Epidemiologia e psichiatria sociale最新文献

{"title":"Development and validation of the RQC: a daily contact log for ACT and ICM teams","authors":"A. Lesage, D. Gelinas, J. Bisson, Eric Dion, N. Ricard","doi":"10.1017/S1121189X00001597","DOIUrl":"https://doi.org/10.1017/S1121189X00001597","url":null,"abstract":"Aim – Instruments to measure the process - the daily activities of home care workers - have received little attention and may impede research in refining the active ingredients, the clientele best served and continuous quality improvement. We developed a decade ago in Quebec, Canada, a new daily contact log (relevé quotidien des contacts or RQC) that has now reached in practice 1 million entries. Methods – Three features distinguish the RQC development, namely, practical ergonomics, a clear logic, and response categories easy to understand and retain. The instrument is filled following any 10-minute or more contact with or about the client, and covers the location, time and actors of the episode of care, and the nature of the intervention (crisis, representing, accompanying, discussing) in 10 areas (i.e. medication, daily living activities, housing, relationships, substance abuse, legal, etc.). Inter-rater agreement for each RQC response category and rater agreement with a criterion measure (coded vignettes) were evaluated. Results – Kappa coefficients and intra-class correlation coefficients yielded results ranging from at least moderate to generally substantial agreement for all 77 response categories. Conclusions – The new RQC may support international studies of the implementation and application of various forms of intensive home care, refining its indications, and serves as a clinical and managerial tool to ensure quality of the interventions. Declaration of Interest: The study was financed by funds from the Fonds de la recherche en santé du Québec (FRSQ) and the Canadian Institutes of Health Research (CIHR). The authors have not been involved with any other forms of financing that might be considered a conflict of interest in connection with the submitted article. Declaration of Interest: The study was financed by funds from the Fonds de la recherche en santé du Québec (FRSQ) and the Canadian Institutes of Health Research (CIHR). The authors have not been involved with any other forms of financing that might be considered a conflict of interest in connection with the submitted article.","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"44 - 51"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S1121189X00001597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57443264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is a run-in phase?","authors":"A. Cipriani, J. Geddes","doi":"10.1017/S1121189X0000155X","DOIUrl":"https://doi.org/10.1017/S1121189X0000155X","url":null,"abstract":"Abstract Run-in periods are frequently used when designing a clinical trial. In this paper we analysed the implications of runin periods for interpreting the results of clinical trials and applying these results in clinical practice. Study reports should indicate in details how run-in periods were carried out.","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"21 - 22"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S1121189X0000155X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57443490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EPS volume 19 issue 1 Front matter","authors":"","doi":"10.1017/s1121189x00001494","DOIUrl":"https://doi.org/10.1017/s1121189x00001494","url":null,"abstract":"","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"f1 - f4"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/s1121189x00001494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57442777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a set of schizophrenia quality indicators for integrated care.","authors":"Stefan Weinmann,&nbsp;Christiane Roick,&nbsp;Luise Martin,&nbsp;Stefan Willich,&nbsp;Thomas Becker","doi":"10.1017/s1121189x00001603","DOIUrl":"https://doi.org/10.1017/s1121189x00001603","url":null,"abstract":"<p><strong>Aim: </strong>We aimed at developing a prioritized set of quality indicators for schizophrenia care to be used for continuous quality monitoring. They should be evidence-based and rely on routine data.</p><p><strong>Methods: </strong>A systematic literature search was performed to identify papers on validated quality indicators published between 1990 to April 2008 in MEDLINE, the Cochrane databases, EMBASE and PsycINFO. Databases of relevant national and international organizations were searched. Indicators were described with respect to meaningfulness, feasibility and actionability. A workshop with relevant stakeholders evaluated the measures through a structured consensus process.</p><p><strong>Results: </strong>We identified 78 indicators through literature search and selected 22 quality indicators. Furthermore, 12 structural and case-mix indicators were choosen. Only five quality indicators were rated \"essential indicators\" (priority 1), 14 were rated \"additional first choice\" (priority 2), and three were rated as \"additional second choice\" (priority 3). Only four indicators assessed outcome quality. In the majority of indicators the evidence base supporting the indicator recommendation was weak. None of the selected indicators was validated in experimental studies.</p><p><strong>Conclusions: </strong>Evidence and validation base played only a subordinate role for indicator prioritisation by stakeholders indicating that there are discrepancies between clinical questions and requirements in schizophrenia care and scientific research.</p>","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"52-62"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/s1121189x00001603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29002766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing psychotic disorders: validity, reliability and applications of the Diagnostic Interview for Psychosis (DIP). Italian version.","authors":"Alberto Rossi,&nbsp;Vera Morgan,&nbsp;Francesco Amaddeo,&nbsp;Marco Sandri,&nbsp;Laura Grigoletti,&nbsp;Francesca Maggioni,&nbsp;Adele Ferro,&nbsp;Elena Rigon,&nbsp;Valeria Donisi,&nbsp;Valeria Vailati Venturi,&nbsp;Fabrizio Goria,&nbsp;Ingunn Skre,&nbsp;Michele Tansella,&nbsp;Assen Jablensky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>The Diagnostic Interview for Psychoses (DIP) is a comprehensive interview schedule for psychotic disorders, linked to the OPCRIT diagnostic algorithm, bridging the gap between fully structured, lay-administered schedules and semistructured, psychiatrist-administered interviews. Here we describe the validity, reliability and applications of the Italian version of the DIP.</p><p><strong>Methods: </strong>The interview was translated into Italian and its content validity tested by back translation. Sixty patients, drawn from among those who contacted the South-Verona Community Mental Health Service, were included in the study. Each patient was first assessed independently by two raters, one of whom conducted the interview, while the other assumed the role of observer. Subsequently (median: 89 days), 44 of these patients were re-interviewed by a third rater, who made an independent assessment. Diagnostic validity was assessed in 18 cases, interviewed with the DIP and using the SCAN as 'gold standard'.</p><p><strong>Results: </strong>The mean duration of the interview was 37 minutes for the inter-rater interviews and 39 minutes for the retest interviews. Good to excellent inter-rater reliability was demonstrated for both ICD-10 and DSM-IV diagnoses, while in the test-retest reliability pairwise agreement was high for half of the items. Diagnostic validity was good, with twelve out of the 18 DIP-OPCRIT diagnoses (67%) matching the SCAN diagnosis.</p><p><strong>Conclusions: </strong>Overall, the results support the reliability and validity of the Italian translation of the DIP. The Italian version will be useful both in routine practice to establish standard reference diagnoses of psychosis and in the research field, where it can be used by academic researchers in clinical trials and epidemiological studies.</p>","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"33-43"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29002771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The methodological and conceptual aspects of mortality studies in psychiatry.","authors":"Annibale Biggeri,&nbsp;Dolores Catelan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An extensive literature documented a mortality differential for natural causes between psychiatric patients and the general population. Less clear is the pattern for cancer diseases. Methodological problems arise when trying to explain such mortality gap: selection bias and reverse causation; time-dependent confounders that are also intermediate variables; complex relationships within a life course have to be considered. We try to explain such problems in terms of causal graphs. Excess risk for causes of death which are not attributable to higher prevalence of risk factors or treatment side-effects and higher mortality rates for avoidable causes have been also documented. These findings underline the need for research on health promotion and preventive programs targeted to psychiatric patients.</p>","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29003346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal imaging studies in schizophrenia: the relationship between brain morphology and outcome measures.","authors":"M. Bellani, N. Dusi, P. Brambilla","doi":"10.1705/524.6263","DOIUrl":"https://doi.org/10.1705/524.6263","url":null,"abstract":"Imaging studies have tried to identify morphological outcome measures of schizophrenia in the last two decades. In particular, longitudinal studies have reported a correlation between larger ventricles, decreased prefrontal volumes and worse outcome. This would potentially allow to isolate subtypes of schizophrenia patients with a worse prognosis and more evident biological impairments, ultimately helping in designing specific rehabilitation interventions.","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 3 1","pages":"207-10"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67615254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Messages to use in population-level campaigns to reduce mental health-related stigma: consensus development study.","authors":"Sarah Clement,&nbsp;Manuela Jarrett,&nbsp;Claire Henderson,&nbsp;Graham Thornicroft","doi":"10.1017/s1121189x00001627","DOIUrl":"https://doi.org/10.1017/s1121189x00001627","url":null,"abstract":"<p><strong>Aim: </strong>To develop and measure consensus about which type of message should be included in population-level campaigns to reduce mental health-related stigma.</p><p><strong>Methods: </strong>A panel of 32 experts attending an international conference on mental health stigma participated in a consensus development exercise. A modified nominal group technique was used incorporating two voting rounds, an overview of research evidence and group discussion.</p><p><strong>Results: </strong>There was high consensus (> or = 80%) regarding the inclusion of two of the message types presented--(i) recovery-oriented and (ii) see the person messages, and reasonable consensus (> or = 70%) regarding (iii) social inclusion/human rights and (iv) high prevalence of mental disorders messages. Ratings differed according to whether the participant was a psychiatrist or had personal experience of mental ill health. Analysis of the qualitative data revealed four themes: (i) benefits of messages countering the 'otherness' of people with mental ill health; (ii) problematic nature of messages referring to aetiology; (iii) message impact being dependent on the particular audience; (iv) need for specific packages of messages.</p><p><strong>Conclusions: </strong>This study supports the use of recovery-oriented messages and see the person messages. Social inclusion/human rights messages and high prevalence of mental disorders messages also merit consideration.</p>","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"72-9"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/s1121189x00001627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29002769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What can we do to reduce the burden of avoidable deaths in those with serious mental illness?","authors":"David Crompton,&nbsp;Aaron Groves,&nbsp;John McGrath","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Individuals with schizophrenia have higher mortality rates compared to the general community. Apart from an increased risk of suicide, people with schizophrenia have an increased risk of death related to a wide range of comorbid physical conditions. There is evidence to suggest that much of this mortality is avoidable. The provision of assertive management of comorbid physical disorders has the potential to help close the differential mortality gap. While the primary data are robust, there is less empirical evidence to guide policy makers and service providers when dealing with these problems. Focused clinical programs aimed at reducing risk factors (e.g. smoking, obesity) and shared care between mental health teams and primary care providers can help reduce the burden of avoidable deaths. In light of recent evidence suggesting that the mortality gap has widened in recent decades, there is an urgent need to address the burden of avoidable deaths in those with serious mental illnesses.</p>","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29003344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicides in psychiatric in-patients: what are we doing wrong?","authors":"Diego de Leo,&nbsp;Jerneja Sveticic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Given the uncontested role of psychiatric illnesses in both fatal and non-fatal suicidal behaviours, efforts are continuously made in improving mental health care provision. In cases of severe mental disorder, when intensified treatment protocols and continuous supervision are required due to individual's impaired emotional, cognitive and social functioning (including danger to self and others), psychiatric hospitalisation is warranted. However, to date there is no convincing evidence that in-patient care prevents suicide. In fact, quite paradoxically, both admissions to a psychiatric ward and recent discharge from it have been found to increase risk for suicidal behaviours. What elements in the chain of well-intentioned approaches to treating psychiatric illness and suicidality fail to protect this vulnerable population is still unclear. The same holds true for the identifications of factors that may increase the risk for suicide. This editorial discusses current knowledge on this subject, proposing strategies that might improve prevention.</p>","PeriodicalId":72946,"journal":{"name":"Epidemiologia e psichiatria sociale","volume":"19 1","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29003345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}