Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries.

BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS: About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

Connor-Davidson Resilience Scale: validation study in a Portuguese sample.

OBJECTIVE: The objective of this paper was to evaluate the structural validity and convergent validity of the first Portuguese version of the Connor-Davidson Resilience Scale (CD-RISC). SETTINGS: The data sets come from two studies conducted in Portugal, respectively, from the Resilience Effect in Coping with Trauma (RECT) project and from the Health Impact Assessment of Employment Strategies (HIAES) project. PARTICIPANTS: The sample is composed of 476 participants from the RECT project and 405 participants from the HIAES project. In both projects, convenience samples were used. MEASURES: The original CD-RISC items were translated to Portuguese and were used in a survey along with additional psychosocial and biomedical measures. RESULTS: Independent exploratory factorial analysis (EFA) with each of the two samples revealed that the best solution in both samples had three factors consistent with the self-efficacy, spirituality and social support factors from the original scale. A Confirmatory factor analysis using the two samples together and specifying the three factors from the EFA revealed a good overall fit and, comparatively, better fit than a model specified with the five factors from the original scale. The study of the convergent validity revealed that bivariate correlations between the three factors and validated measures of stress, life satisfaction, mental health and physical health are globally consistent with previous research. CONCLUSIONS: This study makes available to the broad Community of Portuguese Language Countries a validated measure of resilience extensively used for research and intervention. The results encourage future studies using this translated version of CD-RISC to explore further the three-factor structure found here and to test the convergent validity with new samples.

Portuguese version of a stress and well-being evaluation tool (ASSET)at the workplace: validation of the psychometric properties.

OBJECTIVE: The main objective of this work was to translate the English version of ASSET (A Shortened Stress Evaluation Tool) into the Portuguese version and to validate its psychometric properties. Additionally, this work tested the convergent validity of the instrument. METHODS: The translation and retroversion were conducted by experts and submitted to the authors for approval. Within an observational, cross-sectional study, regarding mental health at the workplace, ASSET together with other scales was applied to a sample of 405 participants. The psychometric validity of the subscales was studied using confirmatory factorial analysis. RESULTS: The factorial structure of ASSET is globally supported by the results, with the Perceptions of Your Job and Attitudes Towards your Organisation subscales requiring slight adjustments in the item structure and the Your Health subscales replicating the original structure. The convergent validity also supports the ASSET, showing that all subscales are significantly correlated with variables used to test convergence. CONCLUSIONS: Globally, the results constitute an important contribution to ASSET and open the possibility of its usage among Portuguese-speaking countries. The results provide an evidence on the validity of the instrument and, in particular, of the mental and physical health subscales.