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.
Subject(s)
Humans , Male , Female , Mental Health , Psychosomatic Medicine , Mental Disorders , Psychiatry , NeuroticismABSTRACT
Presentamos un raro caso de camptocormía exclusivamente psíquico comórbido con una epilepsia y, a lo que hemos podido alcanzar en la literatura, es el único caso observado en un paciente con un diagnóstico de trastorno obsesivo-compulsivo. Los otros casos publicados han sido considerados como trastornos de conversión dentro de las neurosis de guerra. Descartado cualquier otro origen neurológico o reumático proponemos que se podría adscribir a los trastornos de tics. La camptocormía podría ser considerada como un "síndrome frontera", ya que puede presentarse en diversas enfermedades (neurológicas y reumáticas, fundamentalmente) y con distintos mecanismos fisiopatológicos (AU)
We present a rare case of exclusively psychic camptocormia comorbid with epilepsy, which, to ourknowledge, is the only case reported in the literaturein a patients with a diagnosis of obsessive-compulsive disorder. In other published reports, this condition has been considered as a conversion disorder within war neurosis. When a neurological or rheumatic origin has been excluded, we suggest that camptocormia could be included in the group of tic disorders. Camptocormia could be considered as a "frontier syndrome", because it can appear in several illnesses(mainly neurological and rheumatological) and with several physio-pathological mechanisms (AU)
Subject(s)
Humans , Male , Middle Aged , Somatoform Disorders/diagnosis , Tic Disorders/diagnosis , Diagnosis, Differential , Epilepsy/complications , Obsessive-Compulsive Disorder/diagnosis , Rheumatic Diseases/diagnosisSubject(s)
Addison Disease/drug therapy , Bipolar Disorder/drug therapy , Drug Resistance/drug effects , Fludrocortisone/pharmacology , Lithium Carbonate/adverse effects , Addison Disease/complications , Adrenocorticotropic Hormone/blood , Adult , Bipolar Disorder/complications , Drug Interactions , Epilepsy, Tonic-Clonic/etiology , Fludrocortisone/therapeutic use , Haloperidol/therapeutic use , Humans , Hydrocortisone/therapeutic use , Hyponatremia/etiology , Lithium Carbonate/pharmacology , Male , Prednisone/therapeutic useABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Fludrocortisone/adverse effects , Lithium Carbonate/adverse effects , Drug Interactions , Bipolar Disorder/drug therapy , Addison Disease/drug therapyABSTRACT
No disponible
