RESUMO
AIM: The aim of the study was to evaluate the psychometric properties of the 10 subscales of the Ward Atmosphere Scale (WAS) in a Russian psychiatric hospital. METHODS: A total of 212 patients and 96 staff members at five wards for acute psychiatric patients completed the WAS. We calculated Cronbach's alpha, the Corrected Item Total Subscale Correlation (CITC), and item-revised subscale intercorrelations. RESULTS: By removing a total of 32 items, the psychometric properties for all subscales except "Autonomy", reached an acceptable level for the patient scores. Although several of the revised subscales were highly intercorrelated, the specificity of the items of the revised scales appeared acceptable. CONCLUSIONS: The revised WAS version appeared applicable within this Russian psychiatric hospital context. Several of the items that were dropped appeared inapplicable because of differences between Russian and Western culture and psychiatry.
Assuntos
Atitude do Pessoal de Saúde , Comparação Transcultural , Hospitais Psiquiátricos/organização & administração , Satisfação do Paciente , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Esquizofrenia/terapia , Psicologia do Esquizofrênico , Meio Social , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Autonomia Pessoal , Relações Profissional-Paciente , Distância Psicológica , Psicometria/estatística & dados numéricos , Psicotrópicos/uso terapêutico , Reprodutibilidade dos Testes , Federação Russa , Tradução , Adulto JovemRESUMO
A number of dopamine-related genes have been implicated in the etiology of violent behavior and conduct problems. Of these genes, the ones that code for the enzymes that influence the turnover of dopamine (DA) have received the most attention. In this study, we investigated 12 genetic polymorphisms in four genes involved with DA functioning (COMT, MAOA and MAOB, and DbetaH) in 179 incarcerated male Russian adolescents and two groups of matched controls: boys without criminal records referred to by their teachers as (a) "troubled-behavior-free" boys, n=182; and (b) "troubled-behavior" boys, n=60. The participants were classified as (1) being incarcerated or not, (2) having the DSM-IV diagnosis of conduct disorder (CD) or not, and (3) having committed violent or nonviolent crimes (for the incarcerated individuals only). The findings indicate that, although no single genetic variant in any of the four genes differentiated individuals in the investigated groups, various linear combinations (i.e., haplotypes) and nonlinear combinations (i.e., interactions between variants within and across genes) of genetic variants resulted in informative and robust classifications for two of the three groupings. These combinations of genetic variants differentiated individuals in incarceration vs. nonincarcerated and CD vs. no-CD groups; no informative combinations were established consistently for the grouping by crime within the incarcerated individuals. This study underscores the importance of considering multiple rather than single markers within candidate genes and their additive and interactive combinations, both with themselves and with nongenetic indicators, while attempting to understand the genetic background of such complex behaviors as serious conduct problems.
Assuntos
Agressão , Transtorno da Conduta/genética , Dopamina/genética , Polimorfismo Genético/genética , Adolescente , Agressão/psicologia , Catecol O-Metiltransferase/genética , Transtorno da Conduta/psicologia , Crime , Dopamina/metabolismo , Dopamina/fisiologia , Dopamina beta-Hidroxilase/genética , Frequência do Gene , Estudos de Associação Genética , Marcadores Genéticos/genética , Genótipo , Haplótipos/genética , Humanos , Masculino , Monoaminoxidase/genética , Polimorfismo de Nucleotídeo Único/genética , Escalas de Graduação Psiquiátrica , Violência/psicologiaRESUMO
BACKGROUND: There is virtually no readily accessible systematically recorded evidence on how the organization of mental health services in Europe's largest country, Russia, may differ from other national systems. This study systematically compares the mental health services in Archangelsk County and Northern Norway using instruments developed for trans-cultural use. METHODS: The European Service Mapping Schedule (ESMS) and The International Classification of Mental Health Care (ICMHC) were used to describe: (i) resources, organisation and utilisation of the services; (ii) their decentralisation and differentiation; (iii) some interventions delivered by the mental health service units (n = 132) in both regions. RESULTS: The Norwegian services are more decentralised and differentiated, while the Russian services are largely hospital-based. The GPs are of considerable importance to the Norwegian services, functioning as gatekeepers-both centrally and peripherally. In contrast, the GP model is still poorly established in Archangelsk County. There are more units for long term stay in the Russian services than in Norway. General health care and taking over daily living activities are more organised in Archangelsk County, while psychopharmacological treatment and psychosocial interventions are more developed in Norway. CONCLUSION: The study has revealed several differences in resources, organisation and utilisation of the mental health services between the two compared areas. The very large variations indicate that underlying local patterns of service delivering must be further investigated and taken into account in the planning of the services development.
