A brief and rapid procedure to measure the intensity of depressive symptoms in Primary Care.

INTRODUCTION: Depression occupies a substantial part of medical visit attendance. However, medical practitioners have very little time so that a brief, quick and reliable procedure to evaluate the intensity of symptoms and their changes could be useful. Our objective has been to analyze the reliability of a self-applied Visual Analogue Scale (VAS) to measure symptom intensity in depressed patients within this context. MATERIAL AND METHODS: One hundred depressed outpatients (ICD-10) stated their clinical situation on a VAS. The psychiatrist evaluated them using a Global Clinical Impression (GGI) and Hamilton Depression Rating Scale (HDRS-17). RESULTS AND CONCLUSIONS: The patient's VAS showed high correlation with the HDRS-17 and with the GCI used by the psychiatrist (r = 0.63 and r=0.58; p=0.000). This suggests that the use of a VAS in Primary Care could be useful and reliable for these purposes within the medical contexts of those having little time availability. Key-words: Depression, primary care, medical patients, assessment, evaluation.

A study of the relationship between impulsiveness and obsessiveness in the general population. Inconsistency of the idea of the spectrum.

INTRODUCTION: The obsessivity and the impulsivity as personality traits have been object of few studies on the general population. The authors outline as objective to study if such features are co-existing constructs, as advocate some authors or the opposite extremes of a continuum as assert other. MATERIAL AND METHODS: They are studied the answers to a questionnaire on obsessive traits of the personality (MIRAP) and other referred to the impulsivity as trait, also, (ECIRYC) of a random sample of 418 subject extracted of the general population. They are applied multivariate statistic analysis technical (Factorial Analysis, Correspondence Analysis, and linear Regression Analysis) to establish the type of relationship that have the two studied personality traits. RESULTS: The total scores of the MIRAP and the ECIRYC are correlated of a manner statistically significant (r = .39; p< .01). The Correspondence Analysis of those total scores distributed in deciles and two linear Regression Analysis show, also, a direct relationship between both traits that it is statistically significant. The obsessivity and the impulsivity do not correlate with the principal factor of the opposite trait. All the factors of both traits are grouped mutually in a factor in a positive way, except the impulsive factor "haste" that makes it negatively with the obsessive factor "order". CONCLUSIONS: Our results indicate that the obsessivity and the impulsivity, as personality traits, they are constructs convergent and not opposite poles of a continuum. But, simultaneously, one of the five factors of each trait ("haste" and "order"), yes are behaved as opposite extremes of a continuum, within conceptual framework, wider, of the traits to those which belong.

Un estudio de la relación entre impulsividad y obsesividad en la población general. Inconsistencia de la idea del espectro / A study of the relationship between impulsiveness and obsessivity in the general population. Inconsistency of the idea of the spectrum

Introducción. La obsesividad y la impulsividad como rasgos de la personalidad han sido objeto de pocos estudios sobre la población general. Los autores plantean como objetivo estudiar si tales rasgos son constructos coexistentes, como abogan algunos autores o los polos opuestos de un continuum como afirman otros. Material y Métodos. Se estudian las respuestas a un cuestionario sobre rasgos obsesivos de la personalidad (MIRAP) y otro referido a la impulsividad como rasgo (ECIR y C) de 418 sujetos extraídos al azar de la población general. Se aplican técnicas de análisis estadístico multivariantes (Análisis Factorial, Análisis de Correspondencias, Análisis de Regresión lineal) para establecer el tipo de relación que tienen los dos rasgos estudiados. Resultados. Las puntuaciones totales del MIRAP y la ECIR y C correlacionan de un modo estadísticamente significativo(r=0,39; p<0,01). El Análisis de Correspondencias de esas puntuaciones totales distribuidas en deciles y dos Análisis de Regresión lineal muestran, también, una relación directa entre ambos rasgos que es estadísticamente significativa. La obsesividad y la impulsividad no correlacionan con el principal factor del rasgo opuesto. Todos los factores de ambos rasgos se agrupan factorialmente entre sí de forma positiva, excepto el factor impulsivo “precipitación” que lo hace negativamente con el factor obsesivo “orden”. Conclusiones. Nuestros resultados señalan que la obsesividad y la impulsividad, como rasgos de la personalidad, son constructos convergentes y no polos opuestos de un continuum. Pero, simultáneamente, uno de los factores de cada rasgo (“precipitación” y “orden”), entre cinco, sí se comportan como polos opuestos de un continuum, dentro del marco conceptual, más amplio, de los rasgos a los que pertenecen (AU)

Introduction. The obsessivity and the impulsivity as personality traits have been object of few studies on the general population. The authors outline as objective to study if such features are co-existing constructs, as advocate some authors or the opposite extremes of a continuum as assert other. Material and Methods. They are studied the answers to a questionnaire on obsessive traits of the personality (MIRAP) and other referred to the impulsivity as trait, also, (ECIRYC) of a random sample of 418 subject extracted of the general population. They are applied multivariate statistic analysis technical (Factorial Analysis, Correspondence Analysis, and linear Regression Analysis) to establish the type of relationship that have the two studied personality traits. Results. The total scores of the MIRAP and the ECIRYC are correlated of a manner statistically significant(r = 0.39; p< 0.01). The Correspondence Analysis of those total scores distributed in deciles and two linear Regression Analysis show, also, a direct relationship between both traits that it is statistically significant. The obsessivity and the impulsivity do not correlate with the principal factor of the opposite trait. All the factors of both traits are grouped mutually in a factor in a positive way, except the impulsive factor “haste” that makes it negatively with the obsessive factor “order”. Conclusions. Our results indicate that the obsessivity and the impulsivity, as personality traits, they are constructs convergent and not opposite poles of a continuum. But, simultaneously, one of the five factors of each trait (“haste” and “order”), yes are behaved as opposite extremes of a continuum, within conceptual framework, wider, of the traits to those which belong (AU)

The axial diagnostic and sensitive-to-change for depression index: diagnostic utility and use in studies of therapeutic evaluation.

INTRODUCTION: The authors develop a new rating scale for to measure its sensibility to the change of the intensity of the depressive symptoms under the effects of antidepressants drugs, and for to analyze the predictive validity of its total score. Designate it: The Axial Diagnostic and Sensitive-to-Change for Depression Index (ADSCDI). For this, use only seven nuclear items for the depression diagnosis (mood, interest, impulse/drive, pleasure, energy, daily job and different quality) without vegetative symptoms or anxious. METHODOLOGY: The authors interview to 111 psychiatric outpatients attended consecutively in a Mental Health Center. Sixty were fulfilling the criteria for depressive episode of the ICD-10 and fifty and one were forming part of the group of control: psychiatric outpatients not depressed. They use for this a protocol of collection of data that contains the ADSCDI, where the patients indicate how are found on a Visual Analogical Scale in the one which quantify their answers in each item, the Hamilton Rating Scale for Depression of 17 articles (HRSD-17) and an Global Clinical Impression scale (GCI). Each depressed patient receipt the antidepressant treatment that better were adjusted to his clinical profile according to the psychiatrist that was trying to him. The depressed patients were evaluated a second time after thirty days of treatment. RESULTS: All the items of the ADSCDI perceive a change statistically significant in the intensity of the depressive symptoms (p=0.00). The total score of the ADSCDI, also, at same level of statistical significance that the total scores of the HRSD-17 and of the GCI p=0.000). The ADSCDI interrelates high and significatively with the HRSD-17 as with the GCI (r=0.77 and r=0.73 respectively; p=0.00). Equally makes it with the average of the "proportion of improvement" that evaluates, with the one evaluated by the HRSD-17 and the GCI (r=0.74 and r=0.68 respectively; p=0.000). A cut-off of 39 offers the best predictive values for the ADSCDI respect to the clinical and the ICD-10 criteria for depression. With a sensibility of 0.97, a specificity of 0.76 (of 0.88 with psychiatric patients free of symptoms), a total probability of guessing right of 93% and a kappa reliability of 0.74. The results improve when the ADSCDI is used as external criterion. For this new operative diagnostic criteria (ADCD), a cut-off of 40 offers a sensibility of 1.00, a specificity of 0.96 a probability of guessing right of 99% and a kappa reliability of 0.96. CONCLUSIONS: The ADSCDI offers sufficient concurrent validity with the HRSD-17 and the GCI. It can be considered a sensitive instrument to the change, with the advantage of containing, only, items that have shown be frequent, discriminant and predictives. The ADSCDI also is a good instrument to establish diagnostic of depression in the system ADCD/ADSCDI or in the ICD-10 one.

El Índice Diagnóstico Axial y de Seguimiento para la Depresión. Su utilidad diagnóstica y en estudios de evaluación terapéutica / The Axial Diagnostic and Sensitive-to-Change for Depression Index: Diagnostic utility and use in studies of therapeutic evaluation

Introducción. Los autores desarrollan una nueva escala para medir el cambio de la intensidad de los síntomas depresivos bajo los efectos de fármacos antidepresivos y analizarla validez predictiva de su puntuación total. La denominan: Índice Diagnóstico y de Seguimiento para la Depresión (IDASD). Para ello, utilizan solamente siete ítems nucleares para el diagnóstico de depresión (ánimo, interés, impulso, gusto/placer, energía, trabajo y distinta cualidad) sin síntomas vegetativos o ansiosos. Metodología. Los autores entrevistan a 111 pacientes psiquiátricos atendidos consecutivamente en régimen ambulatorio. Sesenta cumplían los criterios para episodio depresivo de la CIE-10 y 51 formaban parte del grupo de control: enfermos psiquiátricos no deprimidos. Utilizan para ello un protocolo de recogida de datos que contiene el IDASD, donde los pacientes señalan cómo se encuentran sobre una Escala Analógico-Visual en la que cuantifican sus respuestas en cada ítem, la Escala de Hamilton para la Depresión de 17ítems (EHD-17) y una Impresión Clínica Global (ICG). Cada paciente deprimido recibía el tratamiento antidepresivo que mejor se ajustaba a su perfil clínico según el psiquiatra que le trataba. Los pacientes deprimidos fueron evaluados una segunda vez tras 30 días de tratamiento. Resultados. Todos los ítems de la IDASD perciben un cambio en la intensidad de la sintomatología estadísticamente significativo (p = 0,00). La puntuación total del IDASD, también, al mismo nivel de significación estadística que las puntuaciones totales de la EHD-17 y de la ICG (p = 0,000). ElIDASD correlaciona alto y significativo tanto con la EHD-17como con la ICG (r = 0,77 y r = 0,73, respectivamente; p =0,00). Igualmente lo hace el promedio de la «proporción de mejoría» que evalúa, con la evaluada por la EHD-17 y la ICG(r = 0,74 y r = 0,68 respectivamente; p = 0,000). Un punto de corte de 39 ofrece las mejores prestaciones predictivas del IDASD respecto al criterio clínico y al criterio diagnóstico de depresión de la CIE-10. Con una sensibilidad de 0,97, una especificidad de 0,76 (de 0,88 con pacientes psiquiátricos asintomáticos), una probabilidad total de acertar de 93% y una fiabilidad kappa de 0,74. Los resultados mejoran cuando se utiliza como criterio externo el CDAD. Para ese nuevo criterio diagnóstico operativo (CDAD), un punto de corte de40 ofrece una sensibilidad de 1,00, una especificidad de 0,96 una probabilidad de acertar del 99% y una fiabilidad kappa de 0,96.Conclusiones. El IDASD ofrece suficiente validez concurrente con la EHD-17 y la ICG. Puede considerarse un instrumento sensible al cambio, con la ventaja de contener, tan sólo, ítems que han mostrado ser frecuentes, discriminantes y predictivos. El IDASD también es un buen instrumento para establecer diagnósticos de depresión en el sistema CDAD/IDASD o en el de la CIE-10 (AU)

Introduction. The authors develop a new rating scale for to measure its sensibility to the change of the intensity of the depressive symptoms under the effects of antidepressants drugs, and for to analyze the predictive validity of its total score. Designate it: The Axial Diagnostic and Sensitive-to-Change for Depression Index (ADSCDI).For this, use only seven nuclear items for the depression diagnosis (mood, interest, impulse/drive, pleasure, energy, daily job and different quality) without vegetative symptoms or anxious. Methodology. The authors interview to 111 psychiatric outpatients attended consecutively in a Mental Health Center. Sixty were fulfilling the criteria for depressive episode of the ICD-10 and fifty and one were forming part of the group of control: psychiatric outpatients not depressed. They use for this a protocol of collection of data that contains the ADSCDI, where the patients indicate how are found on a Visual Analogical Scale in the one which quantify their answers in each item, the Hamilton Rating Scale for Depression of 17 articles (HRSD-17) and an Global Clinical Impression scale (GCI). Each depressed patient receipt the antidepressant treatment that better were adjusted to his clinical profile according to the psychiatrist that was trying to him. The depressed patients were evaluated a second time after thirty days of treatment. Results. All the items of the ADSCDI perceive a change statistically significant in the intensity of the depressive symptoms (p=0.00). The total score of the ADSCDI, also, at same level of statistical significance that the total scores of the HRSD-17 and of the GCI (p=0.000).The ADSCDI interrelates high and significatively with the HRSD-17 as with the GCI (r=0.77 and r=0.73 respectively; p=0.00). Equally makes it with the average of the “proportion of improvement” that evaluates, with the one evaluated by the HRSD-17 and the GCI (r=0.74 and r=0.68 respectively; p=0.000). A cut-off of 39 offers the best predictive values for the ADSCDI respect to the clinical and the ICD-10 criteria for depression. With a sensibility of 0.97, a specificity of 0.76 (of 0.88 with psychiatric patients free of symptoms), a total probability of guessing right of 93% and a kappa reliability of 0.74. The results improve when the ADSCDI is used as external criterion. For this new operative diagnostic criteria (ADCD),a cut-off of 40 offers a sensibility of 1.00, a specificity of 0.96 a probability of guessing right of 99% and a kappa reliability of 0.96. Conclusions. The ADSCDI offers sufficient concurrent validity with the HRSD-17 and the GCI. It can be considered a sensitive instrument to the change, with the advantage of containing, only, items that have shown be frequent, discriminant and predictives. The ADSCDI also is a good instrument to establish diagnostic of depression in the system ADCD/ADSCDI or in the ICD-10 one (AU)

El Criterio diagnóstico axial para la depresión. Desarrollo, validez constructiva, validez predictiva y fiabilidad / The Axial Diagnostic Criteria for Depression. Development, construct and predictive validity and reliability

Introducción. Los autores desarrollan un nuevo Criterio diagnóstico para la depresión (CDAD) compuesto por siete ítems: ánimo, motivación/interés, impulso, gusto/placer, trabajo cotidiano, energía y distinta cualidad. Se proponen examinar su validez predictiva, y fiabilidad, así como sus propiedades psicométricas y su validez constructiva. Existen pocos estudios que hayan examinado las propiedades psicométricas de otros criterios diagnósticos para la depresión actualmente en uso. Material y métodos. Entrevistan a 111 pacientes psiquiátricos atendidos consecutivamente en régimen ambulatorio. Sesenta cumplían los criterios para episodio depresivo de la CIE-10 y 51 formaban parte del grupo de control: enfermos psiquiátricos no deprimidos. Utilizan para ello un breve cuestionario autoaplicado (IDASD) donde los pacientes señalan cómo se encuentran. Cada ítem tiene una escala analógico visual para que los sujetos cuantifiquen sus respuestas. Resultados. Para que el CDAD diagnostique correctamente depresión, debe exigírsele reunir cuatro ítems o más. De ellos, al menos dos deben pertenecer a un grupo de tres ítems que fueron extraídos mediante una función discriminante (ánimo, energía y distinta cualidad). El CDAD así construido tiene una sensibilidad de 0,93 y una especificidad de 0,82, con una fiabilidad kappa de 0,76 y una proporción de casos totales acertados del 88% al 93%.Cuando el grupo de control está formado exclusivamente por pacientes psiquiátricos asintomáticos, la especificidad sube hasta 0,92. Un análisis factorial revela que el CDAD es unidimensional y tiene una buena validez de constructo (0,69). También tiene una buena fiabilidad alfa (alfa= 0,92), una consistencia por la prueba de las dos mitades elevada (R = 0,91) y una correlación test-retest alta (r=0,67). El acuerdo diagnóstico CDAD entre dos psiquiatras que utilizan como fuente de datos el IDASD es muy alta (K: 1,00). Conclusiones. El sistema CDAD/IDASD ofrece un procedimiento para diagnosticar depresión valido y fiable. También posee una excelente arquitectura interna, una buena validez de constructo y consistencia interna. Estos datos son mucho más de lo que se puede decir de otros criterios diagnósticos más al uso, de los que se carece de esta información (AU)

Introduction. The authors have developed a new axial diagnostic criterion for depression (ADCD) made up of seven items: mood, motivation/interest, impulse/drive, liking/pleasure, daily job, energy and different quality. They have aimed to examine its predictive validity and reliability, psychometric properties and constructive validity. There are few studies that have examined the psychometric properties of other diagnostic criteria for depression currently in use. Material and methods. A total of 111 psychiatric outpatients who attended an out-patient clinic consecutively were interviewed. Sixty met the ICD-10 criteria for depressive episode and 51 formed a part of the control group: non-depressed psychiatric outpatients. For the interview, the authors used a brief self-administered questionnaire (IDASD) in which the patients indicated how they felt. Each item had a Visual Analogue Scale so that the subjects could quantify their answers. Results. Four or more items are needed for the ADCD to correctly diagnose depression. At least two of these should belong to a group of three items that were extracted using a discriminant function (mood, energy and different quality). The ADCD constructed in this way has a 0.93 sensitivity and 0.82 specificity, with a kappa reliability of 0.76 and a proportion of total cases correctly classified ranging from 88% to 93%. Specificity reaches up to 0.92 when the control group is formed exclusively by symptom-free psychiatric out patients. A factor analysis reveals that the ADCD is a one-dimensional model that has good construct validity (0.69).It also has good alpha reliability (alpha = 0.92), elevated consistency of the two halves of the test (R = 0.91) and a high test-retest correlation (r = 0.67).The ADCD diagnostic agreement between two psychiatrists who use the IDASD as a data source is very high (K: 1.00). Conclusions. The ADCD/IDASD system offers a valid and reliable procedure to diagnose depression. It also has an excellent internal architecture, good construct validity and internal consistency. These data are much more than what can be said about other more used diagnostic criteria, which lack this information (AU)

Frecuencia de síntomas anancásticos en la población general / No disponible

Introducción: Los autores se proponen analizar lafrecuencia de los síntomas anancásticos en la poblacióngeneral, dada su relación con los trastornos depresivos ycon la elección de pareja. Lo que influye en la genéticade las poblaciones.Material y métodos: Utilizan las respuestas al Mini-Inventario de Rasgos Anancásticos de la Personalidad(MIRAP) de una muestra de 418 sujetos extraídos de lapoblación general. Se dividió la muestra entre sujetosanancásticos (puntuación total en el MIRAP-2 ≥ 37) yno-anancásticos (puntuación total en el MIRAP-2 ≤ 36).Las pruebas estadísticas empleadas han sido la pruebaexacta de Fisher, la “t” de Student y un análisis discriminanteescalonado.Resultados y discusión: Los síntomas anancásticosaislados son frecuentes en la población general. Sinembargo, existen diferencias estadísticamente significativasen ambos grupos estudiados. Los sujetos anancásticosmuestran más síntomas presentes y con mayorintensidad que los no-anancásticos. El análisis discriminanterevela que dieciséis de los veinte ítems originalesdel MIRAP separan con un 96% de eficacia a ambosgrupos. Los autores concluyen que los síntomas anancásticosson frecuentes en la población general. Pero nopueden dar respuesta a si tal incidencia es real o unacorrelación ilusoria socialmente condicionada(AU)

Introduction: The authors are proposed to analyzethe frequency of anankastic symptoms in the generalpopulation, given its relationship with depressive disordersand with the couple election. What influences thegenetics of the populations.Material and methods: Use the answers to the MiniAnankastic Traits of the Personality Inventory (MATPI)of a sample of 418 subject from the general population.The sample was divided between anankastic subjects(MATPI total score ≥ 37) and no-anankasticsubjects (MATPI total score ≤ 36). The statistics testsemployed have been the Fisher’s exact test, the Student’s"t" and a stepwise discriminant analysis.Results and discussion: The anankastic symptomsisolated are frequent in the general population. However,they exist differences statistically significant inboth studied groups. The anankastic subjects show morepresent symptoms and with greater intensity than theno-anankastic subjetcs. The analysis discriminate revealsthat sixteen of the twenty original items of the MATPIseparate with a 96% from efficiency to both groups.The authors conclude that the anankastic symptoms arefrequent in the general population. But they can not giveresponse to if such incidence is real or a socially conditionedillusory correlation(AU)

Measuring anankastic personality traits.

INTRODUCTION: The authors validate a 20 item scale designed to measure anankastic (obsessive) personality traits: the Mini-Inventory of Anankastic Personality Traits, 2nd version (MIAPT-2). MATERIAL AND METHODS: The answers of a sample of 418 subject of both genders obtained from the general population were used to analyze construct validity (factorial analysis), its alpha reliability and its internal consistency through the item/total correlations and the two halves test. An additional sample of 22 medical students was used to analyze the concurrent validity of the scale (external criterion: the Maudsley Obsessional-Compulsive Inventory) and the temporary reliability with the test-retest method. After this, the total scores of the instrument and the factorial scores were standardized and distributed into percentiles. RESULTS: The scale shows good concurrent validity (r = 0.67; p < 0.000) and construct validity (56 % of the total of the variance explained by the factorial analysis) as well as a good internal consistency through the item/total correlations (all p = 0.000) and two halves test (r = 0.71; p < 0.000; with the Spearman-Brown correction R= 0.83). The alpha reliability of the scale (alpha = 0.84), and the test-retest (r = 0.69; p < 0.000) are high. CONCLUSIONS: The validated MIAPT-2 shows good validity and reliability to evaluate anankastic personality traits. The authors include an appendix with the scale and the standardization of its total and factorial scores distributed into percentiles to be used in clinical and general population samples.

Evaluando los rasgos anacásticos de la personalidad / Measuring anankastic personality traits

Introducción. Los autores validan una escala de 20 ítems diseñada para medir rasgos anancásticos de la personalidad: el Mini-Inventario de Rasgos Anancásticos de la Personalidad, segunda versión (MIRAP-2). Material y métodos. Utilizan las respuestas de una muestra de 418 sujetos de ambos sexos extraídos de la población general para analizar la validez de constructo (análisis factorial), su fiabilidad alfa y su consistencia interna mediante la correlación ítem/total y prueba de las dos mitades. Se utiliza una muestra adicional de 22 estudiantes de medicina para analizar la validez concurrente de la escala (criterio externo: el Maudsley Obsessional-Compulsive Inventory) y la fiabilidad temporal mediante la prueba testretest. Tras ello se procede a estandarizar las puntuaciones totales del instrumento y las puntuaciones factoriales, distribuyéndolas en percentiles. Resultados. La escala muestra una buena validez concurrente (r = 0,67; p < 0,000) y validez de constructo (56 % del total de la varianza explicada por el análisis factorial), así como una buena consistencia interna mediante las correlaciones ítem/total (todas p = 0,000) y prueba de las dos mitades (r = 0,71; p < 0,000; con la corrección de Spearman-Brown R= 0,83). La fiabilidad alfa de la escala es elevada (α= 0,84), así como lo es la prueba test-retest (r = 0,69; p < 0,000). Conclusiones. La escala validada muestra una buena validez y fiabilidad para evaluar los rasgos anacásticos de la personalidad. Los autores incluyen un apéndice con la escala y la estandarización de sus puntuaciones totales y factoriales distribuidas en percentiles para su uso en muestras tanto clínicas como de la población general

Introduction. The authors validate a 20 item scale designed to measure anankastic (obsessive) personality traits: the Mini-Inventory of Anankastic Personality Traits, 2nd version (MIAPT-2). Material and methods. The answers of a sample of 418 subject of both genders obtained from the general population were used to analyze construct validity (factorial analysis), its alpha reliability and its internal consistency through the item/total correlations and the two halves test. An additional sample of 22 medical students was used to analyze the concurrent validity of the scale (external criterion: the Maudsley Obsessional-Compulsive Inventory) and the temporary reliability with the testretest method. After this, the total scores of the instrument and the factorial scores were standardized and distributed into percentiles. Results. The scale shows good concurrent validity (r = 0.67; p < 0.000) and construct validity (56 % of the total of the variance explained by the factorial analysis) as well as a good internal consistency through the item/total correlations (all p = 0.000) and two halves test (r = 0.71; p < 0.000; with the Spearman-Brown correction R= 0.83). The alpha reliability of the scale (α = 0.84), and the test-retest (r = 0.69; p < 0.000) are high. Conclusions. The validated MIAPT-2 shows good validity and reliability to evaluate anankastic personality traits. The authors include an appendix with the scale and the standardization of its total and factorial scores distributed into percentiles to be used in clinical and general population samples

The functional genetic variation in the PTPN22 gene has a negligible effect on the susceptibility to develop inflammatory bowel disease.

The aim of this study was to assess the possible association between the protein tyrosine phosphatase non-receptor 22 (PTPN22) gene 1858C-->T (rs2476601, encoding R620W) polymorphism and inflammatory bowel disease (IBD). Our study population consisted of 1113 IBD [544 ulcerative colitis (UC) and 569 Crohn's disease (CD)] patients and 812 healthy subjects. All the individuals were of Spanish white origin. Genotyping of the PTPN22 gene 1858C-->T polymorphism was performed by real time polymerase chain reaction technology, using TaqMan 5'-allelic discrimination assay. The frequency of the PTPN22 1858T allele in healthy subjects was 6.2% compared with 6.7% in the UC patients and 5.1% in Crohn's patients. No statistically significant differences were observed when the PTPN22 1858C-->T allele and genotype distribution among CD patients, UC patients and healthy controls were compared. These results indicate that the PTPN22 1858C-->T polymorphism does not appear to play a major role in IBD predisposition in our population.

CTLA4/CT60 polymorphism is not relevant in susceptibility to autoimmune inflammatory intestinal disorders.

The aim of this work was to investigate the possible influence of the recently described CT60 A/G dimorphism of the CTLA4 (cytotoxic T-lymphocyte antigen 4) gene in the susceptibility to two different autoimmune inflammatory intestinal disorders, inflammatory bowel disease (IBD) and celiac disease. We analyzed a case-control cohort composed of 528 Spanish patients with IBD (284 with Crohn disease and 244 with ulcerative colitis) and 454 unrelated healthy individuals, and additionally a group of 90 celiac disease families. CT60 genotyping was performed with a TaqMan 5' allelic discrimination assay. After comparing patients with IBD with the control population, we found no significant deviation in the distribution of the alleles or genotypes of CTLA4/CT60 dimorphism. In addition, by means of familial and case-control analysis, no evidence for a statistically significant association was observed between CTLA4/CT60 and celiac disease susceptibility. Therefore, our results suggest that the CTLA4/CT60 polymorphism does not play a major role in inflammatory intestinal disorders.

Isolation, maturational level, and functional capacity of human colon lamina propria plasma cells.

BACKGROUND AND AIMS: Large numbers of plasma cells (PC) localise in the intestinal lamina propria (LP) where they play a critical role in the defence against pathogens. This study analyses the level of maturation reached by normal human colon LPPC in comparison with that of bone marrow (BM) PC. METHODS: A technique was designed to purify LPPC by combining collagenase digestion of the mucosal layer and immunomagnetic selection of CD54(+) LP cells. It provided highly purified PC, as demonstrated by morphology, CD38(h) phenotype, and cytoplasmic IgA staining criteria. This procedure allowed comparison of in vitro functional capacities and a broad phenotypic analysis of BMPC and LPPC. RESULTS: LPPC and BMPC exhibited identical expression of differentiation markers (CD19(-/+), CD20(-), HLA-DR(low/-), VS38c(high)), survival molecules (CD95 (low/-), Bcl-2(+)), and B cell transcription factor profile, as well as similar in vitro Ig secreting kinetics (14 days) and lack of susceptibility to apoptosis by CD95 ligation. In contrast, they markedly differed in adhesion molecule expression, as LPPC showed higher levels of CD44 and CD21 and were alpha 4 beta 7(+) whereas BMPC lacked this integrin and expressed higher levels of CD49d and CD31. CONCLUSION: These data indicate that PC at effector sites of the humoral response (BM and LP) show similar high differentiation, survival, and functional features but display a distinctive pattern of adhesion molecules, probably related to their respective homing locations.

[The Scale for measure Control of Impulses Ramón y Cajal (ECIRyC). Development, validation and standardization]. / Escala de Control de los Impulsos Ramón y Cajal (ECIRyC). Desarrollo, validación y baremación.

INTRODUCTION: We are now seeing an increasing need of the measurement of impulsivity by clinicians and researchers due to the present prevalence of impulsivity control disorders. The authors develop and validate a new tool for measuring impulsivity: the Impulsive Control Scale Ramón y Cajal (ECIRyC) that has 20 items. MATERIAL AND METHODS: The first version of ECIRyC was applied to a sample recruited from general population. From their responses the scale was reduced to the present version and the construct validity coefficients and the alpha reliability of Cronbach were calculated. Also, the scores of the ECIRyC were standardized. RESULTS AND DISCUSSION: The Factor Analysis of the ECIRyC shows that there are five factors explaining 53% of the total variance obtained. This factorial structure is practically unidimensional. In the same way, the reliability of ECIRyC is high; obtaining the same score (0.85) with the Cronbach alpha intraclass correlation coefficient as with the two halves procedure plus the Spearman-Brown correction. The ECIRyC has proven to have a very good convergent validity with other foreign impulsivity measurement instruments. The ECIRyC scores, obtained with general population show a normal distribution which has permitted their standardization for applicating them both to large groups of people and to single individuals. All the initial validation data of the ECIRyC seem to show that it is a useful tool for the evaluation of impulsivity.

Escala de Control de los Impulsos 'Ramón y Cajal' (ECIRyC). Desarrollo, validación y baremación / The Scale for measure Control of Impulses 'Ramón y Cajal' (ECIRyC). Development, validation and standardization

Introducción. Actualmente se asiste a un incremento de las necesidades de medir la impulsividad, dada la prevalencia de los trastornos del control de los impulsos. Los autores desarrollan y validan un nuevo instrumento para medir la impulsividad: la Escala de Control de los Impulsos 'Ramón y Cajal' (ECIRyC) que contiene 20 ítems. Material y método. Se aplicó la versión inicial de la ECIRyC a una muestra extraída de la población general. Sobre esas respuestas se redujo la escala a su versión actual y se calcularon los coeficientes de validez de constructo y la fiabilidad alfa de Cronbach. También se utilizaron esas respuestas para estandarizar las puntuaciones en la ECIRyC. Resultados y discusión. El análisis factorial de la ECIRyC arroja la presencia de cinco factores que explican el 53 por ciento de la varianza total obtenida. Dicha estructura factorial es prácticamente unidimensional. Así mismo, la fiabilidad del ECIRyC es elevada; obteniendo el mismo valor (0,85) con el coeficiente de correlación intraclase alfa de Cronbach y con el procedimiento de las dos mitades más la corrección de Spearman-Brown. La ECIRyC ha demostrado tener una muy buena validez convergente con otras medidas foráneas de impulsividad. Las puntuaciones de la ECIRyC, obtenidas entre la población general, muestran una distribución normal que ha permitido estandarizarlas para su aplicación a grandes grupos y a sujetos individuales. Todos los datos iniciales de validación de la ECIRyC parecen mostrar un instrumento útil para evaluar la impulsividad (AU)

[Development, validity and reliability of a general addiction scale. A preliminary study]. / Desarrollo, validez y seguridad de una escala de adicción general. Un estudio preliminar.

INTRODUCTION: The authors develop a General Scale to measure the intensity of the addiction to substances (not alcohol, not opiates) and addictive behaviors. METHODS: The General Scale is a self-scale compound by eleven ítems that was delivered to fifty and five students of the courses 5 masculine and 6 masculine of the Medicine of the University of Alcalá (Madrid, Spain), and was them requested that applied said scale from different supposed addictive: tobacco; tea, coffee or cola drinks; chocolate; others sweet; alcohol; sex; use of the personal computer and/or Internet and/or videoplay; and to practice sports. Of that manner, each subject provided a total of 440 complimented scales.Finally, it was requested the subjects that indicated in a scale apart, their degree of addiction from the different exposed concepts. Those data served of external criterion. RESULTS AND DISCUSSION: The Scale is monodimensional, and shows a high construct validity (account 63% of the total variance obtained by a Factorial Analysis), a high alpha reliability (alpha: 0.94) and a good internal consistency (split-half method with the Spearman-Brown correction; R: 0.92). All items share with the general addiction concept that represents the total score of the Scale, an common variance proportion equal or over the 52%. CONCLUSION: The Scale seems be a valid and reliable instrument to compare groups of the calls new addictions of a measurable manner.

Desarrollo, validez y seguridad de una escala de adicción general. Un estudio preliminar / Development, validity and reliability of a general adiction scale. A preliminary study

Introducción: Los autores desarrollan una Escala de Adicción General para medir la intensidad de la adicción a sustancias (no alcohol no opioides) y comportamientos adictivos. Métodos: La EAG es una escala autoaplicada compuesta por once ítems que se entregó a cincuenta y cinco estudiantes de los cursos 5º y 6º de la licenciatura de Medicina de la Universidad de Alcalá, y se les solicitó que aplicaran dicha escala a diferentes supuestos adictivos: a) el tabaco; b) té, café o bebidas de cola; c) el chocolate; d) otros dulces; e) el alcohol; f) el sexo; g) uso del ordenador y/o Internet y/o videojuego; y h) practicar deportes. De ese modo, cada sujeto proporcionó un total de ocho escalas cumplimentadas, lo que en conjunto supuso manejar 440 Escalas de Adicción General cubiertas. Al final se solicitó a los sujetos que señalaran en una escala aparte su grado de adicción a los diferentes conceptos expuestos. Esos datos sirvieron de criterio externo. Resultados y discusión: La Escala es monodimensional y muestra una elevada validez de constructo (explica el 63 por ciento de la varianza total obtenida por un análisis factorial), una alta fiabilidad alfa ( : 0,94) y una buena consistencia interna por el método de las dos mitades con la corrección de Spearman-Brown (R: 0,92). Todos los ítems comparten con el concepto de adicción general que representa la puntuación total de la Escala, una proporción de varianza igual o superior al 52 por ciento. Conclusión: La Escala parece ser un instrumento válido y fiable para comparar grupos de las llamadas 'nuevas adicciones' de un modo mensurable (AU)

Desarrollo de la versión española del cuestionario de personalidad Zuckerman-Kuhlman (ZKPQ-III) y propiedades psicométricas / Development of the spanish version of Zuckerman-Kuhlman personality questionnaire (ZKPQ-III) and psychometric properties

El presente trabajo investiga las propiedades factoriales y características psicométricas de la versión española del ZKPQ Forma 111, que fue analizado en una muestra de 573 mujeres y 186 hombres españoles. Fueron calculados las medias y desviaciones estándar. las fiabilidad e intercorrelación de las escalas y las diferencias en género y edad que fueron comparados con la versión americana de la prueba. El coeficiente de homegeneidad demostró unas buenas correlaciones ínter ítem en cada dimensión. Los análisis de distribución de las dimensiones se testaron con los coeficientes de Kolmogorov-Smirnov y Kurtosis. Una solución de cinco factores fue probada para ambos sexos para intentar replicar la correspondencia con la versión americana del cuestionario apoyando la existencia de esas cinco dimensiones. La estructura factorial en hombres y mujeres fue comparada y se encontró una similar a la americana excepto en las saturaciones de algunos ítems en Búsqueda de Sensaciones Impulsivas y Sociabilidad (AU)

Thyroid-infiltrating B lymphocytes in Graves' disease are related to marginal zone and memory B cell compartments.

B lymphocytes that infiltrate the thyroid (Thy-B cells) in Graves' patients appear to be implicated in the pathophysiology of this disorder. The goal of the present study was to examine the nature of these Thy-B cells. To this end, Thy-B lymphocytes were isolated from surgical thyroidal samples, and their phenotype was determined by using mouse monoclonal antibodies (mAb) directed against a wide variety of surface markers, followed by flow cytometry multicolor analysis. The results show that most Thy-B cells (approximately 60%) exhibited IgM(+) IgD(low to -) surface immunoglobulin (Ig) profile, whereas the minor cell fraction (approximately 30%) consisted of switched IgG(+) memory B lymphocytes. Thy-B cells expressed low levels of CD5, CD23, and CD62L, which distinguished them from the resting B-cell pool, the major B-cell subset in the blood. In addition, they lacked CD38, CD10, and CD71, characteristic molecules for the germinal center B lymphocytes. In addition, Thy-B lymphocytes showed peculiar patterns both of adhesion molecules (CD62L(-), CD44(intermediate)), and of activation molecules (CD69(+), CD80(+), and, in part, CD95(+)). Taken together, these results suggest that the Thy-B lymphocyte subset consists of a combination of IgM(+) B cells resembling marginal zone B lymphocytes, and isotype-switched memory B cells.

Chronic lymphocytic leukemia B cells inhibit spontaneous Ig production by autologous bone marrow cells: role of CD95-CD95L interaction.

A variable degree of humoral immunodeficiency is a common feature in patients with B-cell chronic lymphocytic leukemia (B-CLL). The aim of this study was to explore the possibility that B-CLL cells play a direct role in this phenomenon. To this end, patients' bone marrow (BM) immunoglobulin (Ig)-secreting cells were cocultured with autologous purified B-CLL cells. The results show that tumoral cells inhibited the spontaneous IgG secretion by BM plasma cells, and this effect increased after PMA-induction of B-CLL cells. This inhibitory process was proportional to the number of B-CLL cells added and depended on cellular contact. Adhesion molecules did not appear to be involved in the cellular interaction, because the inclusion of blocking antibody to a variety of these proteins did not reverse the inhibitory phenomenon. However, the addition of monoclonal antibody that blocked the function of either CD95 or CD95L clearly reversed B-CLL cell inhibition on autologous BM plasma cells. These latter cells were shown to express CD95, and B-CLL cells contained detectable quantities of CD95L at the level of messenger RNA and protein. Annexin V-binding experiments revealed increased apoptosis of BM Ig-secreting cells when cocultured with autologous B-CLL cells. Finally, this inhibitory phenomenon might be operative in vivo because (a) there was a good correlation between the intensity of the inhibitory effect in vitro and the serum IgG level exhibited by every patient and (b) B-CLL cells also inhibited in vivo antigen-induced IgG-tetanus toxoid-secreting cells obtained from normal immunized subjects. Collectively, these data suggest that B-CLL cells inhibit autologous CD95-bearing Ig-secreting cells by the interaction with CD95L present on B-CLL cells and, hence, contribute to the state of humoral immunodeficiency that occurs in these patients.