of older adults is suboptimal with redundant items, inadequate precision, and no linkage to prevention. A machine learning fall injury prediction method can accurately predict risk with superior sensitivity while freeing up clinical time for initiating personalized fall prevention interventions. The developed algorithm and data science pipeline can impact routine primary care fall prevention practice.

Anxiety and depression symptoms among a sample of Khartoum civilians during the 2023 Sudan armed conflict: A cross-sectional study.

Mental health during armed conflicts is of paramount importance, as such situations often lead to increased risks of anxiety and depression symptoms among civilians. The military conflict between the Sudanese army and Rapid Support Forces, which began on April 15, 2023, is currently ongoing mainly in Khartoum State. Despite the significant impact of the conflict on the region, there is a lack of data regarding the mental health status of the residents. The aim of this study is to assess anxiety and depression symptoms among residents of Khartoum State during the first months of the 2023 military conflict. We conducted a cross-sectional study among residents of Khartoum State between May 27 and June 19 using an online questionnaire. We used standardized screening questionnaires, namely the Generalized Anxiety Disorder (GAD-7) for anxiety and the Patient Health Questionnaire (PHQ-9) for depression. Multiple logistic regression was used to identify sociodemographic factors that are associated with anxiety and depression symptoms. Out of the 393 participants in the study, 70% had symptoms suggestive of depression and 57.3% suffered from anxiety symptoms. Both anxiety and depression were associated with being female (p < 0.001). Being married was a predictor of anxiety (p = 0.028) but not depression (p = 0.3). Other predictors were not significant (p > 0.05). High levels of anxiety and depression symptoms were prevalent among Khartoum residents during the conflict, with females and married individuals at higher risk. Immediate medical assessment is essential for identifying cases and providing support. Mental health services should be integrated into emergency response efforts, particularly focusing on vulnerable groups. Future research should address study limitations and explore coping strategies for anxiety and depression in Sudanese adults.

Olfactory and taste disorders in COVID-19: a cross-sectional study in primary health care.

The objective of this study was to describe the occurrence of self-reported olfactory and taste disorders in non-hospitalized Brazilian adults who presented severe acute respiratory syndrome-related coronavirus 2 infection symptoms and attended primary health care. This cross-sectional study was based on a routine standardized diagnostic screening questionnaire applied in a Brazilian primary care facility. The olfactory and taste disorder occurrence was compared between severe acute respiratory syndrome-related coronavirus 2-positive and severe acute respiratory syndrome-related coronavirus 2-negative cases and described by age and sex. Severe acute respiratory syndrome-related coronavirus 2-positive patients had a higher proportion of self-reported olfactory and taste disorders, as compared with severe acute respiratory syndrome-negative (50.7%, vs. 20.6%, p<0.0001). Of all individuals with self-reported olfactory and taste disorder cases, 69% presented both olfactory and taste impairments, 13% olfactory only, and 17% taste only. In severe acute respiratory syndrome-related coronavirus 2-positive cases, the frequency of olfactory and taste disorders was significantly higher among females as compared with males (71% vs. 34%). Additionally, people with olfactory and taste disorders were significantly younger in the severe acute respiratory syndrome-related coronavirus 2-positive group. Self-reported olfactory and taste disorders are highly common among non-hospitalized severe acute respiratory syndrome-related coronavirus 2-positive Brazilian people who attended the Family Health Care Unit. The co-occurrence of both self-reported olfactory and taste disorders was more frequent than self-reported olfactory or taste disorders alone.

Leveraging Technology and Workflow Optimization for Health-Related Social Needs Screening: An Improvement Project at a Large Health System

The collection of health-related social needs (HRSN) data at one large health system has historically been inconsistent. This project was aimed to increase annual HRSN screening rates by standardizing data collection in the electronic health record (EHR) through optimized clinical workflows. The authors designed a standard screening questionnaire in alignment with the Accountable Health Communities model, and they conducted interviews with eleven US-based health systems and one medical center on best practices for ambulatory HRSN screening and interventions, which identified five possible methods to administer the questionnaire. After testing, the authors opted to send questionnaires to patients through the patient portal three days prior to an ambulatory visit. For inpatients, in-person interviews were implemented. Staff implementing the updated processes included registered nurses, social workers, preventive health coordinators, and community health workers. The annual screening rate for all active ambulatory patients increased from 0.4% to 15.9% (p < 0.001), and 10.7% of all patients had at least one health-related social need. The annual screening rate for inpatients was estimated to be zero at baseline and increased by 66 percentage points (p < 0.001). The most prevalent health-related social need in both settings was financial resource strain, followed closely by food insecurity. Well-designed interventions and technology support were effective in achieving improved screening and data collection. Leadership support, building interventions within preexisting workflows, and ensuring standard data capture in the EHR were key factors leading to successful process improvement.

Abstract 15542: Social Determinants of Health Screening of Patients With Congestive Heart Failure Within Multiple Urban Ambulatory Clinics

Introduction: There is a growing body of literature dedicated to understanding the implications of social determinants of health (SDOH) on cardiovascular disease. This study evaluated a pilot of standardized SDOH screening questionnaires in two large urban ambulatory clinics within a quaternary integrated health network in the Northeastern United States. Goals/Aims: This study aims to investigate common social determinants of health which may influence patients with congestive heart failure (CHF). Methods: A retrospective review of the incidence of SDOH in adult patients from two Internal Medicine outpatient residency clinics between 2020 and 2023 was performed. SDOH assessment was performed at every visit. Multivariate logistic regression analysis was performed to assess the association of SDOH in patients with and without CHF. Results: A total of 14,516 patients were evaluated during this study period (mean age 66 years, 62% female). When matched for age and sex, 808 patients with CHF were compared to those without CHF. In matched data, those with CHF were significantly less likely to endorse food insecurity (64.2% vs 94.6%, p&lt;0.05), lack of safety (1.4% vs 2.8%, p&lt;0.05), lack of social connection (34.4% vs 86.8%, p&lt;0.05), and stress (29.1% vs 84.3%, p&lt;0.05). Patients with CHF were more likely (91% vs 26%, p&lt;0.05) to report a positive PHQ-9 depression screen [Table 1]. Patients with CHF were also noted to have a higher incidence of comorbid illnesses. Conclusions: Utilization of evidence-based SDOH screening questions in the workflow can help identify key barriers to cardiovascular diseases such as CHF. Multidisciplinary care in patients with CHF may contribute to improved SDOH reporting. Future studies should use qualitative and quantitative data in combination to further evaluate and address barriers to care in patients with CHF.

(122) Provider Attitude towards Postpartum Sexual Health

Abstract Introduction The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41% and is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic and the use of a standardized screening questionnaire could be implemented to improve outcomes during postpartum appointments. Objective To assess provider knowledge and practices towards postpartum sexual health with the goal of improving postpartum sexual health. Methods Providers who care for postpartum patients at [institution and city obscured], were asked to complete an anonymous survey online to assess providers’ general knowledge and practices. Results 79% of respondents answered that they felt very comfortable assessing postpartum sexual health and 88% expressed a need for continuing education on sexual medicine. The most common response for barriers to care was a lack of time. None of the respondents reported using questionnaires to assess sexual health. Conclusions The most significant barriers to assessing postpartum sexual health are a lack of time and provider knowledge. To overcome this, a standardized questionnaire should be created and improved continuing education should be implemented. Disclosure No

Validated French translation of the ESIT-SQ standardized tinnitus screening questionnaire

ObjectivesThe heterogeneity of tinnitus in terms of etiology, presentation and sometimes severe impact on quality of life hinders treatment and clinical research. The European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ) collects standardized tinnitus characteristics for patient subtyping. A validated French translation of the ESIT-SQ is presented here. MethodOn the initiative of the French Interdisciplinary Tinnitus Association (AFREPA), 3 translators (1 professional translator, 1 clinician and 1 researcher) were missioned to translate the English version of the ESIT-SQ into French, adhering to good practice guidelines. Nine patients were recruited with the help of the France-Acouphènes patient association, to test and validate the translation. Lastly, an exploratory survey of responses to the French questionnaire was conducted online via the Siopi mobile phone application. ResultsThe French translation of the ESIT-SQ was successfully validated. 105 patients responded to the exploratory survey, and their characteristics are presented here. ConclusionThis new validated French translation of the ESIT-SQ will enable epidemiological and clinical data to be collected in French-speaking populations, and thus compiled and compared with data collected with other versions of this questionnaire already published in other languages.

Substance Use, Health, and Adverse Life Events amongst Amphetamine-Type Stimulant Users in North East England: A Cross-Sectional Study.

Amphetamine-type stimulants (ATS) are the second most commonly used class of illicit drugs globally, yet there is limited understanding of which factors contribute to different pathways of ATS use. We sought to compare current, former, and exposed non-ATS users’ substance use, mental/physical health, and adverse life experiences. A cross-sectional survey, using computer-assisted personal interview software, was conducted between June 2018 and March 2019 in North East England. Quota-based sampling was used to recruit 389 individuals (aged 18 to 68; 52.6% male): 137 current ATS users; 174 former users; and 78 exposed non-users. Standardized screening questionnaires captured current/prior substance use. Participants self-reported diagnoses of selected physical and mental health disorders and specific adverse life experiences. Analysis used descriptive statistics and comparative tests (including chi-square, Kruskal–Wallis and Mann–Whitney U). Early exposure to illicit substances, challenging mental health, and certain adverse life experiences (such as growing up in statutory care) were more common in individuals currently using ATS compared to those who had never used or stopped using stimulants. Multi-level interventions are needed that address the mental health, social, and economic needs of people with dependent drug use. These could include targeted efforts to support children growing up under care, integrated mental health and substance use support, and joined-up substance use interventions reflective of wider structural factors.

Evaluation of a social determinants of health screening questionnaire and workflow pilot within an adult ambulatory clinic

BackgroundThere is increased recognition in clinical settings of the importance of documenting, understanding, and addressing patients’ social determinants of health (SDOH) to improve health and address health inequities. This study evaluated a pilot of a standardized SDOH screening questionnaire and workflow in an ambulatory clinic within a large integrated health network in Northern California.MethodsThe pilot screened for SDOH needs using an 11-question Epic-compatible paper questionnaire assessing eight SDOH and health behavior domains: financial resource, transportation, stress, depression, intimate partner violence, social connections, physical activity, and alcohol consumption. Eligible patients for the pilot receiving a Medicare wellness, adult annual, or new patient visits during a five-week period (February-March, 2020), and a comparison group from the same time period in 2019 were identified. Sociodemographic data (age, sex, race/ethnicity, and payment type), visit type, length of visit, and responses to SDOH questions were extracted from electronic health records, and a staff experience survey was administered. The evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.ResultsTwo-hundred eighty-nine patients were eligible for SDOH screening. Responsiveness by domain ranged from 55 to 67%, except for depression. Half of patients had at least one identified social need, the most common being stress (33%), physical activity (22%), alcohol (12%), and social connections (6%). Physical activity needs were identified more in females (81% vs. 19% in males, p < .01) and at new patient/transfer visits (48% vs. 13% at Medicare wellness and 38% at adult wellness visits, p < .05). Average length of visit was 39.8 min, which was 1.7 min longer than that in 2019. Visit lengths were longer among patients 65+ (43.4 min) and patients having public insurance (43.6 min). Most staff agreed that collecting SDOH data was relevant and accepted the SDOH questionnaire and workflow but highlighted opportunities for improvement in training and connecting patients to resources.ConclusionUse of evidence-based SDOH screening questions and associated workflow was effective in gathering patient SDOH information and identifying social needs in an ambulatory setting. Future studies should use qualitative data to understand patient and staff experiences with collecting SDOH information in healthcare settings.

Effects of Trauma and Anxiety on Adherence in Pediatric Type 1 Diabetes.

Psychiatric factors such as depression, anxiety, and life stressors have been shown to negatively affect diabetes self-management and A1C in children and adolescents. However, less is known about how trauma exposure and symptoms of post-traumatic stress disorder (PTSD) may affect type 1 diabetes. To determine the rates of trauma exposure and PTSD symptoms in patients aged 7-21 years with type 1 diabetes and to examine the relationships among trauma exposure, PTSD, anxiety, depression, and diabetes self-management. Patients underwent standardized psychiatric screening questionnaires during clinic visits. A1C at goal was defined as <7.0%, and behavioral adherence was defined as specific parameters of blood glucose monitoring. χ2 and Fisher exact tests were used to assess the relationships among trauma, PTSD, anxiety, and behavioral adherence. ANOVA was conducted to examine group differences between A1C and the presence of suicidal ideation. Of the participants, 38.4% (n = 99, mean age 13.8 ± 3.5 years, 51.5% female) had trauma symptoms and functional impairment concerning for PTSD. Rates of trauma secondary to accidental injury, medical traumatic stress, natural disaster, and witness to family violence were 28.3, 22.2, 10.1, and 6.1%, respectively. Neither PTSD nor anxiety nor depression symptoms were associated with behavioral nonadherence (P = 0.546, P = 0.337, and P = 0.697, respectively), but the subscales for significant school avoidance and generalized anxiety disorders were associated with behavioral nonadherence (P = 0.023 and P = 0.032, respectively). Those who reported suicidal ideation had higher mean A1C than those who did not (A1C 8.9 vs. 8.3, P = 0.047). Although trauma was common among youth with type 1 diabetes, neither trauma nor PTSD was associated with changes to self-management. However, certain forms of anxiety and suicidal ideation were associated with poor self-management and higher A1C, respectively.

English

BACKGROUND Autism is a complex developmental disorder that is not fully understood and is still debated. Till recently, there is no standardised treatment option for autism, earlier the diagnosis better the prognosis but there are only few Indian studies to establish the relationship between early diagnosis and effectiveness of treatment in autistic children and hence this study was conducted. METHODS This was a cross sectional study. Parents of 51 autistic children were asked to fill the Childhood Autism Rating Scale (CARS-2) questionnaire,1 which is a standard screening questionnaire and the CARS-0 and CARS-1 scores were studied. The therapists of the respondents were asked to fill CARS-2 questionnaire based on the characteristics of the respondent when he / she was diagnosed and before he / she started his / her treatment. This score has been documented as CARS-0 score. Then another CARS-2 test was scored by the therapists / researcher based on the present characteristics of the respondent. The relationship between CARS0 score and CARS-1 score, the age of diagnosis and the difference in CARS score were investigated based on paired t-test and Pearson’s correlation. Analysis was done using SPSS and Microsoft Excel. RESULTS CARS scores decreased after treatment and the decrease in CARS 1 scores was more in age groups of 0 - 3 and 3 - 5 years as compared to 5 - 10 years. Pearson’s correlation was done to study the association between the age of diagnosis and the difference between CARS-0 and CARS-1 scores and a negative correlation was seen. CONCLUSIONS There was a significant correlation between the age of diagnosis and the treatment outcome in autistic children. KEYWORDS Autism, Autism Spectrum Disorder, CARS Questionnaire, CARS 0, CARS 1

Management and implementation strategies of pre-screening triage in children during coronavirus disease 2019 pandemic in Guangzhou, China.

BACKGROUNDEmerging infectious diseases are a constant threat to the public’s health and health care systems around the world. Coronavirus disease 2019 (COVID-2019), which was defined by the World Health Organization as pandemic, has rapidly emerged as a global health threat. Outbreak evolution and prevention of international implications require substantial flexibility of frontline health care facilities in their response.AIMTo explore the effect of the implementation and management strategy of pre-screening triage in children during COVID-19.METHODSThe standardized triage screening procedures included a standardized triage screening questionnaire, setup of pre-screening triage station, multi-point temperature monitoring, extensive screenings, and two-way protection. In order to ensure the implementation of the pre-screening triage, the prevention and control management strategies included training, emergency exercise, and staff protection. Statistical analysis was performed on the data from all the children hospitalized from January 20, 2020 to March 20, 2020 at solstice during the pandemic period. Data were obtained from questionnaires and electronic medical record systems. RESULTSA total of 17561 children, including 2652 who met the criteria for screening, 192 suspected cases, and two confirmed cases without omission, were screened from January 20, 2020 to March 20, 2020 at solstice during the pandemic period. There was zero transmission of the infection to any medical staff. CONCLUSIONThe effective strategies for pre-screening triage have an essential role in the prevention and control of hospital infection.

Detecting and Assessing Suicide Ideation During the COVID-19 Pandemic

BackgroundThe COVID-19 pandemic prompted a rapid shift to virtual (video and telephone) delivery of mental health care, disrupting established processes for identifying people at increased risk of suicidal behavior.MethodsFollowing the shift to virtual care, Kaiser Permanente Washington implemented a series of workflow changes to administer standard screening and monitoring questionnaires at virtual visits and to complete structured suicide risk assessments for patients reporting frequent suicidal ideation. These new workflows included automated distribution of questionnaires via the electronic health record (EHR) patient portal and automated alerts to clinicians regarding indicators of high risk.ResultsIn March 2020, in-person mental health visits were rapidly and completely replaced by video and telephone visits. The proportion of mental health visits with completed screening and monitoring questionnaires fell from approximately 80% in early 2020 to approximately 30% in late March, then gradually recovered to approximately 60% by the end of 2020. Among patients reporting frequent suicidal ideation on monitoring questionnaires, the proportion with a recorded suicide risk assessment fell from over 90% in early 2020 to approximately 40% in late March, then gradually recovered to nearly 100% by the end of 2020.ConclusionUse of EHR patient portal messaging capabilities can facilitate systematic identification and assessment of suicide risk for patients receiving mental health care by telephone or video visit.

An epidemiological survey of epilepsy in tropical rural areas of China.

ObjectiveEpilepsy is a chronic neurological disease that is characterized by seizures. Seizure episodes, stigma, and high medical costs associated with this condition caused significant psychological distress. This study aimed to evaluate epidemiological characteristics and treatment status of epilepsy in individuals existing in the tropical rural areas of Hainan Province of China.MethodsA household survey on epilepsy was conducted among the rural population of Chengmai County, Danzhou City, Baoting Autonomous County (Li and Miao nationalities), and Dingan County in Hainan Province, China. A screening questionnaire based on the standard screening questionnaires of the World Health Organization (WHO) was designed and a screening instrument of International Community‐based Epilepsy Research Group was used. Individuals suspected or previously diagnosed with epilepsy were reexamined by an experienced neurologist. Further clinical data were collected from subjects with confirmed diagnosis of epilepsy.ResultsThis study included 16 676 subjects with 8827 men (52.93%) and 7849 women (47.07%). Majority of the study subjects included were of Han Chinese (N = 13 145, 78.83%), and the remaining were of Li minority ethnicity. The incidence of epilepsy was 0.24 per 1000, and the total prevalence of active epilepsy was 2.33 per 1000. The prevalence of epilepsy in the Han and Li nationalities was 3.27 and 2.27 per 1000, respectively, which was shown to be higher in people aged ≥ 60. The initial onset of epilepsy tended to trigger among children aged between 0 and 9 years old. Initial assessment revealed that the treatment gap for active epilepsy was 58.97%, and stroke is shown as the most common cause of symptomatic epilepsy.SignificanceThe prevalence and incidence of epilepsy in tropical rural areas of Hainan Province were close to those of the earlier findings that are reported in other regions of China and lower than those remaining in the tropical areas around the world. There exists a huge treatment gap for active epilepsy, which indicates an urgent need for a rational intervention strategy.

Применение параметрических и опросниковых методов исследования депрессивных и тревожных расстройств при шизофрении

Objective of the Review: To develop scales and questionnaires used to diagnose depressive disorders in schizophrenia patients. Key Points. We have analysed Russian and foreign publications for a period of 10 years (2010–2020) in the following databases: Clinicalkeys, Google Scholar, PubMed, Springer, Wiley Online Library, Taylor &amp; Francis Online, US National Library of Medicine National Institutes of Health, ScienceDirect, and eLIBRARY.RU. Depression and anxiety disorders are diagnosed and their dynamics is evaluated using both standardized psychiatric screening and valid scales and questionnaires. Timely diagnosis and follow-up of depressive disorders in schizophrenia patients are based on a wide range of scales and questionnaires. However, they are useful not only for diagnosis and evaluation of the severity and/or the rate of depressive disorders, but also sometimes complicate comparison of observation results in different clinics, countries and globally. There is currently no unified methodology or algorithm for using of scales and questionnaires for depressive disorders in schizophrenia in general and depending on the condition stage and severity. Conclusion. Depressive disorders diagnosis in schizophrenia patients requires a multidisciplinary approach with participation of psychiatrists, neurologists and clinical pharmacologists to improve therapy results and patients’ quality of life. Depression and anxiety disorders are diagnosed and their dynamics is evaluated using both standardised psychiatric screening and valid scales and questionnaires. However, currently there is no a unified protocol for using a wide range of diagnostic scales and questionnaires for schizophrenia patients at high risk of depressive disorders, thus complicating continuation in follow-up of these patients both in inpatient and outpatient settings. Keywords: research methods, depressive disorders, schizophrenia, scale, questionnaire.

An association between chronic widespread pain and the gut microbiome.

Chronic widespread musculoskeletal pain (CWP) is a characteristic symptom of fibromyalgia, which has been shown to be associated with an altered gut microbiome. Microbiome studies to date have not examined the milder CWP phenotype specifically nor have they explored the role of raised BMI. The aim of this study was to investigate whether the microbiome is abnormal in CWP. CWP was assessed using a standardized screening questionnaire in female volunteers from the TwinsUK cohort including 113 CWP cases and 1623 controls. The stool microbiome was characterized using 16S rRNA amplicon sequencing and amplicon sequence variants, and associations with CWP examined using linear mixed-effects models adjusting for BMI, age, diet, family relatedness and technical factors. Alpha diversity was significantly lower in CWP cases than controls (Mann-Whitney test, P-values 2.3e-04 and 1.2e-02, for Shannon and Simpson indices respectively). The species Coprococcus comes was significantly depleted in CWP cases (Padj = 3.04e-03). A genome-wide association study (GWAS) performed for C. comes in TwinsUK followed by meta-analysis with three Dutch cohorts (total n = 3521) resulted in nine suggestive regions, with the most convincing on chromosome 4 near the TRAM1L1 gene (rs76957229, P = 7.4e-8). A Mendelian randomization study based on the results of the GWAS did not support a causal role for C. comes on the development of CWP. We have demonstrated reduced diversity in the microbiome in CWP, indicating an involvement of the gut microbiota in CWP; prospectively the microbiome may offer therapeutic opportunities for this condition.

56-LB: Trauma and Anxiety Effects on Adherence in Pediatric Type 1 Diabetes Mellitus

Background: Psychiatric factors, such as depression, anxiety, and life stressors, have been shown to negatively affect diabetes adherence and glycemic control in children and adolescents. However, less is known about how trauma exposure and symptoms of post-traumatic stress disorder (PTSD) may impact adherence and glycemic control. Objectives: Determine the rates of trauma exposure and PTSD symptoms in patients ages 7-21 with type 1 diabetes (T1DM). Examine the relationship between trauma exposure, PTSD, Anxiety, behavioral adherence and glycemic control. Methods: We enrolled 99 patients (mean age 13.8 ± 3.5 years, 51.5% female) who had been diagnosed with T1DM for at least 6 months and underwent standardized psychiatric screening questionnaires during their clinic visits. HbA1c at goal was defined by HbA1c &amp;lt; 7.5% and behavioral adherence were defined by self-monitoring of blood glucose (SMBG) ≥ 4/day or continuous glucose monitoring (CGM) calibration ≥ 2/day and/or CGM use ≥ 75%. All participants and/or their guardians provided assent and consent. Chi-square tests were used to assess the relationships between trauma, PTSD, anxiety and behavioral adherence. One-way ANOVA was conducted to examine group differences between HbA1c scores and the presence of suicidal ideation. Results: 38.4% of participants had trauma symptoms and functional impairment. Rates of trauma secondary to accidental injury, medical traumatic stress, natural disaster and witness to family violence were 28.3%, 22.2%, 10.1%, and 6.1%, respectively. Neither trauma exposure nor PTSD predicted diabetes adherence. Anxiety was significantly associated with diabetes nonadherence (p=0.006). The group with suicidal ideation had higher HbA1c compared to the group without suicidal ideation (8.92 ± 1.40 vs. 8.30 ± 1.35, p=0.047). Conclusions: Although trauma was common among young patients with T1DM, other factors, such as anxiety and suicidal ideation, maybe more important indicators of adherence and glycemic control. Disclosure R. Raj: None. M. Nguyen: None. A. Morales: None. A.L. Meadows: None. Funding Children’s Miracle Network/Kentucky Children’s Hospital Research Fund; National Institutes of Health (UL1TR001998)