ABSTRACT
INTRODUCTION: Research about the reliability of retrospective self-report rating scales for attention deficit hyperactivity disorder (ADHD) in adults has been limited. METHOD: A self-report scale named "FASCT" was created with two versions: self-reported and observer. The self-reported version was applied to 393 subjects and the observer version to 377. An exploratory and confirmatory factorial analysis was made in order to obtain the final adaptation of both versions. Finally they were applied to 205 subjects and 105 of their first degree relatives. RESULTS: Cronbach's alpha for the self-reported version was 0.84 and 0.87 for the observer version. The total score that had the best balance between sensitivity and 1-specificity was 23 points for each version of the "FASCT". Correlation between both versions was 0.88. The correlation coefficient between the Wender-UTAH scale and self-reported version was 0.71 and for the observer version was 0.66. Agreement degree between dichotomized total score and the diagnosis made by structured interview was 0.82, for the self-reported version and 0.88 for the observer version. Sensitivity and specificity for the self-reported version were 80.36 and 97.9, respectively. Sensitivity and specificity values for the observer version were 95.4 and 96.3 respectively. CONCLUSIONS: Both versions of the "FASCT" scale were shown to be valid and reliable for adult ADHD screening.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/epidemiology , Mass Screening/methods , Surveys and Questionnaires , Adult , Factor Analysis, Statistical , Feasibility Studies , Female , Humans , Male , Observer Variation , Reproducibility of Results , Self DisclosureABSTRACT
Fundamento: Los resultados de los estudios abiertos y de los estudios controlados con placebo indican que la fluoxetina posee un efecto farmacológico beneficioso en niños y adolescentes con trastorno depresivo mayor (TDM). No obstante, las diferencias han sido pequeñas y también se ha observado una alta respuesta a placebo en estos estudios. Pacientes y métodos: Veintitrés pacientes ambulatorios, con una edad media de 11,5 años, que cumplieron con los criterios del Manual diagnóstico y estadístico de los trastornos mentales (DSM-IV-TR) para TDM fueron aleatorizados en 2 grupos. Uno de ellos recibió placebo y el otro, fluoxetina 20 mg/día durante 6 semanas. Las medidas primarias de eficacia fueron la Escala de Depresión Infantil de Birleson (DSRS), la Escala de Impresión Global Clínica (CGI) y la Escala de Evaluación del Funcionamiento Global para Niños (CGAS). Resultados: No se encontraron diferencias estadísticamente significativas entre la fluoxetina y el placebo en ninguna de las medidas de eficacia ni en la frecuencia y gravedad de los efectos secundarios. Conclusiones: Observamos una alta respuesta a placebo, así como una baja incidencia de efectos secundarios en niños y adolescentes con TDM tratados con fluoxetina
Background: Results from open-label and placebo controlled studies suggest that fluoxetine has a beneficial pharmacological effect in children and adolescents with major depressive disorder (MDD). However, the differences have been small and a high placebo response has also been found. Patients and methods: Twenty-three outpatients with a mean age of 11.5 years, who met the DSM-IV-TR criteria for MDD were randomly allocated in 2 groups. One group received placebo and the other received fluoxetine 20 mg/day for 6 weeks. The primary outcome measures were: DSRS, CGI, and CGAS. Results: There were no significant differences between the 2 groups in any of the rating scales, or in the frequency or intensity of adverse effects. Conclusions: We found a high placebo response rate and a low incidence of adverse effects in children and adolescents with MDD treated with fluoxetine
Subject(s)
Male , Female , Child , Adolescent , Humans , Fluoxetine/pharmacokinetics , Depressive Disorder, Major/drug therapy , Double-Blind Method , Placebos/therapeutic use , Psychometrics/methodsABSTRACT
OBJECTIVE: To determine if there is a relation to low serum cholesterol, lipoprotein, serotonin or tryptophan levels in patients with depression who have recently attempted suicide. DESIGN: Biochemical and behavioural study. SETTING: Inpatient and outpatient treatment at the Instituto Mexicano de Psiquiatría. PARTICIPANTS: Thirty-three patients with a diagnosis of major depressive episode. Eighteen of these patients had attempted suicide in the month before the start of the study; 15 patients had never attempted suicide. OUTCOME MEASURES: Serum levels of total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, serotonin (5-HT) and tryptophan. Scores on Hamilton Depression Rating Scale, Carroll Depression Rating Scale, Beck Hopelessness Scale and Beck Suicide Attempt Severity Scale. RESULTS: There were no significant differences between patients who had attempted suicide and those who had not in terms of serum cholesterol, HDL, LDL and triglyceride levels. Serum levels of 5-HT and tryptophan were significantly lower in patients with depression who had a recent suicide attempt than in those patients who had never attempted suicide. A comparison of patients not taking antidepressant medication found serum 5-HT levels to be more than 3 times lower in those patients with a recent suicide attempt than in patients with no history of suicide attempt. CONCLUSIONS: The study found no difference in lipid profiles between patients who had attempted suicide and those who had not. Low serum levels of 5-HT may increase the risk of suicide attempt in patients who are depressed.
