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López-Díaz Á, Palermo-Zeballos FJ, Gutierrez-Rojas L, Alameda L, Gotor-Sánchez-Luengo F, Garrido-Torres N, Métrailler J, Alerci L, Bonnarel V, Cano-Domínguez P, Avanesi-Molina E, Soto-Ontoso M, Torrecilla-Olavarrieta R, Muñoz-Manchado LI, Torres-Hernández P, González-Higueras F, Prados-Ojeda JL, Herrera-Cortés M, Meca-García JM, Gordillo-Urbano RM, Sánchez-Robles C, Delgado-Durán T, Soriano-Peña MF, Golay P, Conus P, Crespo-Facorro B, Ruiz-Veguilla M. Proxy measures for the assessment of psychotic and affective symptoms in studies using electronic health records. BJPsych Open 2024; 10:e22. [PMID: 38179604 PMCID: PMC10790217 DOI: 10.1192/bjo.2023.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research. AIMS This study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery-Åsberg Depression Rating Scale (MADRS-6). METHOD A cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation. RESULTS The proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set. CONCLUSIONS The proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.
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Affiliation(s)
- Álvaro López-Díaz
- Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Fernanda Jazmín Palermo-Zeballos
- Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Luis Gutierrez-Rojas
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; Mental Health Clinical Management Unit, San Cecilio University Hospital, Granada, Spain; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Spain; and Department of Psychiatry, University of Granada, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Francisco Gotor-Sánchez-Luengo
- Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Nathalia Garrido-Torres
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Johann Métrailler
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Livia Alerci
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Vincent Bonnarel
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Pablo Cano-Domínguez
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Elma Avanesi-Molina
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Miguel Soto-Ontoso
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Torrecárdenas University Hospital, Almería, Spain
| | - Rocio Torrecilla-Olavarrieta
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain
| | - Leticia Irene Muñoz-Manchado
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain
| | - Pedro Torres-Hernández
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain
| | - Fermín González-Higueras
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain
| | - Juan Luis Prados-Ojeda
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - Mario Herrera-Cortés
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - José Miguel Meca-García
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Poniente University Hospital, Almería, Spain
| | - Rafael Manuel Gordillo-Urbano
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Infanta Margarita Hospital, Córdoba, Spain
| | - Cristina Sánchez-Robles
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain
| | - Tomás Delgado-Durán
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain
| | - María Felipa Soriano-Peña
- First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, San Agustín University Hospital, Linares, Spain
| | - Philippe Golay
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Benedicto Crespo-Facorro
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
| | - Miguel Ruiz-Veguilla
- Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain
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Sevilla-Llewellyn-Jones J, Cano-Domínguez P, de-Luis-Matilla A, Espina-Eizaguirre A, Moreno-Kustner B, Ochoa S. Subjective quality of life in recent onset of psychosis patients and its association with sociodemographic variables, psychotic symptoms and clinical personality traits. Early Interv Psychiatry 2019; 13:525-531. [PMID: 29278295 DOI: 10.1111/eip.12515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/12/2017] [Revised: 06/26/2017] [Accepted: 09/30/2017] [Indexed: 01/16/2023]
Abstract
AIM There is lack of research on the study of clinical personality traits in recent onset of psychosis (ROP) patients. The aims of this research were to study the relations among psychosocial, personality and clinical characteristics in ROP patients and also the effect that significant variables had on the different domains of Quality of Life (QoL). METHODS Data for these analyses were obtained from 81 ROP patients. The Millon Clinical Multiaxial Inventory, the Positive and Negative Syndrome Scale and the World Health Organization Quality of Life Brief Scale were used to assess personality, symptoms and QoL. RESULTS Correlations between the negative symptoms and the physical, psychological and social domains of QoL, and the disorganized symptoms and physical domain, were found. Furthermore, the physical, psychological and social relationship domains of QoL were lower in patients with schizoid traits and the psychological domain was lower in patients with depressive traits. In contrast, the psychological and social domains were higher in patients with histrionic traits, while the physical domain was higher for patients with narcissistic traits. Multiple linear regressions demonstrated that negative symptoms and narcissistic and depressive traits explained 16.9% of the physical domain. Narcissistic and depressive traits explained 15% of the psychological domain. Finally, the negative symptoms and histrionic traits explained 13.7% of the social domain. CONCLUSIONS QoL seems to be better explained by negative psychotic symptoms and some clinical personality traits. Our results support the importance of integrated intervention approaches that consider personality.
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Affiliation(s)
- Julia Sevilla-Llewellyn-Jones
- Department of Mental Health, Clínico Universitario Virgen de la Victoria Hospital, Málaga, Spain.,Faculty of Psychology, Malaga University, Málaga, Spain.,Institute of Psychiatry and Mental Health, Clínico San Carlos Hospital, Madrid
| | - Pablo Cano-Domínguez
- Department of Mental Health, Clínico Universitario Virgen de la Victoria Hospital, Málaga, Spain
| | - Antonia de-Luis-Matilla
- Department of Mental Health, Clínico Universitario Virgen de la Victoria Hospital, Málaga, Spain
| | | | | | - Susana Ochoa
- Research Unit of Parc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu, CIBERSAM
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Sevilla-Llewellyn-Jones J, Cano-Domínguez P, de-Luis-Matilla A, Espina-Eizaguirre A, Moreno-Küstner B, Ochoa S. Personality traits in recent-onset-of-psychosis patients compared to a control sample by gender. Schizophr Res 2018; 195:86-92. [PMID: 28867518 DOI: 10.1016/j.schres.2017.08.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/20/2017] [Revised: 08/01/2017] [Accepted: 08/21/2017] [Indexed: 11/27/2022]
Abstract
Personality traits in recent onset of psychosis (ROP) patients are an under-researched area. Our aim was to examine clinical and clinically significant personality traits in ROP patients compared with a healthy control sample by gender. Data were obtained from 94 ROP patients and a control sample matched in gender and age. The Millon Clinical Multiaxial Inventory and a sociodemographic scale were used. T for independent samples, U-Mann-Whitney and Fisher tests were applied to make comparisons. All personality traits were significantly higher in ROP than control participants in the general sample, except histrionic, narcissistic, and compulsive traits which were higher in controls. Clinically significant schizoid, avoidant, dependent and antisocial personality traits were more common in the ROP than the control participants. However, histrionic clinically significant trait was more common in the control sample. In relation to the males and female samples, more significant differences were found in the male sample in comparison to their control counterparts than in the female sample. These results highlight the importance of the study of clinical personality traits in patients with ROP and the importance of viewing these differences in relation to gender because of the possible therapeutic implications.
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Affiliation(s)
- Julia Sevilla-Llewellyn-Jones
- Department of Mental Health, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos, S/N, 29010 Málaga, Spain; Faculty of Psychology, Malaga University, Campus de Teatinos, 29010 Málaga, Spain.
| | - Pablo Cano-Domínguez
- Department of Mental Health, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos, S/N, 29010 Málaga, Spain
| | - Antonia de-Luis-Matilla
- Department of Mental Health, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos, S/N, 29010 Málaga, Spain
| | - Alberto Espina-Eizaguirre
- Department of Mental Health, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos, S/N, 29010 Málaga, Spain
| | - Berta Moreno-Küstner
- Faculty of Psychology, Malaga University, Campus de Teatinos, 29010 Málaga, Spain
| | - Susana Ochoa
- Research and Developmental Unit, Hospital Sant Joan de Deu, Carrer Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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