Clinical validity and intrarater and test-retest reliability of the Structured Clinical Interview for DSM-5 - Clinician Version (SCID-5-CV).

AIM: The Structured Clinical Interview for the DSM is one of the most used diagnostic instruments in clinical research worldwide. The current Clinician Version of the instrument (SCID-5-CV) has not yet been assessed in respect to its psychometric qualities. We aimed to assess the clinical validity and different reliability indicators (interrater test-retest, joint interview, face-to-face vs telephone application) of the SCID-5-CV in a large sample of 180 non-prototypical and psychiatric patients based on interviews conducted by raters with different levels of clinical experience. METHODS: The SCID-5-CV was administered face-to-face and by telephone by 12 psychiatrists/psychologists who took turns as raters and observers. Clinical diagnoses were established according to DSM-5 criteria and the longitudinal, expert, all data (LEAD) procedure. We calculated the percentage of agreement, diagnostic sensitivity and specificity, and the level of agreement (kappa) for diagnostic categories and specific diagnoses. RESULTS: The percentage of positive agreement between the interview and clinical diagnoses ranged between 73% and 97% and the diagnostic sensitivity/specificity were >0.70. In the joint interview, the levels of positive agreement were high (>75%) and kappa levels were >0.70 for most diagnoses. The values were less expressive, but still adequate, for interrater test-retest interviews. CONCLUSION: The SCID-5-CV presented excellent reliability and high specificity as assessed with different methods. The clinical validity of the instrument was also confirmed, which supports its use in daily clinical practice. We highlight the adequacy of the instrument to be used via telephone and the need for careful use by professionals with little experience in psychiatric clinical practice.

Maternal depression: Associations between behavioral problems in school-aged children, organization patterns, adversities, and family environment resources / Depressão materna: associações entre problemas comportamentais de escolares e padrões de organização familiar

The objective of this study was to verify possible associations between family organization patterns, adversities, family environment resources, and behavioral problems "in children of mothers with recurrent depression" (Group 1) compared with "children of mothers without psychiatric disorders" (Group 2). A total of 100 mother-child dyads were divided into two equal groups and were evaluated individually using the following instruments: General questionnaire; Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders; Strengths and Difficulties Questionnaire; Escala de Eventos Adversos; Escala de Adversidade Crônica; Inventário de Recursos do Ambiente Familiar; Raven, and an interview about family patterns. When compared to Group 2, Group 1 showed significantly more behavioral problems, adverse events, and chronic adversities and fewer family resources and family organization patterns. Negative and moderate associations were observed between behavioral problems and positive family organization patterns, evidencing the importance of mental health actions aimed at improving these patterns.

Objetivou-se verificar as possíveis associações entre padrões de organização familiar, adversidades e recursos do ambiente familiar e problemas de comportamento de "crianças que convivem com mães com depressão recorrente" (Grupo 1), em comparação às que "convivem com mães sem transtornos psiquiátricos" (Grupo 2). Avaliaram-se individualmente cem díades mãe-criança, distribuídas em dois grupos do mesmo tamanho amostral, por meio dos instrumentos: Questionário Geral; Entrevista Clínica Estruturada para Manual Diagnóstico e Estatístico de Transtornos Mentais; Questionário de Capacidades e Dificuldades; Escala de Eventos Adversos; Escala de Adversidades Crônicas; Inventário de Recursos do Ambiente Familiar, Raven e Entrevista sobre padrões de organização familiar. Em comparação ao Grupo 2, o Grupo 1 apresentou significativamente mais problemas comportamentais, bem como eventos adversos, adversidades crônicas e menos recursos do ambiente familiar e padrões de organização familiar. Foram detectadas correlações negativas e moderadas entre problemas comportamentais e padrões positivos de organização familiar, evidenciando a relevância de ações em saúde mental que favoreçam o desenvolvimento desses padrões.

Cross-cultural adaptation and psychometric assessment of a Brazilian-Portuguese version of the Resident Questionnaire.

BACKGROUND: Despite the general agreement regarding the central role of the clinical learning environment in graduate medical education, its assessment remains challenging owing to the lack of available standardized measures. We report on the cross-cultural adaptation and psychometric assessment of the Brazilian-Portuguese version of Seelig's Resident Questionnaire. METHODS: The present study was performed in two steps. First, a cross-cultural translation and adaptation of the Resident Questionnaire was conducted through multiple translations, synthesis of versions, back-translation, content validation, and face validation. Subsequently, a sample of 288 (72%) resident physicians enrolled in 40 residency programs at a Brazilian university hospital completed the following measures: 1) the Brazilian-Portuguese version of the Resident Questionnaire (for factor analysis and to determine internal consistency, reliability, and validity); 2) three existing, validated psychometric measures (to determine convergent and divergent validity); and 3) a self-report questionnaire. RESULTS: Confirmatory factor analysis results provided support for the three-dimensional model of the Resident Questionnaire in use on a sample of Brazilian resident physicians, having been previously verified for use in American samples. All three factors (emotional distress, learning environment satisfaction, and workload satisfaction) verified in the confirmatory factor analysis showed good internal consistency (α > .80), reliability (Raykov's rho > .80), and correlations in the expected directions and magnitude with measures of depressive symptoms, duty hours, organizational conditions, and emotional exhaustion. CONCLUSIONS: This study is the first to adapt a measure of the clinical learning environment of residency programs into Brazilian Portuguese. Our findings suggest that the adapted version of the Resident Questionnaire is valid and reliable for assessing Brazilian residency programs. This free, easy-access, and fast-application instrument may be a useful standardized measure for research and educational purposes concerning the clinical learning environments of resident physicians.