ABSTRACT
Introducción. Pocas escalas se han validado en castellano para el riesgo suicida y en ninguna de ellas se ha hallado la validez predictiva. Objetivo. Determinar la validez y confiabilidad de la Escala de Desesperanza de Beck en pacientes con suicidabilidad que acuden a consulta especializada. Métodos. Se aplicaron la Escala de Desesperanza de Beck, el Inventario de Razones para Vivir y el Cuestionario de Comportamiento Suicida a pacientes con suicidabilidad que asistieron a consulta externa y urgencias. A los 30 días se realizó una valoración para determinar la validez predictiva del intento suicida o suicidio. Resultados. Se evaluaron 244 pacientes con una edad promedio de 30,7 años±13,2; la mayoría de ellos fueron mujeres. La consistencia interna de la Escala de Desesperanza de Beck es de 0,9 (fórmula 20 de Kuder-Richardson). Se encontraron 4 dimensiones que explican el 50% de la varianza. Tuvo una correlación positiva con el Cuestionario de Comportamiento Suicida (Spearman 0,48, p<0,001), número de intentos suicidas (Spearman 0,25, p<0,001), y severidad del riesgo suicida (Spearman 0,23, p<0,001). La correlación con el Inventario de Razones para Vivir fue negativa (Spearman -0,52, p<0,001). Con un punto de corte ≥12 el valor predictivo negativo fue de 98,4% (IC 95%: 94,2-99,8), y el valor predictivo positivo fue de 14,8% (IC 95%: 6,6-27,1). Conclusión. La Escala de Desesperanza de Beck en pacientes colombianos con suicidabilidad presenta unas dimensiones similares a la versión original, con adecuada confiabilidad y moderada validez, tanto concurrente como predictiva
Introduction. Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity. Objective. To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic. Methods. The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department. A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt. Results. The evaluation included a total of 244 patients, with a mean age of 30.7±13.2 years, and the majority were women. The internal consistency was .9 (Kuder-Richardson formula 20). Four dimensions were found which accounted for 50% of the variance. It was positively correlated with the suicidal behaviour questionnaire (Spearman .48, P<.001), number of suicide attempts (Spearman .25, P<.001), severity of suicide risk (Spearman .23, P<.001). The correlation with the reasons for living inventory was negative (Spearman -52, P<.001). With a cut-off ≥12, the negative predictive value was 98.4% (95% CI: 94.2-99.8), and the positive predictive value was 14.8% (95% CI: 6.6-27.1). Conclusion. The Beck Hopelessness Scale in Colombian patients with suicidality shows results similar to the original version, with adequate reliability and moderate concurrent and predictive validity
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Suicide, Attempted/psychology , Suicidal Ideation , Predictive Value of Tests , Reproducibility of Results/methods , Reproducibility of Results , Surveys and Questionnaires , Risk FactorsABSTRACT
INTRODUCTION: Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity. OBJECTIVE: To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic. METHODS: The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department. A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt. RESULTS: The evaluation included a total of 244 patients, with a mean age of 30.7±13.2 years, and the majority were women. The internal consistency was .9 (Kuder-Richardson formula 20). Four dimensions were found which accounted for 50% of the variance. It was positively correlated with the suicidal behaviour questionnaire (Spearman .48, P<.001), number of suicide attempts (Spearman .25, P<.001), severity of suicide risk (Spearman .23, P<.001). The correlation with the reasons for living inventory was negative (Spearman -.52, P<.001). With a cut-off ≥12, the negative predictive value was 98.4% (95% CI: 94.2-99.8), and the positive predictive value was 14.8% (95% CI: 6.6-27.1). CONCLUSION: The Beck Hopelessness Scale in Colombian patients with suicidality shows results similar to the original version, with adequate reliability and moderate concurrent and predictive validity.
Subject(s)
Hope , Psychiatric Status Rating Scales , Suicide , Adolescent , Adult , Aged , Child , Colombia , Female , Follow-Up Studies , Humans , Male , Middle Aged , Predictive Value of Tests , Reproducibility of Results , Risk Assessment , Translations , Young AdultABSTRACT
Dengue is the most prevalent human arbovirus disease worldwide. Dengue virus (DENV) infection causes syndromes varying from self-limiting febrile illness to severe dengue. Although dengue pathophysiology is not completely understood, it is widely accepted that increased inflammation plays important roles in dengue pathogenesis. Platelets are blood cells classically known as effectors of hemostasis which have been increasingly recognized to have major immune and inflammatory activities. Nevertheless, the phenotype and effector functions of platelets in dengue pathogenesis are not completely understood. Here we used quantitative proteomics to investigate the protein content of platelets in clinical samples from patients with dengue compared to platelets from healthy donors. Our assays revealed a set of 252 differentially abundant proteins. In silico analyses associated these proteins with key molecular events including platelet activation and inflammatory responses, and with events not previously attributed to platelets during dengue infection including antigen processing and presentation, proteasome activity, and expression of histones. From these results, we conducted functional assays using samples from a larger cohort of patients and demonstrated evidence for platelet activation indicated by P-selectin (CD62P) translocation and secretion of granule-stored chemokines by platelets. In addition, we found evidence that DENV infection triggers HLA class I synthesis and surface expression by a mechanism depending on functional proteasome activity. Furthermore, we demonstrate that cell-free histone H2A released during dengue infection binds to platelets, increasing platelet activation. These findings are consistent with functional importance of HLA class I, proteasome subunits, and histones that we found exclusively in proteome analysis of platelets in samples from dengue patients. Our study provides the first in-depth characterization of the platelet proteome in dengue, and sheds light on new mechanisms of platelet activation and platelet-mediated immune and inflammatory responses.
