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Dunn VS, Petty S, Laver‐Fawcett A. Provenance of a "sense-sational" wait: A call for introducing sensory processing differences into diagnostic criteria for attention-deficit/hyperactivity disorder. Brain Behav 2024; 14:e3501. [PMID: 38747736 PMCID: PMC11095298 DOI: 10.1002/brb3.3501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/13/2024] [Accepted: 04/05/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Victoria Sally Dunn
- Humber Foundation NHS Teaching TrustYork St John University, Lord Mayor's WalkYorkUK
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2
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Amos AJ. Rapidly expanding gender-affirming care based on consensus instead of evidence justifies rigorous governance and transparency. Australas Psychiatry 2024:10398562241249579. [PMID: 38686826 DOI: 10.1177/10398562241249579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Public services offering gender-affirming care to minors have rapidly expanded across Australia. Despite limited evidence of safety and efficacy, no public information about these services is routinely available. Data from freedom of information requests sent to Australian public gender services for minors is summarised. Gender service numbers increased rapidly in Queensland (2017:190 - 2022:922) and in Victoria (2019:472 - 2023:1290). Limited transparency prevented strong confidence in the number of patients receiving hormone therapy. Staff FTE employed by gender services jumped after 2020 in NSW (to 16.7 across two sites in 2023), Queensland (to 11.4 in 2023), Victoria (to 9.4 in 2022), and WA (to 10.2 in 2023). CONCLUSIONS Despite low confidence in their safety and efficacy, the number of patients seen by public gender services has expanded rapidly since 2018. Limited transparency makes it difficult to judge the number of patients seen, treatments provided, and outcomes achieved. Safe, effective care of this vulnerable group requires clear treatment goals, and annual reporting.
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Affiliation(s)
- Andrew James Amos
- Division of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, Australia
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3
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Jiang Z, Seyedi S, Griner E, Abbasi A, Rad AB, Kwon H, Cotes RO, Clifford GD. Multimodal Mental Health Digital Biomarker Analysis From Remote Interviews Using Facial, Vocal, Linguistic, and Cardiovascular Patterns. IEEE J Biomed Health Inform 2024; 28:1680-1691. [PMID: 38198249 PMCID: PMC10986761 DOI: 10.1109/jbhi.2024.3352075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Psychiatric evaluation suffers from subjectivity and bias, and is hard to scale due to intensive professional training requirements. In this work, we investigated whether behavioral and physiological signals, extracted from tele-video interviews, differ in individuals with psychiatric disorders. METHODS Temporal variations in facial expression, vocal expression, linguistic expression, and cardiovascular modulation were extracted from simultaneously recorded audio and video of remote interviews. Averages, standard deviations, and Markovian process-derived statistics of these features were computed from 73 subjects. Four binary classification tasks were defined: detecting 1) any clinically-diagnosed psychiatric disorder, 2) major depressive disorder, 3) self-rated depression, and 4) self-rated anxiety. Each modality was evaluated individually and in combination. RESULTS Statistically significant feature differences were found between psychiatric and control subjects. Correlations were found between features and self-rated depression and anxiety scores. Heart rate dynamics provided the best unimodal performance with areas under the receiver-operator curve (AUROCs) of 0.68-0.75 (depending on the classification task). Combining multiple modalities provided AUROCs of 0.72-0.82. CONCLUSION Multimodal features extracted from remote interviews revealed informative characteristics of clinically diagnosed and self-rated mental health status. SIGNIFICANCE The proposed multimodal approach has the potential to facilitate scalable, remote, and low-cost assessment for low-burden automated mental health services.
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4
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Tolin DF, Sain KS, Davis E, Gilliam C, Hannan SE, Springer KS, Stubbing J, George JR, Jean A, Goldblum R, Katz BW, Everhardt K, Darrow S, Ohr EE, Young ME, Serchuk MD. The DIAMOND-KID: Psychometric Properties of a Structured Diagnostic Interview for DSM-5 Anxiety, Mood, and Obsessive-Compulsive and Related Disorders in Children and Adolescents. Assessment 2023; 30:2351-2363. [PMID: 36632642 DOI: 10.1177/10731911221143994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The objective of the present study was to examine the reliability and validity of a new semi-structured interview for pediatric psychiatric disorders, which is needed as existing interviews do not cover the full range of anxiety, mood, and obsessive-compulsive disorder (OCD)-related disorders. Three hundred eleven child patients (aged 10-17) were administered the Diagnostic Interview for Anxiety, Mood, and OCD and Related Neuropsychiatric Disorders-Child and Adolescent Version (DIAMOND-KID). Of these, 65 provided interrater reliability data and 59 provided test-retest reliability data. Participants also completed self-report measures that assessed symptoms of anxiety, mood, and OCD and related disorders. Although parents/guardians could participate in the interview at the clinician's discretion, most of the initial interviews and all of the reliability interviews were based on the child's self-report. Test-retest reliability ranged from very good to excellent. Interrater reliability was more variable, with estimates for generalized anxiety disorder and major depressive disorder in the questionable range; the other interrater reliability estimates ranged from good to very good. Convergent validity was established by significant between-group comparisons on applicable self-report measures for all diagnoses. The results of the present study indicate that the DIAMOND-KID is a promising semi-structured diagnostic interview for 5th edition of the Diagnostic and Statistical Manual of Mental Disorders in pediatric populations.
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Affiliation(s)
- David F Tolin
- Institute of Living, Hartford, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | | | | | | - Jamilah R George
- Institute of Living, Hartford, CT, USA
- University of Connecticut, Storrs, USA
| | | | | | | | | | | | | | - Matthew E Young
- The University of Chicago Pritzker School of Medicine, IL, USA
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5
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Ivarsson D, Delfin C, Enebrink P, Wallinius M. Pinpointing change in virtual reality assisted treatment for violent offenders: a pilot study of Virtual Reality Aggression Prevention Training (VRAPT). Front Psychiatry 2023; 14:1239066. [PMID: 38034926 PMCID: PMC10687219 DOI: 10.3389/fpsyt.2023.1239066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Preventing relapse into violence and its destructive consequences among persistent re-offenders is a primary concern in forensic settings. The Risk-Need-Responsivity framework models the best current practice for offender treatment, focused on building skills and changing pro-criminal cognitions. However, treatment effects are often modest, and the forensic context can obstruct the delivery of interventions. Developing treatments for offenders should focus on the best method of delivery to make "what works work." Virtual reality (VR)-assisted treatments such as Virtual Reality Aggression Prevention Training (VRAPT) are a new and innovative approach to offender treatment. This pilot study followed 14 male violent offenders who participated in VRAPT in a Swedish prison context and measured changes from pre-treatment to post-treatment and 3-month follow-up in targeted aggression, emotion regulation, and anger. It also investigated potential impact factors (pro-criminal cognitions, externalizing behaviors, psychosocial background, and childhood adverse experiences). In Bayesian linear mixed effects models, participants showed a high probability of change from pre-treatment to post-treatment and to follow-up on all outcome measures. All outcome measures demonstrated a low probability of change from post-treatment to follow-up. Analysis of reliable change showed that participants' results ranged from recovery to deterioration. We discuss the implications of the study for VRAPT's impact on the target group, those who might benefit from the approach, and suggested foci for future studies in the field of VR-assisted offender treatment. The study was preregistered at the International Standard Randomized Controlled Trial Number registry (https://doi.org/10.1186/ISRCTN14916410).
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Affiliation(s)
- David Ivarsson
- Evidence-based Forensic Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
- Swedish Prison and Probation Service, Norrköping, Sweden
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Delfin
- Evidence-based Forensic Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pia Enebrink
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Märta Wallinius
- Evidence-based Forensic Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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6
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Gilbert M, Boecker M, Reiss F, Kaman A, Erhart M, Schlack R, Westenhöfer J, Döpfner M, Ravens-Sieberer U. Gender and Age Differences in ADHD Symptoms and Co-occurring Depression and Anxiety Symptoms Among Children and Adolescents in the BELLA Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01622-w. [PMID: 37851158 DOI: 10.1007/s10578-023-01622-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most diagnosed neurodevelopmental disorders of childhood. Current studies addressing gender and age differences in ADHD are lacking. The present study aims to fill this research gap by dimensionally evaluating gender and age differences in ADHD symptoms, as measured by a DSM-5-based parent rating scale, in children and adolescents who participated in the two-year follow-up of the community-based BELLA study (n = 1326). Associations between ADHD symptoms and depression symptoms and anxiety symptoms were also examined. Multiple linear regressions revealed significant associations between gender and all ADHD symptoms. Age was significantly associated with hyperactive/impulsive symptoms. Additional multiple linear regressions demonstrated significant positive associations between depression and anxiety symptoms and ADHD symptoms. Further, female gender was found to be positively associated with both depression and anxiety symptoms. These findings may suggest a need for more gender-specific approaches to ADHD diagnosis and treatment, as well as more research into the intersections of ADHD and depression and anxiety symptoms in children and adolescents.
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Affiliation(s)
- Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Alice Salomon University of Applied Sciences, Berlin, Germany
- Apollon University of Applied Sciences, Bremen, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Section "Child Public Health", University Medical Center Hamburg-Eppendorf, Martinistraße 52, W 29, 20246, Hamburg, Germany.
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7
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Jiang Z, Seyedi S, Griner E, Abbasi A, Bahrami Rad A, Kwon H, Cotes RO, Clifford GD. Multimodal mental health assessment with remote interviews using facial, vocal, linguistic, and cardiovascular patterns. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.11.23295212. [PMID: 37745610 PMCID: PMC10516063 DOI: 10.1101/2023.09.11.23295212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective The current clinical practice of psychiatric evaluation suffers from subjectivity and bias, and requires highly skilled professionals that are often unavailable or unaffordable. Objective digital biomarkers have shown the potential to address these issues. In this work, we investigated whether behavioral and physiological signals, extracted from remote interviews, provided complimentary information for assessing psychiatric disorders. Methods Time series of multimodal features were derived from four conceptual modes: facial expression, vocal expression, linguistic expression, and cardiovascular modulation. The features were extracted from simultaneously recorded audio and video of remote interviews using task-specific and foundation models. Averages, standard deviations, and hidden Markov model-derived statistics of these features were computed from 73 subjects. Four binary classification tasks were defined: detecting 1) any clinically-diagnosed psychiatric disorder, 2) major depressive disorder, 3) self-rated depression, and 4) self-rated anxiety. Each modality was evaluated individually and in combination. Results Statistically significant feature differences were found between controls and subjects with mental health conditions. Correlations were found between features and self-rated depression and anxiety scores. Visual heart rate dynamics achieved the best unimodal performance with areas under the receiver-operator curve (AUROCs) of 0.68-0.75 (depending on the classification task). Combining multiple modalities achieved AUROCs of 0.72-0.82. Features from task-specific models outperformed features from foundation models. Conclusion Multimodal features extracted from remote interviews revealed informative characteristics of clinically diagnosed and self-rated mental health status. Significance The proposed multimodal approach has the potential to facilitate objective, remote, and low-cost assessment for low-burden automated mental health services.
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Wu H, Manglike A, Chen Y, Liu Z, Fritzsche K, Lu Z. Scoping review update on somatic symptom disorder that includes additional Chinese data. Gen Psychiatr 2023; 36:e100942. [PMID: 37337547 PMCID: PMC10277133 DOI: 10.1136/gpsych-2022-100942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/23/2023] [Indexed: 06/21/2023] Open
Abstract
Somatic symptom disorder (SSD) is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is expected to solve the diagnostic difficulties of patients with medically unexplained symptoms. Based on the previous work, this review aims to comprehensively synthesise updated evidence related to SSD from recent years in English publications and, more extensively, from data published in Chinese language journals. The scoping review update was based on an earlier scoping review and included Chinese language publication data from China National Knowledge Internet (CNKI), WANFANG and WEIPU between January 2013 and May 2022 and data from PubMed, PsycINFO, and Cochrane Library between June 2020 and May 2022. Initially, 2 984 articles were identified, of which 63 full texts were included for analysis. In China, SSD is mainly applied in scientific research, but it also shows good predictive validity and clinical application potential. The mean frequency of SSD was 4.5% in the general population, 25.2% in the primary care population and 33.5% in diverse specialised care settings. Biological factors, such as brain region changes and heart rate variability, are associated with the onset of SSD. Psychological impairment related to somatic symptoms is the best predictor of prognosis. While adolescent SSD was significantly associated with family function, SSD overall is associated with an increased dysfunction of cognition and emotion, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Further research is needed on suicide risk and cultural and gender-related issues. Updating the data of Chinese language studies, our research enriches the evidence-based findings related to the topics addressed in the text sections of the SSD chapter of DSM-5. However, research gaps remain about SSD reliability, population-based prevalence, suicide risk, and cultural and gender-related issues.
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Affiliation(s)
- Heng Wu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ayinuer Manglike
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yixiao Chen
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ziming Liu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Zheng Lu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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9
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Rabot J, Rødgaard EM, Joober R, Dumas G, Bzdok D, Bernhardt B, Jacquemont S, Mottron L. Genesis, modelling and methodological remedies to autism heterogeneity. Neurosci Biobehav Rev 2023; 150:105201. [PMID: 37116771 DOI: 10.1016/j.neubiorev.2023.105201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
Diagnostic criteria used in autism research have undergone a shift towards the inclusion of a larger population, paralleled by increasing, but variable, estimates of autism prevalence across clinical settings and continents. A categorical diagnosis of autism spectrum disorder is now consistent with large variations in language, intelligence, comorbidity, and severity, leading to a heterogeneous sample of individuals, increasingly distant from the initial prototypical descriptions. We review the history of autism diagnosis and subtyping, and the evidence of heterogeneity in autism at the cognitive, neurological, and genetic levels. We describe two strategies to address the problem of heterogeneity: clustering, and truncated-compartmentalized enrollment strategy based on prototype recognition. The advances made using clustering methods have been modest. We present an alternative, new strategy for dissecting autism heterogeneity, emphasizing incorporation of prototypical samples in research cohorts, comparison of subgroups defined by specific ranges of values for the clinical specifiers, and retesting the generality of neurobiological results considered to be acquired from the entire autism spectrum on prototypical cohorts defined by narrow specifiers values.
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Affiliation(s)
| | - Eya-Mist Rødgaard
- Department of Psychology, Copenhagen University, Copenhagen, Denmark,.
| | - Ridha Joober
- Neurological Institute and Hospital, McGill University, Montreal, Quebec, H4H 1R3, Canada,.
| | - Guillaume Dumas
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada,.
| | - Danilo Bzdok
- Mila - Quebec Artificial Intelligence Institute, Montreal, Canada, Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, H3A 2B4, QC, Canada,.
| | - Boris Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, McGill University, Montreal, QC, H3A 2B4, Canada,.
| | - Sebastien Jacquemont
- Department of Pediatrics, University of Montreal, Montréal, Quebec, H3T 1C5, Canada,.
| | - Laurent Mottron
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, CIUSSS-NIM, Research Center, Montréal, QC, H1E 1A4, Canada,.
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10
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Morris NP. Injustice Disorder. N Engl J Med 2022; 387:2017-2019. [PMID: 36440897 DOI: 10.1056/nejmp2211154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Abasi I, Ghapanchi A, Toussaint A, Bitarafan M, Zarabi H, Derakhshan FS, Banihashem S, Mohammadi N, Ghasemzadeh MR, Derakhshan MK. Psychometric properties of the Persian version of the somatic symptom disorder-B Criteria Scale (SSD-12) in community and clinical samples. Gen Hosp Psychiatry 2022; 78:1-8. [PMID: 35728363 DOI: 10.1016/j.genhosppsych.2022.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In the DSM-5's diagnostic criteria of somatic symptom disorders (SSD), the presence of psychological problems (i.e., excessive thoughts, feelings, or behaviors) is emphasized more than the absence of the medical causes of patients' bothersome symptoms. In this regard, the Somatic Symptom Disorder-B Criteria Scale (SSD-12) is a screening tool for assessing these psychological features in somatic symptom disorder. This study aimed to validate the Persian version of SSD-12 in the Iranian community (non-clinical) and clinical samples. METHODS Data was gathered from 291 individuals in a community sample (aged 18 to 54, M-age = 36.62, SD = 10.56, 79.7% females) and from clinical setting, including 118 patients diagnosed with major depressive disorder (MDD, aged 18 to 60, M-age = 36.52, SD = 11.39, 75.8% females) and 120 patients diagnosed with somatic symptom disorders (aged 18 to 60, M-age = 35.17, SD = 8.77, 73.7% females). To assess the convergent validity of SSD-12 in the clinical samples, participants were asked to complete measures assessing anxiety, depression, somatic symptoms, health anxiety, and emotional regulation. RESULTS Confirmatory Factor Analyses (CFAs) showed that the three-factor model of the SSD-12 reached acceptable fit in the community and clinical samples and yielded excellent internal consistency across the samples. Also, test-retest reliability analysis results were good in the community sample. Convergent validity could be shown in the clinical samples. A cut-off score greater than 14 was in the optimal state with a sensitivity of 70.83 and a specificity of 70.07. CONCLUSION The current study provides evidence on the factor structure, reliability, and validity of the Persian SSD-12 in the Iranian community and clinical samples. A sum score of 14 can be recommended as the cut-off point. Further studies are needed to assess SSD-12 in different clinical populations and larger samples.
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Affiliation(s)
- Imaneh Abasi
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ala Ghapanchi
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Maryam Bitarafan
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Zarabi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | | | - Seyedshahab Banihashem
- Department of Psychosomatic Medicine, Taleqani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niush Mohammadi
- Psychiatric, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Kamran Derakhshan
- Department of Psychosomatic Medicine, Taleqani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Gauld C, Lopez R, Philip P, Taillard J, Morin CM, Geoffroy PA, Micoulaud-Franchi JA. A Systematic Review of Sleep–Wake Disorder Diagnostic Criteria Reliability Studies. Biomedicines 2022; 10:biomedicines10071616. [PMID: 35884924 PMCID: PMC9313077 DOI: 10.3390/biomedicines10071616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022] Open
Abstract
The aim of this article is to provide a systematic review of reliability studies of the sleep–wake disorder diagnostic criteria of the international classifications used in sleep medicine. Electronic databases (ubMed (1946–2021) and Web of Science (—2021)) were searched up to December 2021 for studies computing the Cohen’s kappa coefficient of diagnostic criteria for the main sleep–wake disorder categories described in the principal classifications. Cohen’s kappa coefficients were extracted for each main sleep–wake disorder category, for each classification subtype, and for the different types of methods used to test the degree of agreement about a diagnosis. The database search identified 383 studies. Fifteen studies were analyzed in this systematic review. Insomnia disorder (10/15) and parasomnia disorder (7/15) diagnostic criteria were the most studied. The reliability of all sleep–wake disorders presented a Cohen’s kappa with substantial agreement (Cohen’s kappa mean = 0.66). The two main reliability methods identified were “test–retest reliability” (11/15), principally used for International Classification of Sleep Disorders (ICSD), and “joint interrater reliability” (4/15), principally used for Diagnostic and Statistical Manual of Mental Disorders (DSM) subtype diagnostic criteria, in particularl, the DSM-5. The implications in terms of the design of the methods used to test the degree of agreement about a diagnosis in sleep medicine are discussed.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, Hospices Civils de Lyon, 69000 Lyon, France;
- UMR CNRS 8590 IHPST, Sorbonne University, 75007 Paris, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, 34000 Montpellier, France;
- Inserm, Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, 34000 Montpellier, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33 076 Bordeaux, France;
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
| | - Jacques Taillard
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
| | - Charles M. Morin
- École de Psychologie, Université Laval, 2325 Rue des Bibliothèques, Québec City, QC G1V 0A6, Canada;
- Centre D’étude des Troubles du Sommeil, Université Laval, 2325 Rue des Bibliothèques, Québec City, QC G1V 0A6, Canada
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, 75018 Paris, France;
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, 75014 Paris, France
- NeuroDiderot, Inserm, Université de Paris, FHU I2-D2, 75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33 076 Bordeaux, France;
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
- Correspondence: ; Tel.: +33-(0)5-57-82-01-82
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Biberdzic M, Grenyer BFS. How Much Training Do We Need? Assessing the Validity and Interrater Reliability of the PDM-2's Psychodiagnostic Chart among Less Experienced Clinicians. J Pers Assess 2022; 105:436-444. [PMID: 35771210 DOI: 10.1080/00223891.2022.2086133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The Psychodynamic Diagnostic Manual - Second Edition (PDM-2) has emerging evidence supporting its clinical utility, yet one of the main limitations remains the conjecture that considerable training and experience is required. It also remains unclear how the PDM-2 framework compares with current DSM measures of personality pathology such as the Level of Personality Functioning Scale (LPFS). The aim of the present study is to examine these issues by testing whether less clinically experienced second year doctoral psychology students are able to reliably assess patients' level of personality pathology using the PDM-2's Psychodiagnostic Chart (PDC-2), and to investigate the convergence between the PDC-2 and the LPFS. Results showed adequate inter-rater reliability for both of the main PDC-2 axes, with 52% of the variance for the overall personality organization (P-Axis) rating, and 29% of the overall M-Axis score being due to rater consensus. Reliability of individual ratings ranged from fair to excellent for the overall scores on both axes (ICC = 0.59 to .90). Results also showed that student evaluations were valid, with the latter's assessment of the patients' level of personality organization converging both with the experts' rating of the PDC-2 as well as the LPFS. Implications for clinical training are discussed.
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Affiliation(s)
- Marko Biberdzic
- School of Psychology Illawarra Health and Medical Research Institute, University of Wollongong
| | - Brin F S Grenyer
- School of Psychology Illawarra Health and Medical Research Institute, University of Wollongong
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14
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Fried EI, Flake JK, Robinaugh DJ. Revisiting the theoretical and methodological foundations of depression measurement. NATURE REVIEWS PSYCHOLOGY 2022; 1:358-368. [PMID: 38107751 PMCID: PMC10723193 DOI: 10.1038/s44159-022-00050-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 12/19/2023]
Abstract
Depressive disorders are among the leading causes of global disease burden, but there has been limited progress in understanding the causes and treatments for these disorders. In this Perspective, we suggest that such progress crucially depends on our ability to measure depression. We review the many problems with depression measurement, including limited evidence of validity and reliability. These issues raise grave concerns about common uses of depression measures, such as diagnosis or tracking treatment progress. We argue that shortcomings arise because depression measurement rests on shaky methodological and theoretical foundations. Moving forward, we need to break with the field's tradition that has, for decades, divorced theories about depression from how we measure it. Instead, we suggest that epistemic iteration, an iterative exchange between theory and measurement, provides a crucial avenue for depression measurement to progress.
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Affiliation(s)
- Eiko I. Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Jessica K. Flake
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Donald J. Robinaugh
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, US
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, US
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15
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Cautionary Observations Concerning the Introduction of Psychophysiological Biomarkers into Neuropsychiatric Practice. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The combination of statistical learning technologies with large databases of psychophysiological data has appropriately generated enthusiastic interest in future clinical applicability. It is argued here that this enthusiasm should be tempered with the understanding that significant obstacles must be overcome before the systematic introduction of psychophysiological measures into neuropsychiatric practice becomes possible. The objective of this study is to identify challenges to this effort. The nonspecificity of psychophysiological measures complicates their use in diagnosis. Low test-retest reliability complicates use in longitudinal assessment, and quantitative psychophysiological measures can normalize in response to placebo intervention. Ten cautionary observations are introduced and, in some instances, possible directions for remediation are suggested.
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16
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Korwisi B, Garrido Suárez BB, Goswami S, Gunapati NR, Hay G, Hernández Arteaga MA, Hill C, Jones D, Joshi M, Kleinstäuber M, López Mantecón AM, Nandi G, Papagari CSR, Rabí Martínez MDC, Sarkar B, Swain N, Templer P, Tulp M, White N, Treede RD, Rief W, Barke A. Reliability and clinical utility of the chronic pain classification in the 11th Revision of the International Classification of Diseases from a global perspective: results from India, Cuba, and New Zealand. Pain 2022; 163:e453-e462. [PMID: 34393200 DOI: 10.1097/j.pain.0000000000002379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Chronic pain affects 1 in 5 persons and contributes substantially to the global burden of disease. The 11th Revision of the International Classification of Diseases (ICD-11) includes a comprehensive classification of chronic pain. The aim of this ecological implementation field study was to evaluate the classification's interrater reliability and clinical utility in countries with different income levels. The study was conducted in 4 pain clinics in Cuba, India, and New Zealand. Twenty-one clinicians used the ICD-11 to diagnose and code n = 353 patients with chronic pain. Of these, 111 were assessed by 2 clinicians, and Fleiss' kappa was calculated to establish interrater reliability for any diagnosis assigned to ≥15 patients. The clinicians rated the clinical utility of all diagnoses. The interrater reliability could be calculated for 11 diagnoses. It was substantial for 10 diagnoses and moderate for 1 (kappa: 0.596-0.783). The mean clinical utility of the ICD-11 chronic pain diagnoses was rated as 8.45 ± 1.69/10. Clinical utility was rated higher for ICD-11 than for the commonly used classification systems (P < 0.001, η2 = 0.25) and differed between all centers (P < 0.001, η2 = 0.60). The utility of the ICD-11 diagnoses was rated higher than the commonly used diagnoses in Dunedin and Havana, and no difference was found in Kolkata and Hyderabad. The study showed the high interrater reliability of the new chronic pain diagnoses. The perceived clinical utility of the diagnoses indicates their superiority or equality compared with the classification systems currently used in pain clinics. These results suggest the global applicability of the classification in specialized pain treatment settings.
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Affiliation(s)
- Beatrice Korwisi
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Bárbara Beatriz Garrido Suárez
- Department of Pharmacology, Institute of Marine Science (ICIMAR), Havana, Cuba
- Pain Clinic, Hospital 10 de Octubre, Havana, Cuba
| | - Subrata Goswami
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | | | - Ginea Hay
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | | | - Charlotte Hill
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - David Jones
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | | | - Maria Kleinstäuber
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
- Department of Psychological Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Ana Marta López Mantecón
- Pain Clinic, Hospital 10 de Octubre, Havana, Cuba
- Rheumatological Disease Reference Centre, Hospital 10 de Octubre, Havana, Cuba
| | - Gargi Nandi
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | | | | | - Biplab Sarkar
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | - Nicola Swain
- Department of Psychological Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Paul Templer
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Maartje Tulp
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Naomi White
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Rolf-Detlef Treede
- Mannheim Center for Translational Neuroscience (MCTN), Department of Neurophysiology, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Antonia Barke
- Division of Clinical and Biological Psychology, Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
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17
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Löwe B, Levenson J, Depping M, Hüsing P, Kohlmann S, Lehmann M, Shedden-Mora M, Toussaint A, Uhlenbusch N, Weigel A. Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis. Psychol Med 2022; 52:632-648. [PMID: 34776017 PMCID: PMC8961337 DOI: 10.1017/s0033291721004177] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND In 2013, the diagnosis of somatic symptom disorder (SSD) was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This review aims to comprehensively synthesize contemporary evidence related to SSD. METHODS A scoping review was conducted using PubMed, PsycINFO, and Cochrane Library. The main inclusion criteria were SSD and publication in the English language between 01/2009 and 05/2020. Systematic search terms also included subheadings for the DSM-5 text sections; i.e., diagnostic features, prevalence, development and course, risk and prognostic factors, culture, gender, suicide risk, functional consequences, differential diagnosis, and comorbidity. RESULTS Eight hundred and eighty-two articles were identified, of which 59 full texts were included for analysis. Empirical evidence supports the reliability, validity, and clinical utility of SSD diagnostic criteria, but the further specification of the psychological SSD B-criteria criteria seems necessary. General population studies using self-report questionnaires reported mean frequencies for SSD of 12.9% [95% confidence interval (CI) 12.5-13.3%], while prevalence studies based on criterion standard interviews are lacking. SSD was associated with increased functional impairment, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Relevant research gaps remain regarding developmental aspects, risk and prognostic factors, suicide risk as well as culture- and gender-associated issues. CONCLUSIONS Strengths of the SSD diagnosis are its good reliability, validity, and clinical utility, which substantially improved on its predecessors. SSD characterizes a specific patient population that is significantly impaired both physically and psychologically. However, substantial research gaps exist, e.g., regarding SSD prevalence assessed with criterion standard diagnostic interviews.
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Affiliation(s)
- Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - James Levenson
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Miriam Depping
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Hüsing
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marco Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Meike Shedden-Mora
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Natalie Uhlenbusch
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Angelika Weigel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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18
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Towards equitable diagnoses for autism and attention-deficit/hyperactivity disorder across sexes and genders. Curr Opin Psychiatry 2022; 35:90-100. [PMID: 35084380 DOI: 10.1097/yco.0000000000000770] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Sex/gender-related factors contribute to contextual issues influencing the recognition of autism and attention-deficit/hyperactivity disorder (ADHD), and modulate how neurodevelopmental characteristics are manifested. This review summarizes the empirical literature to provide directions for improving clinical diagnostic practices. RECENT FINDINGS Timing of autism and/or ADHD diagnosis, particularly in girls/women, is related to the individual's developmental characteristics and co-occurring diagnoses, and expectancy, alongside gender stereotype biases, of referral sources and clinicians. This is further compounded by sex and gender modulations of behavioural presentations. The emerging 'female autism phenotype' concept may serve as a helpful illustration of nuanced autism phenotypes, but should not be viewed as essential features of autism in a particular sex or gender. These nuanced phenotypes that can present across sexes and genders include heightened attention to socially salient stimuli, friendship and social groups, richness in language expression, and more reciprocal behaviours. The nuanced female-predominant ADHD phenotypes are characterized by subtle expressions in hyperactivity-impulsivity (e.g., hyper-verbal behaviours). Optimizing neurodevelopmental diagnoses across sexes and genders also requires an understanding of sex-related and gender-related variations in developmental trajectories, including compensation/masking efforts, and the influences of co-occurring conditions on clinical presentations. SUMMARY Equitable diagnoses across sexes and genders for autism and ADHD require understanding of the nuanced presentations and the Gestalt clinical-developmental profiles, and addressing contextual biases that influence diagnostic practices.
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19
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Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, Skowyra C, Fusco A, Baio J, Esler A, Zahorodny W, Hobson N, Mars A, Thurm A, Bishop S, Wiggins LD. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord 2022; 52:5308-5320. [PMID: 34981308 DOI: 10.1007/s10803-021-05377-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.
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Affiliation(s)
- C E Rice
- Emory University, Atlanta, GA, USA. .,Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - L A Carpenter
- Medical University of South Carolina, Charleston, SC, USA
| | | | - C Lord
- University of California Los Angeles, Los Angeles, CA, USA
| | - M DiRienzo
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Boan
- Medical University of South Carolina, Charleston, SC, USA
| | - C Skowyra
- Washington University in St. Louis, St. Louis, MO, USA
| | - A Fusco
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Baio
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Esler
- University of Minnesota, Minneapolis, MN, USA
| | - W Zahorodny
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - N Hobson
- Independent Consultant, Keller, TX, USA
| | - A Mars
- Hunterdon Healthcare System, Flemington, NJ, USA
| | - A Thurm
- National Institute of Mental Health, Bethesda, MD, USA
| | - S Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - L D Wiggins
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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20
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Rocha Neto HG, Sinem TB, Koiller LM, Pereira AM, de Souza Gomes BM, Veloso Filho CL, Cavalcanti MT, Telles-Correia D. Intra-rater Kappa Accuracy of Prototype and ICD-10 Operational Criteria-Based Diagnoses for Mental Disorders: A Brief Report of a Cross-Sectional Study in an Outpatient Setting. Front Psychiatry 2022; 13:793743. [PMID: 35308869 PMCID: PMC8924129 DOI: 10.3389/fpsyt.2022.793743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The use of "operational criteria" is a solution for low reliability, contrasting with a prototypical classification that is used in clinics. We aim to measure the reliability of prototypical and ICD-10 diagnoses. METHODS This is a retrospective study, with a convenience sample of subjects treated in a university clinic. Residents reviewed their diagnosis using ICD-10 criteria, and Cohen's kappa statistic was performed on operational and prototype diagnoses. RESULTS Three out of 30 residents participated, reviewing 146 subjects under their care. Diagnoses were grouped in eight classes: organic (diagnoses from F00 to F09), substance disorders (F10-F19), schizophrenia spectrum disorders (F20-F29), bipolar affective disorder (F30, F31, F34.0, F38.1), depression (F32, F33), anxiety-related disorders (F40-F49), personality disorders (F60-F69), and neurodevelopmental disorders (F70-F99). Overall, agreement was high [K = 0.77, 95% confidence interval (CI) = 0.69-0.85], with a lower agreement related to personality disorders (K = 0.58, 95% CI = 0.38-0.76) and higher with schizophrenia spectrum disorders (K = 0.91, 95% CI = 0.82-0.99). DISCUSSION Use of ICD-10 criteria did not significantly increase the number of diagnoses. It changed few diagnoses, implying that operational criteria were irrelevant to clinical opinion. This suggests that reliability among interviewers is more related to information gathering than diagnostic definitions. Also, it suggests an incorporation of diagnostic criteria according to training, which then became part of the clinician's prototypes. Residents should be trained in the use of diagnostic categories, but presence/absence checking is not needed to achieve operational compatible diagnoses.
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Affiliation(s)
- Helio G Rocha Neto
- Programa de Pós Graduação em Psiquiatria e Saúde Mental - PROPSAM, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Programa de Doutoramento do Centro Acadêmico de Medicina da Universidade de Lisboa - CAMLPHD, Lisbon, Portugal
| | - Tomas Boldrini Sinem
- Medicine Faculty, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luisa Mendez Koiller
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amanda Machado Pereira
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Carlos Linhares Veloso Filho
- Programa de Pós Graduação em Psiquiatria e Saúde Mental - PROPSAM, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria T Cavalcanti
- Programa de Pós Graduação em Psiquiatria e Saúde Mental - PROPSAM, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Medicine Faculty, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diogo Telles-Correia
- Programa de Doutoramento do Centro Acadêmico de Medicina da Universidade de Lisboa - CAMLPHD, Lisbon, Portugal.,Clinica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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21
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North CS, Surís AM, Clarke D, Palka JM, Yousif L, Regier DA. A Crosswalk Study of DSM-IV and DSM-5 Criteria for PTSD from the DSM-5 Field Trials. Psychiatry 2022; 85:228-245. [PMID: 35271425 DOI: 10.1080/00332747.2022.2034107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: Posttraumatic stress disorder (PTSD) is prevalent and sometimes severely disabling. Providing effective treatment for PTSD and addressing its social consequences require accurate diagnosis. PTSD criteria have changed in all editions of the American Diagnostic Criteria since introduction of the diagnosis in DSM-III in 1980. The DSM-5 Field Trials demonstrated very good inter-rater reliability for PTSD, but a crosswalk study comparing DSM-IV and DSM-5 criteria has potential to identify diagnostic differences generated by changed criteria. Methods: A DSM-IV to DSM-5 PTSD crosswalk study was conducted in real-world adult clinical treatment settings in two DSM-5 Field Trials sites, the Dallas (N = 93) and Houston (N = 48) Veterans Affairs medical centers. The crosswalk assessment was conducted by trained clinicians who interviewed the patients and rated both sets of criteria on a combined checklist. Results: PTSD prevalence differed insubstantially between criteria sets (42% vs. 45% and 55% vs. 52% in the Dallas and Houston sites, respectively), with moderate to excellent diagnostic agreement (reliability indicated, respectively, by κ = .53 and .93); however, substantial proportions of individuals diagnosed in one criteria set did not meet criteria in the other. Differences in cross-criteria diagnostic reliability were largely a function of differing definitions of criterion A trauma. Conclusions: Reliability across the two criteria sets was generally good to excellent, and diagnostic discrepancy predominantly reflected the elimination of criterion A2 in DSM-5 with a smaller contribution from changes to the avoidance and numbing criteria.
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22
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Gauld C, Giroux É, Micoulaud-Franchi JA. [Introduction to the hierarchical taxonomy of psychopathology]. Encephale 2021; 48:92-101. [PMID: 34544589 DOI: 10.1016/j.encep.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/11/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In clinical practice, the usefulness of diagnosis based on the Diagnostic or Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases, 11th edition, appears essential from a clinical, research, epidemiological, administrative, economic and political level. However, such diagnostic systems have shortcomings in terms of validity, little consideration of comorbidities and strong intra-class heterogeneity. On a structural level, the operationalization of its criteria is based on a reliability which has been defined a posteriori and which does not lead to improving the validity of the diagnosis but rather to the reification of the diagnostic categories. METHODS First published in its current form in 2017, the Hierarchical Taxonomy of Psychopathology (HiTOP) constitutes a nosological alternative based on statistics. It conceptualizes psychopathology as a set of hierarchical dimensions, i.e. in "transdiagnostic" continua. The HiTOP is structured according to super-spectra, spectra, sub-factors, syndromes, components and symptoms. This comes from the current dimensional psychology and quantitative nosology. This article describes the basic principles of the HiTOP project and its potential to integrate into clinical and psychiatric research based on its advantages and limitations. RESULTS Unlike the DSM, which is descriptive and categorical, the HiTOP is first a dimensional classification. This dimensionality describes psychiatric phenomena on continua, each dimension providing a diagnostic continuum to situate a clinical patient. This dimensionality avoids the reification of categories and it limits the dichotomy between normal and pathological. In addition, HiTOP shows a hierarchical structure: vertical refinement of dimensions allows to circumvent the problem of comorbidities, proposes a new conception of etiopathogenic mechanisms, and improves management of care. DISCUSSION Thus, we provide an illustration of the applications of a dimensional and hierarchical classification in current clinical practice and scientific research, compared to traditional nosology. The challenges of the HiTOP arise in terms of validity, i.e. in the relation of dimensions with physiopathological mechanisms, in clinical terms, i.e. in the potential contribution of dimensions in relation to categories. Moreover, methodological challenges will be important given the inherent limitations of the HiTOP. CONCLUSION The HiTOP allows to examine the conceptualization of psychiatric disorders, the search for explanatory mechanisms, and treatment from another perspective for psychiatry.
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Affiliation(s)
- C Gauld
- Service de Psychiatrie, Université Grenoble-Alpes, avenue du Maquis du Grésivaudan, 38000 Grenoble, France; UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, 75231 Paris, France.
| | - É Giroux
- Institut de Recherches philosophiques de Lyon (EA 4187), Université Jean Moulin Lyon 3, 69008 Lyon, France
| | - J-A Micoulaud-Franchi
- Service universitaire de médecine du sommeil, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, université de Bordeaux, CHU Pellegrin, 33076 Bordeaux cédex, France
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23
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McGuire FH, Carl A, Woodcock L, Frey L, Dake E, Matthews DD, Russell KJ, Adkins D. Differences in Patient and Parent Informant Reports of Depression and Anxiety Symptoms in a Clinical Sample of Transgender and Gender Diverse Youth. LGBT Health 2021; 8:404-411. [PMID: 34388043 DOI: 10.1089/lgbt.2020.0478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: We assessed characteristics of patients at a pediatric gender clinic and investigated if reports of mental health concerns provided by transgender and gender diverse (TGD) youth patients differed from reports provided by a parent informant on their behalf. Methods: This cross-sectional study included 259 TGD patients 8 to 22 years of age attending a pediatric gender clinic in the southeast United States from 2015 to 2020. Pearson correlations and paired sample t-tests compared patient-reported mental health concerns at patient intake with those provided by a parent informant. Clinical symptom severity was assessed with standardized T-scores. Level 2 Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress-Depression Scale and Level 2 PROMIS Emotional Distress-Anxiety Scale assessed depression and anxiety symptoms of patients. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure was used with parents. Results: Patients had a mean age of 14.9 at first visit, with most identifying as White (85.5%), non-Hispanic (91.1%), and as a boy or man (63.6%). Half had moderate-to-severe depression (51.2%) or anxiety (47.9%) symptoms. There was a moderate, positive correlation between patient-reported and parent-reported depression symptoms, with no correlation for anxiety symptoms. Informant type differences were statistically significant (patients reporting greater depression and anxiety symptoms). Conclusions: TGD youth patients reported more severe depression and anxiety symptoms compared with parent informants. Despite moderate agreement on depression symptoms, parents did not accurately detect their child's anxiety symptoms. These discrepancies highlight a need for interventions which increase parental recognition of child mental health status.
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Affiliation(s)
- F Hunter McGuire
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alexandra Carl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lindsay Woodcock
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lauren Frey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Emily Dake
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Derrick D Matthews
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kristen J Russell
- Clinical Social Work Division, Department of Case Management, Duke University Medical Center, Durham, North Carolina, USA
| | - Deanna Adkins
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
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Abasi I, Hofmann SG, Kamjou S, Moradveisi L, Motlagh AV, Wolf AS, Sobhani S, Saed O. Psychometric properties of interpersonal emotion regulation questionnaire in nonclinical and clinical population in Iran. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02191-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Davidson M, Gabos-Grecu C. Do DSM classifications help or hinder
drug development?
. DIALOGUES IN CLINICAL NEUROSCIENCE 2021; 22:73-79. [PMID: 32699507 PMCID: PMC7365297 DOI: 10.31887/dcns.2020.22.1/mdavidson] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Development and regulatory approval of psychotropic drugs targets individuals with
syndromes described in the current Diagnostic and Statistical Manual of Mental
Disorders (DSM). This helps drug developers and regulators to communicate
with prescribers, and prescribers to match a specific psychotropic with the individual
patient(s) most likely to benefit from it. However, this practice has been criticized on
the grounds that DSM syndromes are too heterogenous biologically, and
the effects of psychotropics are too nonspecific to allow for an effective match. This
review considers the advantages and disadvantages of the current practice and the
possible alternatives. It concludes that efforts should be made to explore psychotropic
development transdiagnostically, free of the DSM boundaries. However,
currently there exists no alternative diagnostic system that is clearly superior to the
DSM in terms of communications between the stakeholders in drug
development.
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Affiliation(s)
- Michael Davidson
- Professor and Chair, University of Nicosia Medical School, Nicosia, Cyprus
| | - Cristian Gabos-Grecu
- Assistant Professor University of Medicine
Pharmacy Science and Technology Targu Mureş, Romania
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Abstract
Improvements in understanding the neurobiological basis of mental illness have unfortunately not translated into major advances in treatment. At this point, it is clear that psychiatric disorders are exceedingly complex and that, in order to account for and leverage this complexity, we need to collect longitudinal data sets from much larger and more diverse samples than is practical using traditional methods. We discuss how smartphone-based research methods have the potential to dramatically advance our understanding of the neuroscience of mental health. This, we expect, will take the form of complementing lab-based hard neuroscience research with dense sampling of cognitive tests, clinical questionnaires, passive data from smartphone sensors, and experience-sampling data as people go about their daily lives. Theory- and data-driven approaches can help make sense of these rich data sets, and the combination of computational tools and the big data that smartphones make possible has great potential value for researchers wishing to understand how aspects of brain function give rise to, or emerge from, states of mental health and illness.
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Affiliation(s)
- Claire M Gillan
- School of Psychology, Trinity College Institute of Neuroscience, and Global Brain Health Institute, Trinity College Dublin, Dublin 2, Ireland;
| | - Robb B Rutledge
- Department of Psychology, Yale University, New Haven, Connecticut 06520, USA;
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London WC1B 5EH, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, United Kingdom
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Evers K, Maljaars J, Carrington SJ, Carter AS, Happé F, Steyaert J, Leekam SR, Noens I. How well are DSM-5 diagnostic criteria for ASD represented in standardized diagnostic instruments? Eur Child Adolesc Psychiatry 2021; 30:75-87. [PMID: 32076870 DOI: 10.1007/s00787-020-01481-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 01/23/2020] [Indexed: 01/19/2023]
Abstract
Five years after the publication of DSM-5 in 2013, three widely used diagnostic instruments have published algorithms designed to represent its (sub-)criteria for Autism Spectrum Disorder (ASD) in children and adolescents. This study aimed to: (1) establish the content validity of these three DSM-5-adapted algorithms, and (2) identify problems with the operationalization of DSM-5 diagnostic criteria in measurable and observable behaviors. Algorithm items of the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), Developmental, Dimensional and Diagnostic Interview (3di) and Diagnostic Interview for Social and Communication Disorders-11th edition (DISCO-11) were mapped onto DSM-5 sub-criteria. The development and decision-making rules integrated in their algorithms were then compared with DSM-5. Results demonstrated significant variability in the number and nature of sub-criteria covered by the ADOS-2, 3di and DISCO-11. In addition to differences in the development of algorithms and cut-off scores, instruments also differed in the extent to which they follow DSM-5 decision-making rules for diagnostic classification. We conclude that such differences in interpretation of DSM-5 criteria provide a challenge for symptom operationalization which will be most effectively overcome by consensus, testing and reformulation.
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Affiliation(s)
- Kris Evers
- Parenting and Special Education Research Unit, KU Leuven, Leopold Vanderkelenstraat 32, P.O. Box 3765, 3000, Leuven, Belgium. .,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium. .,Child and Adolescent Psychiatry, Z.org UPC KU Leuven, Leuven, Belgium.
| | - Jarymke Maljaars
- Parenting and Special Education Research Unit, KU Leuven, Leopold Vanderkelenstraat 32, P.O. Box 3765, 3000, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, Z.org UPC KU Leuven, Leuven, Belgium
| | - Sarah J Carrington
- School of Life and Health Sciences, Department of Psychology, Aston University, Birmingham, UK
| | | | - Francesca Happé
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jean Steyaert
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, Z.org UPC KU Leuven, Leuven, Belgium.,Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium
| | - Susan R Leekam
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
| | - Ilse Noens
- Parenting and Special Education Research Unit, KU Leuven, Leopold Vanderkelenstraat 32, P.O. Box 3765, 3000, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
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Woods SW, Bearden CE, Sabb FW, Stone WS, Torous J, Cornblatt BA, Perkins DO, Cadenhead KS, Addington J, Powers AR, Mathalon DH, Calkins ME, Wolf DH, Corcoran CM, Horton LE, Mittal VA, Schiffman J, Ellman LM, Strauss GP, Mamah D, Choi J, Pearlson GD, Shah JL, Fusar-Poli P, Arango C, Perez J, Koutsouleris N, Wang J, Kwon JS, Walsh BC, McGlashan TH, Hyman SE, Gur RE, Cannon TD, Kane JM, Anticevic A. Counterpoint. Early intervention for psychosis risk syndromes: Minimizing risk and maximizing benefit. Schizophr Res 2021; 227:10-17. [PMID: 32402605 PMCID: PMC8218020 DOI: 10.1016/j.schres.2020.04.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Malhi et al. in this issue critique the clinical high risk (CHR) syndrome for psychosis. METHOD Response to points of critique. RESULTS We agree that inconsistency in CHR nomenclature should be minimized. We respectfully disagree on other points. In our view: a) individuals with CHR and their families need help, using existing interventions, even though we do not yet fully understand disease mechanisms; b) substantial progress has been made in identification of biomarkers; c) symptoms used to identify CHR are specific to psychotic illnesses; d) CHR diagnosis is not "extremely difficult"; e) the pattern of progression, although heterogenous, is discernible; f) "psychosis-like symptoms" are common but are not used to identify CHR; and g) on the point described as 'the real risk,' CHR diagnosis does not frequently cause harmful stigma. DISCUSSION Malhi et al.'s arguments do not fairly characterize progress in the CHR field nor efforts to minimize stigma. That said, much work remains in areas of consistent nomenclature, mechanisms of disease, dissecting heterogeneity, and biomarkers. With regard to what the authors term the "real risk" of stigma associated with a CHR "label," however, our view is that avoiding words like "risk" and "psychosis" reinforces the stigma that both they and we mean to oppose. Moreover, patients and their families benefit from being given a term that describes what is happening to them.
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Affiliation(s)
- Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA; Department Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
| | - Fred W Sabb
- Lewis Center for Neuroimaging, University of Oregon, Eugene, USA
| | - William S Stone
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA; Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, China
| | - John Torous
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, USA
| | | | - Jean Addington
- Department of Psychiatry, University of Calgary, Alberta, Canada
| | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, USA
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA; Department of Psychology, Northwestern University, Chicago, IL, USA
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | | | - Daniel Mamah
- Department of Psychiatry, Washington University in Saint Louis, MO, USA
| | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT, USA
| | - Jai L Shah
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, UK; Department of Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Celso Arango
- Dept. of Child and Adolescent Psychiatry, Universidad Complutense de Madrid, Spain
| | - Jesus Perez
- Department of Psychiatry, University of Cambridge, UK
| | | | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, China
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, South Korea
| | - Barbara C Walsh
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | | | | | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
| | - John M Kane
- Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
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Taylor JJ, Kurt HG, Anand A. Resting State Functional Connectivity Biomarkers of Treatment Response in Mood Disorders: A Review. Front Psychiatry 2021; 12:565136. [PMID: 33841196 PMCID: PMC8032870 DOI: 10.3389/fpsyt.2021.565136] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 02/26/2021] [Indexed: 12/24/2022] Open
Abstract
There are currently no validated treatment biomarkers in psychiatry. Resting State Functional Connectivity (RSFC) is a popular method for investigating the neural correlates of mood disorders, but the breadth of the field makes it difficult to assess progress toward treatment response biomarkers. In this review, we followed general PRISMA guidelines to evaluate the evidence base for mood disorder treatment biomarkers across diagnoses, brain network models, and treatment modalities. We hypothesized that no treatment biomarker would be validated across these domains or with independent datasets. Results are organized, interpreted, and discussed in the context of four popular analytic techniques: (1) reference region (seed-based) analysis, (2) independent component analysis, (3) graph theory analysis, and (4) other methods. Cortico-limbic connectivity is implicated across studies, but there is no single biomarker that spans analyses or that has been replicated in multiple independent datasets. We discuss RSFC limitations and future directions in biomarker development.
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Affiliation(s)
- Joseph J Taylor
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Hatice Guncu Kurt
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States
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Nussbaum AM. Questionable Agreement: The Experience of Depression and DSM-5 Major Depressive Disorder Criteria. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2020; 45:623-643. [PMID: 33206179 DOI: 10.1093/jmp/jhaa025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Immediately before the release of DSM-5, a group of psychiatric thought leaders published the results of field tests of DSM-5 diagnostic criteria. They characterized the interrater reliability for diagnosing major depressive disorder by two trained mental health practitioners as of "questionable agreement." These field tests confirmed an open secret among psychiatrists that our current diagnostic criteria for diagnosing major depressive disorder are unreliable and neglect essential experiences of persons in depressive episodes. Alternative diagnostic criteria exist, but psychiatrists rarely encounter them, forestalling the discipline's epistemological crisis. In Alsadair MacIntyre's classic essay, such crises occur in science when a person encounters a rival schemata that is incompatible with their current schemata and subsequently constructs a narrative that allows them to reconstruct their own tradition. In search of rival schemata that are in conversation with their own tradition, psychiatric practitioners can utilize alternative diagnostic criteria like the Cultural Formulation Interview, embrace an epistemologically humble psychiatry, and attend to the narrative experience of a person experiencing a depressive episode.
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Psychometric Properties of Persian Version of Structured Clinical Interview for DSM-5-Research Version (SCID-5-RV): A Diagnostic Accuracy Study. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2020. [DOI: 10.5812/ijpbs.100930] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: The structured clinical interview for DSM-5 has recently been revised to reflect the new findings in the diagnostic criteria of psychological disorders. Objectives: The present study aimed to evaluate the reliability and validity of the Persian translation of structured clinical interview for diagnostic and statistical manual of mental disorders-fifth edition (DSM-5)-research version (SCID-5-RV) on Iranian adult population. Methods: In the current diagnostic accuracy study a total of 305 clinical samples were admitted to fifteen adult clinical settings and a subsample of these participants (n = 50, with a mean age of 34.31 and a standard deviation of 11.96) was recruited to evaluate test-retest reliability, and 40 non-clinical participants were recruited to examine construct validity. All participants completed the Millon Clinical Multiaxial inventory-III (MCMI-III) and Brief Symptom inventory (BSI). Results: SCID psychometric properties indicated an acceptable range for internal consistency (0.95 - 0.99), test-retest reliability (0.60 - 0.79), and Kappa reliability (0.57 - 0.72). Further, the agreement between interviewer and psychiatrist diagnoses was assessed using the Kappa index, and the result was satisfactory. The current diagnostic accuracy study used sensitivity and specificity indexes to assess the diagnostic validity of SCID by positive predictive value and also negative predictive value under the “likelihood ratio” domain. Specificity values for most psychiatric disorders were high; the sensitivity values were to somewhat lower. Furthermore, SCID-5-RV categorical diagnoses demonstrated an acceptable construct validity based on the significant differences between the clinical and non-clinical samples in all subscales of BSI except for phobia as well as all clinical subscales of MCMI-III. Conclusions: In general, the Persian translation of SCID-5-RV represented acceptable reliability and validity for various categorical diagnoses in different clinical settings.
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Evaluation of the International Classification of Diseases-11 chronic pain classification: study protocol for an ecological implementation field study in low-, middle-, and high-income countries. Pain Rep 2020; 5:e825. [PMID: 32656459 PMCID: PMC7318717 DOI: 10.1097/pr9.0000000000000825] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction The purpose of the present ecological implementation field study is to evaluate the new classification of chronic pain as implemented in the 11th revision of the International Classification of Diseases (ICD-11) with regard to clinical utility and interrater reliability. To evaluate the classification in a variety of settings, the study will be implemented in different low-, middle-, and high-income countries. Methods The study will be conducted in 2 phases. Participating pain clinics of the first phase are located in India, Cuba, and New Zealand. Two or more clinicians per study center will use the ICD-11 classification of chronic pain to diagnose 75 to 100 consecutive new chronic pain patients per center. A structured classification algorithm will guide the diagnostic process. Interrater reliability will be analyzed for the first 20 consecutive new patients per center. Before the coding, a training workshop will introduce the clinicians to the new classification. The main outcome parameter of the ecological implementation field study is clinical utility. More specifically, this entails clinical utility ratings, interrater reliability, as well as the exhaustiveness of the classification and the mutual exclusiveness of the new chronic pain categories. Differences between countries with different cultural backgrounds and income levels will be analyzed. Perspective The ecological implementation field study presented here will be implemented in several countries with different income levels. This increases the generalizability of the results and allows initial insight into the global applicability of the new chronic pain classification. A positive evaluation can facilitate the implementation of the classification.
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Cai N, Revez JA, Adams MJ, Andlauer TFM, Breen G, Byrne EM, Clarke TK, Forstner AJ, Grabe HJ, Hamilton SP, Levinson DF, Lewis CM, Lewis G, Martin NG, Milaneschi Y, Mors O, Müller-Myhsok B, Penninx BWJH, Perlis RH, Pistis G, Potash JB, Preisig M, Shi J, Smoller JW, Streit F, Tiemeier H, Uher R, Van der Auwera S, Viktorin A, Weissman MM, Kendler KS, Flint J. Minimal phenotyping yields genome-wide association signals of low specificity for major depression. Nat Genet 2020; 52:437-447. [PMID: 32231276 PMCID: PMC7906795 DOI: 10.1038/s41588-020-0594-5] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/19/2020] [Indexed: 12/18/2022]
Abstract
Minimal phenotyping refers to the reliance on the use of a small number of self-reported items for disease case identification, increasingly used in genome-wide association studies (GWAS). Here we report differences in genetic architecture between depression defined by minimal phenotyping and strictly defined major depressive disorder (MDD): the former has a lower genotype-derived heritability that cannot be explained by inclusion of milder cases and a higher proportion of the genome contributing to this shared genetic liability with other conditions than for strictly defined MDD. GWAS based on minimal phenotyping definitions preferentially identifies loci that are not specific to MDD, and, although it generates highly predictive polygenic risk scores, the predictive power can be explained entirely by large sample sizes rather than by specificity for MDD. Our results show that reliance on results from minimal phenotyping may bias views of the genetic architecture of MDD and impede the ability to identify pathways specific to MDD.
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Affiliation(s)
- Na Cai
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.
- European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, UK.
- Helmholtz Pioneer Campus, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Joana A Revez
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Till F M Andlauer
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gerome Breen
- NIHR Maudsley Biomedical Research Centre, King's College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Enda M Byrne
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Andreas J Forstner
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Steven P Hamilton
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Douglas F Levinson
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- Department of Medical & Molecular Genetics, King's College London, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Nicholas G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit and GGZinGeest, Amsterdam, the Netherlands
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Bertram Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit and GGZinGeest, Amsterdam, the Netherlands
| | - Roy H Perlis
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Giorgio Pistis
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Fabien Streit
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Myrna M Weissman
- Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jonathan Flint
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
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Park SC, Kim YK. Anxiety Disorders in the DSM-5: Changes, Controversies, and Future Directions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:187-196. [DOI: 10.1007/978-981-32-9705-0_12] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Strand M, von Hausswolff-Juhlin Y, Welch E. A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder. Int J Eat Disord 2019; 52:331-360. [PMID: 30489647 DOI: 10.1002/eat.22962] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Avoidant/restrictive food intake disorder (ARFID) was introduced as a new diagnosis in the DSM-5. This systematic scoping review explores how ARFID as a diagnostic entity is conceptualized in the research literature and evaluates the diagnostic validity according to the Feighner criteria. METHOD A systematic scoping review of papers on ARFID in PubMed/MEDLINE and Web of Science was undertaken, following PRISMA and Joanna Briggs Institute guidelines. RESULTS Fifty-one original research publications, 23 reviews and commentaries, and 20 case reports were identified. The use of ARFID as a conceptual category varies significantly within this literature. At this time, the ARFID diagnosis does not fulfil the Feighner criteria for evaluating the validity of diagnostic constructs, the most urgent problem being the demarcation toward other disorders. A three-dimensional model-lack of interest in food, selectivity based on sensory sensitivity, and fear of aversive consequences-is gaining support in the research literature. DISCUSSION The introduction of the ARFID diagnosis has undoubtedly increased the recognition of a previously largely neglected group of patients. However, this article points to an inability of the current DSM-5 diagnostic criteria to ensure optimal diagnostic validity, which risks making them less useful in clinical practice and in epidemiological research. To increase the conceptual validity of the ARFID construct, several possible alterations to the current diagnostic criteria are suggested, including a stronger emphasis of the three identified subdomains and further clarifying the boundaries of ARFID.
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Affiliation(s)
- Mattias Strand
- Stockholm Centre for Eating Disorders, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Yvonne von Hausswolff-Juhlin
- Stockholm Centre for Eating Disorders, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Elisabeth Welch
- Stockholm Centre for Eating Disorders, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Parker G, Malhi GS. Persistent Depression: Should Such a DSM-5 Diagnostic Category Persist? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:177-179. [PMID: 30453771 PMCID: PMC6405812 DOI: 10.1177/0706743718814429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gordon Parker
- 1 School of Psychiatry, University of New South Wales, Sydney, Australia.,2 Black Dog Institute, Sydney, Australia
| | - Gin S Malhi
- 3 CADE Clinic, Royal North Shore Hospital, Sydney, Australia.,4 Northern Clinical School, University of Sydney, Sydney, Australia
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Mowlem F, Agnew-Blais J, Taylor E, Asherson P. Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms. Psychiatry Res 2019; 272:765-773. [PMID: 30832197 PMCID: PMC6401208 DOI: 10.1016/j.psychres.2018.12.128] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/23/2018] [Indexed: 01/13/2023]
Abstract
We investigate if different factors influence whether girls versus boys meet diagnostic criteria for attention-deficit/hyperactivity disorder(ADHD) among children with high ADHD symptoms. Participants were 283 children aged 7-12 from a population-based study. Girls and boys meeting diagnostic criteria for ADHD, based on an objective investigator-based interview, were compared to children who did not meet criteria despite high symptoms on a rating-scale measure of ADHD. We assessed factors that could differentially relate to diagnosis across girls and boys including ADHD symptoms, co-occurring behavioural/emotional problems and impairment, and sex-effects in rater perceptions of ADHD symptoms. While overall similar factors distinguished girls and boys who met diagnostic criteria from high-symptom peers, effect sizes were larger in girls. Emotional problems were particularly salient to distinguishing diagnosed versus high-symptom girls but not boys. Parents rated boys meeting diagnostic criteria as more impaired than high-symptom boys but did not do so for girls, and under-rated diagnosed girls' hyperactive/impulsive symptoms compared to more objective interview assessment, with the opposite observed in boys. Results suggest girls' ADHD may need to be made more prominent by additional behavioural/emotional problems for them to meet full diagnostic criteria and that sex differences in parental perceptions of ADHD behaviours and impairment exist.
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Affiliation(s)
- Florence Mowlem
- Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Jessica Agnew-Blais
- Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip Asherson
- Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK
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Kim YK, Park SC. Classification of Psychiatric Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:17-25. [PMID: 31705488 DOI: 10.1007/978-981-32-9721-0_2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Because of the poor link between psychiatric diagnosis and neurobiological findings, it is difficult to classify mental disorders. The changes made to psychiatric diagnostic systems over the years can be understood in terms of "practical conservatism." The Diagnostic and Statistical Manual of Mental Disorders (DSM)-I and DSM-II were theoretically supported by the psychoanalytic and psychodynamic approach. Subsequently, psychiatric diagnoses of this kind were opposed by the anti-psychiatry movement, as well as by the findings of the Rosenhan experiment. Thus, the DSM-III revolution contained more empiricism, aligning psychiatry with biomedicine. Psychiatric diagnoses are classified and defined in terms of Kraepelinian dualism, using a categorical approach. The empirical trend was continued in the DSM-IV. To overcome the limitations of current psychiatric diagnostic systems and integrate fundamental genetic, neurobiological, behavioral, environmental, and experimental components into psychiatry, the Research Domain Criteria (RDoC) were established. To overcome the limitations of the categorical approach, psychiatrists have considered adopting a dimensional approach. However, their efforts were frustrated in the DSM-5 revision process. Thus, the DSM-5 is characterized by the rearrangement of psychiatric diagnoses, the partial adoption of a dimensional approach, the introduction of new diagnoses, and harmonization with the International Classification of Diseases.
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Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University Ansan Hospital, 516, Gojan-dong, 425-707, Ansan, Gyeonggi Province, Republic of Korea
| | - Seon-Cheol Park
- Department of Psychiatry, Inje University Haeundae Paik Hospital, 875, Haeun-daero, Haeundae-gu, 48108, Busan, Republic of Korea.
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Gonçalves AMN, Dantas CDR, Banzato CEM, Oda AMGR. A historical account of schizophrenia proneness categories from DSM-I to DSM-5 (1952-2013). REVISTA LATINOAMERICANA DE PSICOPATOLOGIA FUNDAMENTAL 2018. [DOI: 10.1590/1415-4714.2018v21n4p798.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The history of diagnostic classifications in psychiatry has been recognized as a privileged means of access to the vicissitudes inherent to the configuration of a scientific and professional field, also bringing significant contributions to conceptual history. We have taken as primary sources the five editions of the DSM (1952-2013) to examine the construction of diagnostic categories related to schizophrenia proneness, indicating the scientific and social contexts related to the development of DSM and psychiatry itself. Along this process we highlight the conditions of possibility for the emergence of the Attenuated Psychosis Syndrome, a highly controversial diagnostic proposal, in the elaboration of DSM-5. This proposal ended up being rejected not only on scientific grounds, but also because of feared unintended consequences.
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Drvaric L, Bagby RM, Kiang M, Mizrahi R. Maladaptive personality traits in patients identified at lower-risk and higher-risk for psychosis. Psychiatry Res 2018; 268:348-353. [PMID: 30098542 DOI: 10.1016/j.psychres.2018.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/25/2018] [Accepted: 08/01/2018] [Indexed: 11/27/2022]
Abstract
The 'at-risk' state for psychosis is a high-risk paradigm that examines factors that contribute to conversion to a first episode of psychosis. Although a multitude of contributing factors have been identified in one's susceptibility to conversion to psychosis, dimensional pathological personality traits have not been examined in 'at-risk' populations. In this study we examine lower- versus higher-risk for psychosis using traits from the DSM-5 Alternative Dimensional Model of Personality Disorders (AMPD) to investigate which AMPD personality traits distinguish those 'at-risk' patients at relatively lower-risk for conversion to psychosis versus those at higher-risk. Remitted schizophrenic patients served as the comparison group. MANOVA analyses revealed significant group differences on the PID-5, with the higher-risk patients scoring higher on two of the five AMPD trait domains - Negative Affectivity and Detachment - compared to lower-risk patients. Maladaptive personality traits from the AMPD may serve as potential risk factor for conversion to psychosis.
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Affiliation(s)
- Lauren Drvaric
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - R Michael Bagby
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
| | - Michael Kiang
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Romina Mizrahi
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Buer Christensen T, Paap MCS, Arnesen M, Koritzinsky K, Nysaeter TE, Eikenaes I, Germans Selvik S, Walther K, Torgersen S, Bender DS, Skodol AE, Kvarstein E, Pedersen G, Hummelen B. Interrater Reliability of the Structured Clinical Interview for the DSM–5 Alternative Model of Personality Disorders Module i: Level of Personality Functioning Scale. J Pers Assess 2018; 100:630-641. [DOI: 10.1080/00223891.2018.1483377] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Muirne C. S. Paap
- Department of Special Needs, Education, and Youth Care, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Ingeborg Eikenaes
- Department of Personality Psychiatry, Division of Mental Health and Addiction Treatment, Vestfold Hospital Trust, Vestfold, Norway
| | - Sara Germans Selvik
- Department of Psychiatry, Hospital Namsos, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kristoffer Walther
- Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Donna S. Bender
- Department of Psychiatry and Behavioral Sciences and Counseling and Psychological Services, Tulane University
| | - Andrew E. Skodol
- 9Department of Psychiatry, University of Arizona College of Medicine, Oslo University Hospital, Oslo, Norway
| | - Elfrida Kvarstein
- Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Geir Pedersen
- Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Benjamin Hummelen
- Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Research and Development, Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Normative and Maladaptive Personality Trait Models of Mood, Psychotic, and Substance Use Disorders. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018; 40:606-613. [PMID: 30459484 PMCID: PMC6223804 DOI: 10.1007/s10862-018-9688-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Personality Inventory for DSM-5 (PID-5) is a questionnaire developed to assess the five domains represented in the alternative model for personality disorders proposed in Section III of the DSM-5. This study examined the ability of the PID-5 to distinguish between different mental disorders compared to a questionnaire measure of the five-factor model (FFM) of normative personality. The study included the administration of the PID-5 and Revised NEO Personality Inventory (NEO PI-R), a measure of the FFM, to treatment-seeking individuals with Depressive, Bipolar, Psychotic, and Alcohol Use Disorders (AUD). Diagnostic groups were compared at the domain level of PID-5 and NEO PI-R, with sex and age as covariates. The main findings on the PID-5 included higher Detachment scores for Bipolar and Depressive Disorders than Psychotic and AUDs, lower Psychoticism/higher Disinhibition scores for the AUD group compared to all other groups, and lower Negative Affect for the Psychotic Disorders versus AUD group. On the NEO PI-R, the AUD diagnostic group was associated with lower Conscientiousness and Agreeableness scores compared to all other groups, and lower Neuroticism scores than the Bipolar and Depressive groups. Group pairwise comparisons did not appear to show many differences between the PID-5 and NEO PI-R. The results suggest that the alternative DSM-5 model for personality disorders may have clinical utility in distinguishing personality profiles between diagnostic groups. These findings emphasize the importance of additional research on the capacity of maladaptive personality to contribute to the assessment of differential diagnoses.
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Franklin CL, Raines AM, Walton JL, Chambliss JL, Maieritsch KP. Using a Clinician-Administered Interview to Examine the Overlap in Posttraumatic Stress Disorder Criteria D and E. J Nerv Ment Dis 2018; 206:429-432. [PMID: 29781889 DOI: 10.1097/nmd.0000000000000820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although the diagnosis of posttraumatic stress disorder (PTSD) is often criticized for including symptoms that overlap with one another, only one study has explored the impact of symptom reporting. Using a clinician-rated interview for PTSD (N = 558), the current study examined overlap between PTSD criteria D1, D2, and D3 ("target D symptoms") and criterion E symptoms of similar content (i.e., E1 and E3). Furthermore, their impact on meeting criterion and disorder cutoffs was examined. Results revealed that target symptoms were endorsed in conjunction more than half the time. Criteria D and E also were often coded together. Removal of target D symptoms resulted in 24.7% of participants no longer meeting criterion D, but no reduction in the diagnosis of PTSD. This article is one of the first to report the functioning of the new criterion D symptoms, and the results have diagnostic implications for research and clinical work.
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Reed GM, Sharan P, Rebello TJ, Keeley JW, Elena Medina-Mora M, Gureje O, Luis Ayuso-Mateos J, Kanba S, Khoury B, Kogan CS, Krasnov VN, Maj M, de Jesus Mari J, Stein DJ, Zhao M, Akiyama T, Andrews HF, Asevedo E, Cheour M, Domínguez-Martínez T, El-Khoury J, Fiorillo A, Grenier J, Gupta N, Kola L, Kulygina M, Leal-Leturia I, Luciano M, Lusu B, Nicolas J, Martínez-López I, Matsumoto C, Umukoro Onofa L, Paterniti S, Purnima S, Robles R, Sahu MK, Sibeko G, Zhong N, First MB, Gaebel W, Lovell AM, Maruta T, Roberts MC, Pike KM. The ICD-11 developmental field study of reliability of diagnoses of high-burden mental disorders: results among adult patients in mental health settings of 13 countries. World Psychiatry 2018; 17:174-186. [PMID: 29856568 PMCID: PMC5980511 DOI: 10.1002/wps.20524] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Reliable, clinically useful, and globally applicable diagnostic classification of mental disorders is an essential foundation for global mental health. The World Health Organization (WHO) is nearing completion of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11). The present study assessed inter-diagnostician reliability of mental disorders accounting for the greatest proportion of global disease burden and the highest levels of service utilization - schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress - among adult patients presenting for treatment at 28 participating centers in 13 countries. A concurrent joint-rater design was used, focusing specifically on whether two clinicians, relying on the same clinical information, agreed on the diagnosis when separately applying the ICD-11 diagnostic guidelines. A total of 1,806 patients were assessed by 339 clinicians in the local language. Intraclass kappa coefficients for diagnoses weighted by site and study prevalence ranged from 0.45 (dysthymic disorder) to 0.88 (social anxiety disorder) and would be considered moderate to almost perfect for all diagnoses. Overall, the reliability of the ICD-11 diagnostic guidelines was superior to that previously reported for equivalent ICD-10 guidelines. These data provide support for the suitability of the ICD-11 diagnostic guidelines for implementation at a global level. The findings will inform further revision of the ICD-11 diagnostic guidelines prior to their publication and the development of programs to support professional training and implementation of the ICD-11 by WHO member states.
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Affiliation(s)
- Geoffrey M Reed
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Tahilia J Rebello
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Nigeria
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autonoma de Madrid, IIS-P and Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Kyushu University, Fukuoka City, Japan
| | - Brigitte Khoury
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Valery N Krasnov
- Moscow Research Institute of Psychiatry, National Medical Research Centre for Psychiatry and Narcology, Moscow, Russian Federation
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Jair de Jesus Mari
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Min Zhao
- Shanghai Mental Health Center and Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | | | - Howard F Andrews
- New York State Psychiatric Institute, New York, NY, USA
- Departments of Biostatistics and Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Elson Asevedo
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Majda Cheour
- Department of Psychiatry, Tunis Al Manar University and Al Razi Hospital, Tunis, Tunisia
| | - Tecelli Domínguez-Martínez
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
- Cátedras CONACYT, National Council for Science and Technology, Mexico City, Mexico
| | - Joseph El-Khoury
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Jean Grenier
- Institut du Savoir Montfort - Hôpital Montfort & Université d'Ottawa, Ottawa, Ontario, Canada
| | - Nitin Gupta
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Lola Kola
- Department of Psychiatry, University of Ibadan, Nigeria
| | - Maya Kulygina
- Moscow Research Institute of Psychiatry, National Medical Research Centre for Psychiatry and Narcology, Moscow, Russian Federation
| | - Itziar Leal-Leturia
- Department of Psychiatry, Universidad Autonoma de Madrid, IIS-P and Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Bulumko Lusu
- Department of Psychiatry, University of Cape Town and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | | | - I Martínez-López
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | | | - Sabrina Paterniti
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, and Department of Psychiatry, University of Ottawa, Ontario, Canada
| | - Shivani Purnima
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rebeca Robles
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Manoj K Sahu
- Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India
| | - Goodman Sibeko
- Department of Psychiatry, University of Cape Town and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Na Zhong
- Shanghai Mental Health Center and Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Michael B First
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Anne M Lovell
- Institut National de la Santé et de la Recherche Médicale U988, Paris, France
| | - Toshimasa Maruta
- Health Management Center, Seitoku University, Matsudo City, Japan
| | - Michael C Roberts
- Office of Graduate Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Dereboy F, Dereboy Ç, Eskin M. Validation of the DSM–5 Alternative Model Personality Disorder Diagnoses in Turkey, Part 1: LEAD Validity and Reliability of the Personality Functioning Ratings. J Pers Assess 2018; 100:603-611. [DOI: 10.1080/00223891.2018.1423989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ferhan Dereboy
- Department of Psychiatry, Adnan Menderes Universitesi Tip Fakultesi, Aydin, Turkey
| | - Çiğdem Dereboy
- Department of Psychiatry, Adnan Menderes Universitesi Tip Fakultesi, Aydin, Turkey
| | - Mehmet Eskin
- Department of Psychiatry, Adnan Menderes Universitesi Tip Fakultesi, Aydin, Turkey
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Bagby RM, Sellbom M. The Validity and Clinical Utility of the Personality Inventory for DSM-5 Response Inconsistency Scale. J Pers Assess 2018; 100:398-405. [PMID: 29432027 DOI: 10.1080/00223891.2017.1420659] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) is a self-report instrument designed to assess the personality traits of the alternative model of personality disorders (AMPD) in Section III of the DSM-5. Despite its relatively recent introduction to the field, the instrument is frequently and widely used. One criticism of this instrument is that it does not include validity scales to detect potentially invalidating response style, including noncredible over- and underreporting and inconsistent (random) responding. Keeley, Webb, Peterson, Roussin, and Flanagan (2016) constructed an inconsistency scale (the PID-5-INC) to assess random responding on PID-5 and proposed a number of potential cut scores that could be applied. In this study, we attempted to cross-validate the PID-5-INC, including whether the scale could detect randomly generated protocols and distinguish them from nonrandom protocols produced by two student and two clinical samples. The PID-5-INC successfully distinguished random from nonrandom protocols and the best cut scores were similar to those reported by Keeley et al. (2016). We also found that a relatively low amount of random responding compromised the psychometric validity of the PID-5 trait scales, which extended previous work on this instrument.
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Affiliation(s)
- R Michael Bagby
- a Departments of Psychology and Psychiatry , University of Toronto , Toronto , Canada
| | - Martin Sellbom
- b Department of Psychology , University of Otago , Dunedin , New Zealand
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Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome. Curr Opin Psychiatry 2018; 31:17-25. [PMID: 29120914 DOI: 10.1097/yco.0000000000000376] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Major depressive disorder with a comorbid anxiety disorder or with significant anxiety symptoms (here called anxious depression) is common and has been associated with poor clinical course trajectories. However, various dichotomous as well as dimensional definitions have been used to label anxious depression and it remains unclear to which extent these result in inconsistent findings. This review provides an overview of recent literature on the impact of anxiety in depressed patients on clinical course trajectories, treatment outcomes, and underlying neurobiological dysregulations. RECENT FINDINGS Anxious depression seems associated with poorer clinical course trajectories and treatment nonresponse as compared with 'pure' depression, regardless of which definition is used. Recent studies have attempted to determine specific efficacy of novel pharmacological treatments for anxious depressed patients, but have not been conclusive because of the insufficient number of studies and differences in definitions and assessment of anxious depression. Neurobiology studies suggest that anxious depression is associated with increased immune dysregulation, more cortical thinning, and corticolimbic dysfunctions as compared with 'pure' depression. SUMMARY Anxious depression appears to be a common and clinically relevant subtype of depression as it predicts poorer course trajectories. As populations with anxious depression may benefit from specific treatment regimens, further research is necessary to better delineate its definition and neurobiology. The relatively new Diagnostic and Statistical Manual of Mental Disorders-5 anxious distress specifier is a welcome development and should be further investigated and compared against other anxiety constructs.
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49
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Aggarwal NK. Culture, Communication, and DSM-5 Diagnostic Reliability. J Natl Med Assoc 2017; 109:150-152. [PMID: 28987242 DOI: 10.1016/j.jnma.2017.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/10/2017] [Accepted: 03/12/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Neil Krishan Aggarwal
- New York State Psychiatric Institute, Columbia University Department of Psychiatry, 1051 Riverside Drive, Unit 11, New York, NY 10032, USA
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50
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Kogan CS, Paterniti S. The True North Strong and Free? Opportunities for Improving Canadian Mental Health Care and Education by Adopting the WHO's ICD-11 Classification. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:690-696. [PMID: 28662590 PMCID: PMC5638190 DOI: 10.1177/0706743717717253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Cary S Kogan
- 1 School of Psychology, University of Ottawa, Ottawa, Ontario.,2 Institute of Mental Health Research, Ottawa, Ontario
| | - Sabrina Paterniti
- 2 Institute of Mental Health Research, Ottawa, Ontario.,3 Royal Ottawa Mental Health Centre, Ottawa, Ontario.,4 Department of Psychiatry, University of Ottawa, Ottawa, Ontario
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