scholarly journals The sum of all fears: Comparing networks based on symptom sum-scores.

2021 ◽  
Author(s):  
Jonas M. B. Haslbeck ◽  
Oisín Ryan ◽  
Fabian Dablander
Keyword(s):  
Author(s):  
Joana Straub ◽  
Ferdinand Keller ◽  
Nina Sproeber ◽  
Michael G. Koelch ◽  
Paul L. Plener

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.


2012 ◽  
Vol 28 (4) ◽  
pp. 262-269 ◽  
Author(s):  
Matthias Johannes Müller ◽  
Suzan Kamcili-Kubach ◽  
Songül Strassheim ◽  
Eckhardt Koch

A 10-item instrument for the assessment of probable migration-related stressors was developed based on previous work (MIGSTR10) and interrater reliability was tested in a chart review study. The MIGSTR10 and nine nonspecific stressors of the DSM-IV Axis IV (DSMSTR9) were put into a questionnaire format with categorical and dimensional response options. Charts of 100 inpatients (50 Turkish migrants [MIG], 50 native German patients [CON]) with affective or anxiety disorder were reviewed by three independent raters and MIGSTR10, DSMSTR9, and Global Assessment of Functioning scale (GAF) scores were obtained. Interrater reliability indices (ICC) of items and sum scores were calculated. The prevalence of single migration-related stressors in MIG ranged from 15% to 100% (CON 0–92%). All items of the MIGSTR10 (ICC 0.58–0.92) and the DSMSTR9 (ICC 0.56–0.96) reached high to very high interrater agreement (p < .0005). The item analysis of the MIGSTR10 revealed sufficient internal consistency (Cronbach’s α = 0.68/0.69) and only one item (“family conflicts”) without substantial correlation with the remaining scale. Correlation analyses showed a significant overlap of dimensional MIGSTR10 scores (r² = 0.25; p < .01) and DSMSTR9 scores (r² = 9%; p < .05) with GAF scores in MIG indicating functional relevance. MIGSTR10 is considered a feasible, economic, and reliable instrument for the assessment of stressors potentially related to migration.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 351.2-352
Author(s):  
L. Van de Stadt ◽  
F. Kroon ◽  
M. Reijnierse ◽  
D. Van der Heijde ◽  
F. Rosendaal ◽  
...  

Background:Ultrasound (US) is used in rheumatic musculoskeletal diseases (RMDs) such as hand osteoarthritis (OA) as outcome measure. Traditionally scoring is performed real-time, but central reading of static US images could avoid issues of inter-rater reliability. However, agreement between real-time and static assessment has not been studiedObjectives:To study the agreement between real-time and static scoring of US in inflammatory hand OA.Methods:Ultrasound was performed of 30 joints obtained in 75 patients with hand osteoarthritis, treated with prednisolone or placebo in a randomized double-blind trial. Hand joints were assessed for synovial thickening, effusion, Doppler signal and osteophytes by ultrasound (score 0-3 per joint) at baseline and after treatment. Two ultrasonographers blinded for clinical data scored the live images together (simultaneously) in real-time. A consensus score for each joint was recorded. Representative images stored during scanning were scored by one ultrasonographer minimally 6 months after real-time scoring. For each patient, images of each visit were scored paired, with known chronological order.Agreement between scoring methods was studied at joint level with quadratic weighted kappa. At patient level, intra-class correlations (ICC; mixed effect model, absolute agreement, with clustering taken into account) were calculated at both timepoints. ICCs were also calculated for the delta of sum scores. Responsiveness of scoring methods was analyzed with generalized estimating equations (GEE) with treatment as independent and ultrasonography findings as dependent variable.Results:Thirty-nine patients (52%) were treated with prednisolone and 36 (48%) were treated with placebo. Patient characteristics were well-balanced between treatment groups.All patients had signs of synovial thickening and osteophytes as assessed by real-time ultrasonography, and almost all signs of effusion (99%) or a positive Doppler signal (95%) in at least one joint. Total ultrasonography sum score for osteophytes was high (mean 45 ±SD 12), whereas sum score was low for positive Doppler signal (mean 5.9 ±SD 4.4), with intermediate sum scores for synovial thickening and effusion (mean 16 ±SD 6.3 and 11 ±SD 6.0 respectively). Static sum scores were overall slightly higher (osteophytes mean 48 ±SD 10; Doppler mean 6.9 S±D 5.0; synovial thickening mean 20 ±SD 7.0 and effusion 13 ±SD 6.5)Agreement at baseline was good to excellent at joint level (kappa 0.72-0.88) and moderate to excellent at patient level (ICC 0.59-0.86). Agreement for delta sum scores was poor to fair for synovial thickening and effusion (ICC 0.18 and 0.34 respectively), but excellent for Doppler signal (ICC 0.80) (Table 1).Real-time ultrasonography showed responsiveness to prednisolone with a mean between-group difference of synovial thickening sum score of -2.5 (CI:-4.7 to-0.3). Static ultrasonography did not show a decrease in synovial thickening (Figure 1). No difference in ultrasonography scores was seen for the other ultrasonography features, neither with real-time nor static scoring.Conclusion:While cross-sectional agreement between real-time and static ultrasonography was good, agreement of delta sum scores was not and paired static ultrasonography measurement of synovial thickening did not show responsiveness to prednisone therapy where real-time ultrasonography did. Therefore, when using ultrasonography in clinical trials, real-time dynamic scoring should remain the standard.Table 1.Agreement on patient levelBaselineWeek 6Delta W6-BLICC (95% CI)ICC (95% CI)ICC (95% CI)Synovitis0.59 (0.26-0.76)0.58 (0.24-0.77)0.18 (0 - 0.40)Effusion0.84 (0.66-0.92)0.84 (0.75-0.89)0.34 (0.12-0.53)Osteophytes0.82 (0.50-0.92)0.78 (0.56-0.88)NDDoppler0.86 (0.75-0.92)0.91 (0.85-0.94)0.80 (0.70 -0.87)ICC: intra-class correlation coefficient linear mixed model (random patient, fixed rating), absolute agreement. ND: Not DerterminedDisclosure of Interests:Lotte van de Stadt: None declared, Féline Kroon: None declared, Monique Reijnierse Grant/research support from: Dutch Arthritis Foundation, Désirée van der Heijde Consultant of: bbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma, Frits Rosendaal: None declared, Naghmeh Riyazi: None declared, R. de Slegte: None declared, Jende van Zeben: None declared, Cornelia Allaart: None declared, Margreet Kloppenburg Consultant of: Abbvie, Pfizer, Levicept, GlaxoSmithKline, Merck-Serono, Kiniksa, Flexion, Galapagos, Jansen, CHDR, Grant/research support from: MI-APPROACH, Marion Kortekaas: None declared


Author(s):  
Eglė Slabšinskienė ◽  
Andrej Gorelik ◽  
Aistė Kavaliauskienė ◽  
Apolinaras Zaborskis

Although burnout has been described as a serious hazard for personal and professional lives and has been surveyed among dentists in many countries, no study has been published regarding burnout among dentists in Lithuania. This study aimed to evaluate the burnout level among Lithuanian dentists and its association with demographic variables, job satisfaction, and other job-related variables. The data were collected among dentists online or during professional conferences while using an anonymous questionnaire (n = 380). The Maslach Burnout Inventory (MBI) was used to evaluate the burnout level. A Poisson regression was applied for the analysis of relationships between variables. We observed that 42.3% of the respondents had a high emotional exhaustion (EE) (95% confidence interval (CI): 37.4–42.3%), while 18.7% (95% CI: 15.0–22.9%) and 28,2% (95% CI: 23.4–32.6%) had high depersonalization (DP) and low personal accomplishment (PA), respectively. Nonetheless, 15.3% (95% CI: 11.8–18.9%) of the study population experienced a high level of overall burnout. An original job satisfaction index was elaborated. It was significantly associated with sum scores of all burnout dimensions: with the EE sum score (Ratio of Sum Score Means (RSSM) 1.54; 95% CI: 1.46–1.62), DP sum score (RSSM 1.59; 95% CI: 1.45–1.74), and PA sum score (RSSM 0.88; 95% CI: 0.84–0.92). It was concluded that Lithuanian dentists can be characterised by high burnout intensity and high prevalence of burnout, being especially evident in emotional exhaustion. The dentist with low job satisfaction appeared to be the most vulnerable to all burnout dimensions.


2021 ◽  
Vol 10 (15) ◽  
pp. 3241
Author(s):  
Shih-Hao Chen ◽  
Ya-Yun Cheng ◽  
Chih-Hao Lin

Background: Patients undergoing hemodialysis are prone to cardiac arrests. Methods: This study aimed to develop a risk score to predict in-hospital cardiac arrest (IHCA) in emergency department (ED) patients undergoing emergency hemodialysis. Patients were included if they received urgent hemodialysis within 24 h after ED arrival. The primary outcome was IHCA within three days. Predictors included three domains: comorbidity, triage information (vital signs), and initial biochemical results. The final model was generated from data collected between 2015 and 2018 and validated using data from 2019. Results: A total of 257 patients, including 52 with IHCA, were analyzed. Statistical analysis selected significant variables with higher sensitivity cutoff, and scores were assigned based on relative beta coefficient ratio: K > 5.5 mmol/L (score 1), pH < 7.35 (score 1), oxygen saturation < 85% (score 1), and mean arterial pressure < 80 mmHg (score 2). The final scoring system had an area under the curve of 0.78 (p < 0.001) in the primary group and 0.75 (p = 0.023) in the validation group. The high-risk group (defined as sum scores ≥ 3) had an IHCA risk of 47.2% and 41.7%, while the low-risk group (sum scores < 3) had 18.3% and 7%, in the primary and validation databases, respectively. Conclusions: This predictive score model for IHCA in emergent hemodialysis patients could help healthcare providers to take necessary precautions and allocate resources.


Assessment ◽  
2021 ◽  
pp. 107319112110625
Author(s):  
Tom H. Rosenström ◽  
Ville Ritola ◽  
Suoma Saarni ◽  
Grigori Joffe ◽  
Jan-Henry Stenberg

Assessment of treatment response in psychotherapies can be undermined by lack of longitudinal measurement invariance (LMI) in symptom self-report inventories, by measurement error, and/or by wrong model assumptions. To understand and compare these threats to validity of outcome assessment in psychotherapy research, we studied LMI, sum scores, and Davidian Curve Item Response Theory models in a naturalistic guided internet psychotherapy treatment register of 2,218 generalized anxiety disorder (GAD) patients and 3,922 depressive disorder (DD) patients (aged ≥16 years). Symptoms were repeatedly assessed by Generalized Anxiety Disorder Assessment-7 (GAD-7) or Beck Depression Inventory. The symptom self-reports adhered to LMI under equivalence testing, suggesting sum scores are reasonable proxies for disorder status. However, the standard LMI assumption of normally distributed latent factors did not hold and inflated treatment response estimates by 0.2 to 0.3 standard deviation units compared with sum scores. Further methodological research on non-normally distributed latent constructs holds promise in advancing LMI and mental health assessment.


2020 ◽  
Author(s):  
Pere Ferrando ◽  
Urbano Lorenzo-Seva

<p>Unit-weight sum scores (UWSSs) are routinely used as estimates of factor scores on the basis of solutions obtained with the non-linear exploratory factor analysis (EFA) model for ordered-categorical responses. Theoretically, this practice results in a loss of information and accuracy, and is expected to lead to biased estimates. However, the practical relevance of these limitations is far from clear. In this article we adopt an empirical view, and propose indices and procedures (some of them new) for assessing the appropriateness of UWSSs in non-linear EFA applications. A new automated approach for obtaining UWSSs that maximize fidelity and correlational accuracy is proposed. The appropriateness of UWSSs under different conditions and the behavior of the present proposal in comparison with other more common approaches are assessed with a simulation study. A tutorial for interested practitioners is presented using an illustrative example based on a well-known personality questionnaire. All the procedures proposed in the article have been implemented in a well-known noncommercial EFA program. </p>


2021 ◽  
Vol 12 ◽  
Author(s):  
Lotta-Katrin Pries ◽  
Gamze Erzin ◽  
Bart P. F. Rutten ◽  
Jim van Os ◽  
Sinan Guloksuz

To understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexity of the exposome, which represents the totality of the environment involving many exposures over an individual's lifetime. Therefore, contemporary research adopting the exposome paradigm has aimed at capturing the combined effect of different environmental exposures by utilizing an aggregate environmental vulnerability score for schizophrenia: the exposome score for schizophrenia. Here, we attempt to provide a comprehensive overview of studies applying the exposome score for schizophrenia. First, we describe several approaches estimating exposomic vulnerability for schizophrenia, which falls into three categories: simple environmental sum scores (sum of dichotomized exposures), meta-analysis-based environmental risk score (sum scores weighted by estimates from meta-analyses), and the exposome score (sum score weighted by estimates from an analysis in an independent training dataset). Studies show that the exposome score for schizophrenia that assumes interdependency of exposures performs better than scores that assume independence of exposures, such as the environmental sum score and the meta-analysis-based environmental risk score. Second, we discuss findings on the pluripotency of the exposome score for schizophrenia and summarize findings from gene-environment studies using the exposome score for schizophrenia. Finally, we discuss possible scientific, clinical, and population-based applications of exposome score for schizophrenia, as well as limitations and future directions for exposome research to understand the etiology of psychosis spectrum disorders.


2018 ◽  
Vol 78 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Torsten Diekhoff ◽  
Sevtap Tugce Ulas ◽  
Denis Poddubnyy ◽  
Udo Schneider ◽  
Sandra Hermann ◽  
...  

PurposeTo prove the feasibility and measure the diagnostic accuracy of contrast-enhanced ultra-low-dose CT (ULD-CT) for the depiction of inflammatory soft-tissue changes (synovitis, tenosynovitis and peritendonitis) in patients with arthritis of the hand.Materials and methodsIn this institutional review board–approved study, 36 consecutive patients over the age of 50 with suspected rheumatoid arthritis underwent ULD-CT (estimated radiation exposure <0.01  mSv) and MRI of the hand with weight-adapted intravenous contrast administration. ULD-CT subtraction and MR images were assessed for synovitis, tenosynovitis and peritendonitis by three readers using a modified Rheumatoid Arthritis MRI Score (RAMRIS). Patients were asked which modality they would prefer for future examinations. Sensitivity and specificity of ULD-CT for detection of inflammatory changes were calculated using MRI as standard of reference. The sum scores were correlated using Pearson’s r.ResultsAll 36 patients showed synovitis in MRI. ULD-CT had 69% sensitivity on the patient level and 65% on the joint level with 87% specificity. Sensitivity was higher in patients with more severe inflammation (80% for MRI RAMRIS >1). There was almost perfect correlation between the modified RAMRIS sum scores of ULD-CT and MRI (Pearson’s r=0.94). Regarding preferences for future examinations, 85% preferred ULD-CT over MRI. ULD-CT detected more differential diagnoses than MRI (8 vs 2/12).Conclusion Contrast-enhanced ULD-CT of the hand allows for depiction of soft-tissue inflammation at the hand and can be achieved using very low radiation exposure (<0.01 mSv). ULD-CT may evolve to a fast and comfortable alternative to MRI, although it is not as sensitive as MRI for detecting mild disease.


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