An assessment of the psychometric properties of Lithuanian versions of DSM-IV-MR-J and SOGS-RA.

OBJECTIVE: Since no Lithuanian instrument focuses specifically on the measurement of pathological gambling in adolescence, we aimed to adapt commonly used international instruments (SOGS-RA, DSM-IV-MR-J) and assess their psychometric properties. METHODS: Cross-cultural adaptation of DSM-IV-MR-J and SOGS-RA was performed in several steps including translations, synthesis of translations, back-translations, expert committee review, and pre-testing. Adapted instruments were administered to randomly selected adolescents in grades V through XII from all schools in the second largest Lithuanian city (Kaunas). RESULTS: The DSM-IV-MR-J identified 4.2% of the representative sample as pathological gamblers, whereas the SOGS-RA generated prevalence of 5.2%. Cronbach's alpha for DSM-IV-MR-J in this sample was 0.80 and 0.75 for the SOGS-RA. The correlation coefficient between the SOGS-RA and the DSM-IV-MR-J was statistically significant (Pearson correlation = 0.892, P < 0.001). Using the DSM-IV-MR-J as the baseline for pathological gambling in adolescence, the overall classification accuracy of the SOGS-RA was judged to be adequate, correctly identifying 34 out of 35 pathological gamblers (Kappa = 0.833, P < 0.001). CONCLUSIONS: The Lithuanian versions of DSM-IV-MR-J and SOGS-RA exhibited acceptable validity and reliability. The DSM-IV-MR-J was found to be a more conservative measure of pathological gambling.

Solving the problem of antidepressant selection in Lithuania.

PURPOSE: To ascertain the opinion of psychiatrists of the factors those determine antidepressants selection. MATERIAL AND METHODS: An original questionnaire of 30 questions, which deals with reliance of antidepressants selection according to the subtype of depression, was represented for a quarter of all Lithuanian psychiatrists. RESULTS: Respondents for depression with obsession 36% chose paroxetine. It is interesting that despite the controversial opinion about the TCAprescribing according to their side effects profile and safety to use, our respondent chose amitriptyline for the melancholic depression with suicidal thoughts (50.2%) and for the anesthetic depression (28%). In some cases there is no unanimous opinion among the psychiatrists--data scattering was received in selection, the respondents chose different antidepressants from different groups in similar frequency. For the treatment of the adynamic depression--7.6%--amitriptyline, 12.1%--citalopram, 10.6%--reboxetine, 10.6%--venlafaxine, for the anxious depression--15.2%--amitriptyline, about 20%--citalopram, 15.2%--mirtazapin, for the anesthetic depression 14.3%--escitalopram, 9%--sertraline, 8.3%--venlafaxine. There is no clear tendency or prevailing antidepressant. CONCLUSIONS: Psychopathological peculiarity of depression can be one of the most important criteria in antidepressant selection. However, in many cases, the subtype of depression is ascertained empirically and based solely on the personal experience and clinical practice of the psychiatrist. There are no clear diagnostic criteria or practical guidelines for the reliable verification of the psychopathological subtype of depression, which would allow for the selection of a more adequate and prompt treatment for the patient.

[Psychopathology and the clinical picture of adynamic depressions in the course of schizophrenia]. / Psikhopatologiia i klinika adinamicheskikh depressii v techenii shizofrenii.

Fifty-six patients with attack-type and attack-type progressive schizophrenia with manifestations of adynamic depression have been examined. On the basis of the findings obtained three types of the psychopathological structure of the given variant of the depressive syndrome (ideational, motor and mixed) have been identified. Some characteristics of clinical manifestations and the course of schizophrenia running with adynamic depressive states have been discovered.