ABSTRACT
BACKGROUND: The knowledge that patients with affective disorders have about their illness is attributed increasing importance. For a number of psychiatric disorders, the imparting of information about the illness is now standard treatment. However, the relevance of knowledge about a patient's disorder has to date not been sufficiently studied. One reason for that is that only few psychometrically validated instruments for the assessment of illness knowledge exist. The aim of this study was the development and psychometric evaluation of a questionnaire to assess knowledge about affective disorders. METHODS: The Knowledge about Depression and Mania Inventory (KDMI) was evaluated with a sample of 337 patients with major depression, relatives of patients with depression and schizophrenia, and controls. RESULTS: With the 44-item KDMI, the 3 dimensions knowledge of symptoms, knowledge of treatment and knowledge of coping strategies were differentiated. From these 44 items two 22-item parallel tests were developed for follow-up assessment. The scales showed good internal consistency. There were numerous indicators of the validity and sensitivity to change of the scales. It was shown that older patients and patients with lower levels of education are less knowledgeable about affective disorders. There were significant differences in the scales of the KDMI before and after a psychoeducative group for relatives. CONCLUSIONS: The study showed that knowledge about affective disorders can be reliably and validly measured by a questionnaire. Because of its brevity the KDMI is suitable for everyday use in clinical practice, and it forms the basis for further investigation of the significance of illness knowledge, as well as for evaluation of the effects of psychotherapy in this area.
Subject(s)
Bipolar Disorder/diagnosis , Depressive Disorder, Major/diagnosis , Psychological Tests , Acute Disease , Adult , Female , Humans , Male , Middle Aged , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
BACKGROUND: Increasing importance is attributed to the knowledge that patients have concerning their illness. For psychiatric disorders, imparting information about the illness has become a standard part of treatment. Despite the great clinical relevance of knowledge about depression, only few empirical studies on this subject have been carried out. This study aimed to identify psychosocial factors associated with greater or lesser knowledge about affective disorders. METHODS: Sixty-one in-patients with depression were recruited and tested with the Knowledge about Depression and Mania Inventory. RESULTS: Almost all patients sought specific information about their disorder prior to admission to hospital. There were large differences in patients' knowledge about the disorder and their choice of information source. Older and less educated patients had less knowledge about affective disorders. Patients with less illness knowledge also have a less favourable illness concept, poorer interpersonal relationships and more passive coping strategies. CONCLUSIONS: The results show that knowledge about affective disorders is a central illness characteristic that has numerous implications for the ability to cope with the disorder, as well as for psychotherapeutic management. The results contribute to a clarification of the relationship between psychoeducation and psychotherapy.
Subject(s)
Cognition , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Health Education , Health Knowledge, Attitudes, Practice , Mental Health , Mood Disorders/epidemiology , Mood Disorders/psychology , Patient Education as Topic , Adult , Cross-Sectional Studies , Depressive Disorder, Major/diagnosis , Female , Humans , Interpersonal Relations , Male , Mood Disorders/diagnosis , Psychology , Severity of Illness Index , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Neuropathological evidence suggests that the earliest changes in Alzheimer's disease selectively affect the parahippocampal regions of the brain. This study was conducted to determine if otherwise healthy elderly subjects with mild cognitive impairment had structural volume deficits affecting the parahippocampal gyrus. METHOD: Magnetic resonance imaging (MRI) was used to compare global and regional brain volumes in 21 subjects with mild cognitive deficits defined according to the criteria for aging-associated cognitive decline, 22 cognitively intact comparison subjects, and 12 patients with Alzheimer's disease. RESULTS: Compared with the cognitively intact subjects, the subjects with aging-associated cognitive decline had a significantly smaller mean volume of the right parahippocampal gyrus. The subjects with aging-associated cognitive decline had a mean parahippocampal volume that was intermediate between that of the Alzheimer's disease patients and that of the cognitively intact subjects. CONCLUSIONS: Parahippocampal atrophy underlies the observed cognitive deficits in aging-associated cognitive decline. These findings support the hypothesis that aging-associated cognitive decline represents a preclinical stage of Alzheimer's disease.
