The measurement of depression: enhancing the predictive validity of the Beck Depression Inventory

Changes After Emergency Assessment of Suicidal Patients: An Unexpected Outcome

INTRODUCTION

Acute Suicide Risk (ASR) is widely evaluated at Emergency Departments (ED). Little is known about follow-up of ASR after psychiatric ED evaluation, and if there are differences within No ASR (NASR) counterparts at baseline and afterwards.

METHOD

We developed a naturalistic, 3-month follow-up study of adult patients from a psychiatric ED in Mexico City. Depressive patients who asked voluntarily for an emergency consultation from July 1 to December 1, 2014, were included. We compared depression severity, suicidal ideation, adherence to treatment, and perceived social support scales both in ASR and NASR participants at baseline and follow-up interviews.

RESULTS

Participants (n = 120) were divided into ASR or NASR groups (n = 60 each). The ASR group obtained more negative scores in all scales at baseline evaluation. After three months, 85% (n = 51) of ASR and 75% (n = 45) of NASR completed the second interview. 5.21% (n = 3) of participants showed new suicidal behavior. At follow-up, the ASR group showed a higher relative response in depression scales and treatment adherence (p = 0.036), and lower scores in suicidal ideation scales than NASR group (p = 0.012). Perceived support from family was significantly higher in the NASR group (p = 0.016).

DISCUSSION

These relative higher responses in clinical scales suggest a paradoxical advantage of ASR over NASR patients, suggesting a hypothetical phenomenon similar to "The Tortoise and the Hare" effect. However, it is not applicable for all ASR patients. Results suggest suicidal patients experience stigma from their families. Further research and public health programs for ASR at ED should be implemented.

Electroconvulsive Therapy Hasn't Negative Effects on Short-Term Memory Function, as Assessed Using a Bedside Hand-Held Device

Electroconvulsive therapy (ECT) is effective in the treatment of treatment-resistant major depression. The fear of cognitive impairment after ECT often deters patients from choosing this treatment option. There is little reliable information regarding the effects of ECT on overall cognitive performance, while short-term memory deficits are well known but not easy to measure within clinical routines. In this pilot study, we examined ECT recipients' pre- and post-treatment performances on a digital ascending number tapping test. We found that cognitive performance measures exhibited good reproducibility in individual patients and that ECT did not significantly alter cognitive performance up to 2 hours after this therapy was applied. Our results can help patients and physicians make decisions regarding the administration of ECT. Digital measurements are recommended, especially when screening for the most common side effects on cognitive performance and short-term memory.

Using disablement models and clinical outcomes assessment to enable evidence-based athletic training practice, part II: clinical outcomes assessment

OBJECTIVE

To provide an overview of clinical outcomes assessment, discuss the classification of outcomes measures, present considerations for choosing outcomes scales, identify the importance of assessing clinical outcomes, and describe the critical link between the utilization of disablement models and clinical outcomes assessment.

BACKGROUND

Clinical outcomes are the end result of health care services. Clinical outcomes assessment is based on the conceptual framework of disablement models and serves as the measurement method for the collection of patient-oriented evidence, a concept central to evidence-based practice.

DESCRIPTION

Clinical outcomes management refers to the use of outcomes measures in the course of routine clinical care and provides athletic trainers with a mechanism to assess treatment progress and to measure the end results of the services they provide. Outcomes measures can be classified as either clinician based or patient based. Clinician-based measures, such as range of motion and strength, are taken directly by clinicians. Patient-based measures solicit a patient's perception as to health status in the form of questionnaires and survey scales. Clinician-based measures may assist with patient evaluation, but patient-based measures should always be included in clinical assessment to identify what is important to the patient. CLINICAL AND RESEARCH ADVANTAGES: Evidence-based athletic training practice depends on clinical outcomes research to provide the foundation of patient-oriented evidence. The widespread use of clinical outcomes assessment, based on the disablement model framework, will be necessary for athletic trainers to demonstrate the effectiveness of therapies and interventions, the provision of patient-centered care, and the development of evidence-based practice guidelines.