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Blanchard JJ, Bradshaw KR, Garcia CP, Nasrallah HA, Harvey PD, Casey D, Csoboth CT, Hudson JI, Julian L, Lentz E, Nuechterlein KH, Perkins DO, Skale TG, Snowden LR, Tandon R, Tek C, Velligan D, Vinogradov S, O'Gorman C. Examining the reliability and validity of the Clinical Assessment Interview for Negative Symptoms within the Management of Schizophrenia in Clinical Practice (MOSAIC) multisite national study. Schizophr Res 2017; 185:137-143. [PMID: 28087270 DOI: 10.1016/j.schres.2017.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 11/28/2022]
Abstract
The current study sought to expand on prior reports of the validity and reliability of the CAINS (CAINS) by examining its performance across diverse non-academic clinical settings as employed by raters not affiliated with the scale's developers and across a longer test-retest follow-up period. The properties of the CAINS were examined within the Management of Schizophrenia in Clinical Practice (MOSAIC) schizophrenia registry. A total of 501 participants with a schizophrenia spectrum diagnosis who were receiving usual care were recruited across 15 national Patient Assessment Centers and evaluated with the CAINS, other negative symptom measures, and assessments of functioning, quality of life and cognition. Temporal stability of negative symptoms was assessed across a 3-month follow-up. Results replicated the two-factor structure of the CAINS reflecting Motivation and Pleasure and expression symptoms. The CAINS scales exhibited high internal consistency and temporal stability. Convergent validity was supported by significant correlations between the CAINS subscales with other negative symptom measures. Additionally, the CAINS was significantly correlated with functioning and quality of life. Discriminant validity was demonstrated by small to moderate associations between the CAINS and positive symptoms, depression, and cognition (and these associations were comparable to those found with other negative symptom scales). Findings suggest that the CAINS is a reliable and valid tool for measuring negative symptoms in schizophrenia across diverse clinical samples and settings.
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Affiliation(s)
| | | | | | - Henry A Nasrallah
- Saint Louis University, 1438 S. Grand Boulevard, Saint Louis, MO 63104 3, USA
| | - Philip D Harvey
- University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136, USA
| | - Daniel Casey
- Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | | | - James I Hudson
- Harvard Medical School/McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Laura Julian
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Ellen Lentz
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Keith H Nuechterlein
- University of California, Los Angeles, 300 UCLA Medical Plaza, Los Angeles, CA 90095-6968, USA
| | | | - Tracey G Skale
- Greater Cincinnati Behavioral Health Services, 1501 Madison Road, Walnut Hills, OH 45206, USA
| | | | - Rajiv Tandon
- University of Florida, Gainesville, FL 32611, USA
| | - Cenk Tek
- Yale University/Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA
| | - Dawn Velligan
- University of Texas Health Science Center, 7703 Floyd Curl Dr. San Antonio, San Antonio, TX 78240, USA
| | - Sophia Vinogradov
- University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, USA; San Francisco Veterans Administration Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA
| | - Cedric O'Gorman
- Formerly of Genentech. Currently at Intra-Cellular Therapies, Inc., 430 East 29th Street, New York City, NY 10016, USA
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Abstract
The drastic increase of morbidity and mortality rates in the transforming Central-Eastern European countries, characterizing the last decades, offers a unique opportunity to analyse the relationship of those social, psychological and biological processes that contribute to rapid health modifications. In 1988 and 1995, two national representative surveys of the Hungarian population aged 16 or older ( N = 20,902 and 12,640 respectively) were conducted. The results show that depressive symptom severity mediates between relative socio-economic deprivation and higher self-rated morbidity rates. The worsening of traditional risk factors such as alcohol consumption and smoking, are also the consequences of social and psychological problems. A vicious circle might be hypothesized between social deprivation and depressive symptomatology, which substantially contributes to higher morbidity and mortality rates.
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Affiliation(s)
- Maria S Kopp
- Institute of Behavioural Sciences, Semmelweis University, Hungary.
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Nasrallah HA, Harvey PD, Casey D, Csoboth CT, Hudson JI, Julian L, Lentz E, Nuechterlein KH, Perkins DO, Kotowsky N, Skale TG, Snowden LR, Tandon R, Tek C, Velligan D, Vinogradov S, O'Gorman C. The Management of Schizophrenia in Clinical Practice (MOSAIC) Registry: a focus on patients, caregivers, illness severity, functional status, disease burden and healthcare utilization. Schizophr Res 2015; 166:69-79. [PMID: 26027848 DOI: 10.1016/j.schres.2015.04.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/09/2015] [Accepted: 04/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Management of Schizophrenia in Clinical Practice (MOSAIC), a disease-based registry of schizophrenia, was initiated in December 2012 to address important gaps in our understanding of the impact and burden of schizophrenia and to provide insight into the current status of schizophrenia care in the US. Recruitment began in December 2012 with ongoing assessment continuing through May 2014. METHODS Participants were recruited from a network of 15 centralized Patient Assessment Centers supporting proximal care sites. Broad entry criteria included patients diagnosed with schizophrenia, schizophreniform or schizoaffective disorder, presenting within the normal course of care, in usual treatment settings, aged ≥18years and able to read and speak English. RESULTS By May 2014, 550 participants (65.8% male, 59.8% White, 64.4% single, mean age 42.9years), were enrolled. The majority had a diagnosis of schizophrenia (62.0%). Mean illness duration at entry was 15.0years. Common comorbidities at entry were high lipid levels (26.9%), hypertension (23.1%) and type II diabetes (13%). Participants were categorized by baseline overall Clinical Global Impression-Schizophrenia Severity Score as minimally (9.1%), mildly (25.3%), moderately (39.9%), markedly (22.3%) and severely (3.4%) ill. Most commonly used second generation antipsychotics at entry were risperidone (17.8%), clozapine (16.5%), olanzapine (14.0%), aripiprazole (13.6%) and quetiapine (5.6%). CONCLUSIONS No large-scale patient registry has been conducted in the US to longitudinally follow patients with schizophrenia and describe symptom attributes, support network, care access and disease burden. These data provide important epidemiological, clinical and outcome insights into the burden of schizophrenia in the US.
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Affiliation(s)
- Henry A Nasrallah
- Saint Louis University, 1438 South Grand Boulevard, Saint Louis, MO 63104, USA.
| | - Philip D Harvey
- University of Miami, 1120 NW 14th Street, Miami, FL 33136, USA
| | - Daniel Casey
- Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | | | - James I Hudson
- Harvard Medical School McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Laura Julian
- Genentech, 1 DNA Way, South San Francisco, CA 94080, USA
| | - Ellen Lentz
- Genentech, 1 DNA Way, South San Francisco, CA 94080, USA
| | | | | | | | - Tracey G Skale
- Greater Cincinnati Behavioral Health Services, 1501 Madison Road, Walnut Hills, OH 45206, USA
| | | | - Rajiv Tandon
- University of Florida, Gainesville, FL 32611, USA
| | - Cenk Tek
- Yale University/Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA
| | - Dawn Velligan
- University of Texas, San Antonio, 1 UTSA Circle, San Antonio, TX 78249, USA
| | - Sophia Vinogradov
- University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, USA
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Csoboth CT, Birkás E, Purebl G. Living in Fear of Experiencing Physical and Sexual Abuse Is Associated with Severe Depressive Symptomatology among Young Women. J Womens Health (Larchmt) 2005; 14:441-8. [PMID: 15989417 DOI: 10.1089/jwh.2005.14.441] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To analyze the relationship among fear of being abused, direct experience of physical and sexual abuse, and severe depressive symptoms among young women. METHODS A cross-sectional survey was conducted in schools and households among 3615 young Hungarian women, ages 15-24 years, of whom 2016 were students. A multistage stratified sampling method was applied. The shortened Beck Depression Inventory (BDI) and the modified Abuse Assessment Screen were used. Odds ratios (ORs) were calculated, and a general linear model was used to test effects of variables on the BDI score. RESULTS Severe depressive symptoms were significantly more common among women who were abused physically (OR=3.474, 95% CI 2.170-5.562) or sexually (OR=6.436, 95% CI 3.085-13.429) in the past year or abused by a partner (OR=3.167, 95% CI 1.806-5.554) or important person (OR=2.989, 95% CI 1.922-4.648) during their lifetime. Severe depressive symptoms were also found among those young women who reported feeling fearful of someone in the family (OR=5.027, 95% CI 2.805-9.012) or in their environment (OR=3.779, 95% CI 2.120-6.738). In a linear regression analysis, fear of someone in the environment or family had the strongest effect on BDI scores after controlling for frequent anxiety. CONCLUSIONS Not only the direct lifetime experience of abuse but also the presence of fear of abuse is associated with severe depressive symptomatology among young women. Fear of abuse is also an important factor to take into consideration in assessing young women with depressive symptoms.
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Affiliation(s)
- Csilla T Csoboth
- Semmelweis University, Institute of Behavioral Sciences, 1089 Budapest, Hungary.
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Abstract
The authors used a multistage stratified sampling method to conduct a cross-sectional survey of a nationally representative sample of 3,615 Hungarian women aged 15 to 24 years to acquire epidemiologic data on physical and sexual abuse and analyze the relationship between abuse and health-risk behaviors. Just over 30% of the young women reported having experienced some type of abuse in their lifetimes. All maladaptive coping strategies, especially sedative use, were more prevalent among those who had experienced physical abuse. The prevalence of smoking, drinking alcohol, and experimenting with drugs was closely related to both physical and sexual abuse. Having experienced abuse is an important factor in young women's development of risky health behaviors. Clinicians should screen for abuse in this age group to prevent behaviors that lead to long-term health problems.
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Affiliation(s)
- Csilla T Csoboth
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
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