The factor structure of the Hopkins Symptom Checklist 25 among persons seeking HIV testing.

Rates of anxiety and depression are high among individuals living with HIV. The Hopkins Symptom Checklist (HSCL) is a screening tool to identify symptoms of depression and anxiety. The objective of this study was to determine the factor structure of the 25-item HSCL in a population-based sample of individuals seeking HIV testing in the Western Cape in South Africa. Participants volunteered for HIV testing at two non-medical HIV testing sites in the Western Cape. We used convenience sampling to administer the scale prior to their undergoing HIV testing. Data were analysed using exploratory factor analysis, using an extraction method of principal components with Promax (oblique) rotation. The Cronbach's alpha reliability indices were calculated for each of the independent factors to determine internal consistency. Factor analysis revealed a three-factor structure that explained 56.86% of the total variance. These factors included depression (14 items), anxiety (7 items) and somatic symptoms (4 items). Alpha levels ranged from 0.67 to 0.94. We found that the HSCL is a reliable measure for depression and anxiety, and consists of 3 distinguishable factors depression, anxiety, and somatic symptoms.

Validation of Arabic versions of the child psychosocial distress screener and pediatric symptom checklist for young adolescents living in vulnerable communities in Lebanon.

BACKGROUND: In humanitarian settings, brief screening instruments for child psychological distress have potential to assist in assessing prevalence, monitoring outcomes, and identifying children and adolescents in most need of scarce resources, given few mental health professionals for diagnostic services. Yet, there are few validated screening tools available, particularly in Arabic. METHODS: We translated and adapted the Child Psychosocial Distress Screener (CPDS) and the Pediatric Symptom Checklist (PSC) and conducted a validation study with 85 adolescents (aged 10-15) in Lebanon. We assessed internal consistency; test-retest reliability; convergent validity between adolescent- and caregiver-report and between the two measures; ability to distinguish between clinical and non-clinical samples; and concurrent validity against psychiatrist interview using the Kiddie Schedule for Affective Disorders and Schizophrenia. RESULTS: The translated and adapted child-reported PSC-17 and PSC-35, and caregiver-reported PSC-35 all showed adequate internal consistency and test-retest reliability and high concurrent validity with psychiatrist interview and were able to distinguish between clinical and non-clinical samples. However, the caregiver-reported PSC-17 did not demonstrate adequate performance in this setting. Child-reported versions of the PSC outperformed caregiver-reported versions and the 35-item PSC scales showed stronger performance than 17-item scales. The CPDS showed adequate convergent validity with the PSC, ability to distinguish between clinical and non-clinical samples, and concurrent validity with psychiatrist interview. Internal consistency was low for the CPDS, likely due to the nature of the brief risk-screening tool. There were discrepancies between caregiver and child-reports, worthy of future investigation. For indication of any diagnosis requiring treatment, we recommend cut-offs of 5 for CPDS, 12 for child-reported PSC-17, 21 for child-reported PSC-35, and 26 for caregiver-reported PSC-35. CONCLUSIONS: The Arabic PSC and CPDS are reliable and valid instruments for use as primary screening tools in Lebanon. Further research is needed to understand discrepancies between adolescent and caregiver reports, and optimal methods of using multiple informants.

Unraveling the distinction between depression and anxiety: A machine learning exploration of causal relationships.

OBJECTIVE: Depression and anxiety, prevalent coexisting mood disorders, pose a clinical challenge in accurate differentiation, hindering effective healthcare interventions. This research addressed this gap by employing a streamlined Symptom Checklist 90 (SCL-90) designed to minimize patient response burden. Utilizing machine learning algorithms, the study sought to construct classification models capable of distinguishing between depression and anxiety. METHODS: The study included 4262 individuals currently experiencing depression alone (n = 2998), anxiety alone (n = 716), or both depression and anxiety (n = 548). Counterfactual diagnosis was used to construct a causal network on the dataset. Employing a causal network, the SCL-90 was simplified. Items that have causality with only depression, only anxiety and both depression and anxiety were selected, and these streamlined items served as input features for four distinct machine learning algorithms, facilitating the creation of classification models for distinguishing depression and anxiety. RESULTS: Cross-validation demonstrated the performance of the classification models with the following metrics: (1) K-nearest neighbors (AUC = 0.924, Acc = 92.81 %); (2) support vector machine (AUC = 0.937, Acc = 94.38 %); (3) random forest (AUC = 0.918, Acc = 94.38 %); and (4) adaptive boosting (AUC = 0.882, Acc = 94.38 %). Notably, the support vector machine excelled, with the highest AUC and superior accuracy. CONCLUSION: Incorporating the simplified SCL-90 and machine learning presents a promising, efficient, and cost-effective tool for the precise identification of depression and anxiety.

Test-retest reliability of DSM-5 substance use symptom checklists used in primary care and mental health care settings.

INTRODUCTION: Substance use disorders (SUDs) are underdiagnosed in healthcare settings. The Substance Use Symptom Checklist (SUSC) is a practical, patient-report questionnaire that has been used to assess SUD symptoms based on Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) criteria. This study evaluates the test-retest reliability of SUSCs completed in primary and mental health care settings. METHODS: We identified 1194 patients who completed two SUSCs 1-21 days apart as part of routine care after reporting daily cannabis use and/or any past-year other drug use on behavioral health screens. Test-retest reliability of SUSC scores was evaluated within the full sample, subsamples who completed both checklists in primary care (n=451) or mental health clinics (n=512) where SUSC implementation differed, and subgroups defined by sex, insurance status, age, and substance use reported on behavioral health screens. RESULTS: In the full sample, test-retest reliability was high for indices reflecting the number of SUD symptoms endorsed (ICC=0.75, 95% CI:0.72-0.77) and DSM-5 SUD severity (kappa=0.72, 95% CI:0.69-0.75). These reliability estimates were higher in primary care (ICC=0.81, 95% CI:0.77-0.84; kappa=0.79, 95% CI:0.75-0.82, respectively) than in mental health clinics (ICC=0.74, 95% CI:0.70-0.78; kappa=0.73, 95% CI:0.68-0.77). Reliability differed by age and substance use reported on behavioral health screens, but not by sex or insurance status. CONCLUSIONS: The SUSC has good-to-excellent test-retest reliability when completed as part of routine primary or mental health care. Symptom checklists can reliably measure symptoms consistent with DSM-5 SUD criteria, which may aid SUD-related care in primary care and mental health settings.

The Influence of the Construction of Sports Tourism Towns on the Psychological Status of Local Residents / La influencia de la construcción de ciudades de turismo deportivo en el estado psicológico de los residentes locales

Understand the mental health status of residents aged 15 and above in a sports tourism town, the research aimed was to check the influence of the construction of sports tourism towns on the psychological status of local residents. For this purpose, a multistage random sampling method was used to conduct a questionnaire survey on the mental health status of 3295 local residents, and the data were processed and analysed using SPSS 19.0 software. Of the 3295 residents surveyed, 410 had poor mental health, accounting for 12.44% of the total number of people surveyed. The total score of SCL-90 of residents in local provinces is lower than the national norm (t=14.647, P=0.000), and the scores of various factors of SCL-90 of residents in local provinces are significantly higher than the national norm (P=0.000). The correlation analysis results showed that the total score of happiness was negatively correlated with the total score of SCL-90 (r=1.883, P<0.01), and the psychological awareness and hygiene score was also negatively correlated with the total score of SCL-90 (r=0.598, P<0.01). The results of multiple linear regression analysis showed that the factors that entered the regression equation included total happiness score, marital status, family life, satisfaction with the environment, whether life was monotonous, personality, participation in gatherings, and whether the three generations of the family had mental illness, according to the size of the standard regression coefficient, the most influential factor is the total score of happiness(β= 0.426), followed by marital status(β= 0.097).The mental health status of residents in the local province is not optimistic, the total score of happiness, marital status, family life, satisfaction with the environment, whether life is monotonous, and personality have varying degrees of impact on residents' mental health. Necessary intervention measures should be taken to improve their mental health based on their influencing factors. The research could help to application of targeted interventions and community-based programs to enhance the mental well-being of local residents in sports tourism towns, fostering sustainable development and social harmony. The research limitations and future directions were also discussed.(AU)

Evaluation of the mental health status of community frontline medical workers after the normalized management of COVID-19 in Sichuan, China.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, community medical workers, as the primary enforcers of community control measures, undertook many tasks with high exposure risk, resulting in severe psychological pressure, anxiety, depression and other psychological problems. Gender, type of workers, education, marital status, working years and other demographic factors were affect the mental state of medical workers. Community frontline medical workers gradually returned to normal work and life after the normalized management of COVID-19, but heavy work and high psychological pressure may continue to affect them. Thus, our research team used the same psychological questionnaire to investigate the psychological status of community frontline medical workers after the normalized management of COVID-19 compared with the COVID-19 period. Methods: This was a cross-sectional study of community frontline medical workers in Sichuan, China, from February 6 to 17, 2023. Symptom Checklist-90 (SCL-90) and a self-designed questionnaire of demographic characteristics were provided to the participants point-to-point through a mobile network platform. Multiple logistic regression was used to analyze influencing factors related to community frontline medical workers' psychology. Results: A total of 440 valid questionnaires were statistically analyzed, including 192 (43.64%) from doctors and 248 (56.36%) from nurses. There were 222 (50.45%) participants who were SCL-90 positive. The median total SCL-90 score of medical workers was 105.0 (IQR 95.00-123.75), which was higher than that during the COVID-19 period. The doctor's median SCL-90 score was 108.5 (IQR 96.00-136.25), and the positive item score was 16.5; the nurse's median score was 104.0 (IQR 94.00-119.50), and the positive item score was 12.0. Bachelor's degree education, no fixed contract and working years (10-19 years, 20-29 years, 30-39 years) were independent influencing factors for community frontline medical workers' psychology. Conclusion: After the normalized management of COVID-19, community frontline medical workers still suffered from psychological problems that were even more serious than those during COVID-19. Doctors were more likely to have psychological problems than nurses. In addition, the mental health status of community frontline medical workers was affected by education, type of contract and working years. Managers should pay attention to the mental health of these people.

Prediction of respiratory impairment in myotonic dystrophies using the 'Respiratory involvement symptom checklist' (Respicheck).

Chronic hypoventilation due to involvement of respiratory muscles is a frequent symptom in autosomal dominant inherited myotonic dystrophies, especially in type 1 (DM1), leading to a severely reduced quality of life, an early need for ventilatory support, or premature death. Thus, early knowledge of respiratory muscle weakness is essential to initiate further diagnostic and therapeutic measures. To get early, simple, and reliable information about respiratory impairment in DM patients, we performed a prospective controlled cohort study with DM1 and DM2 patients analysing the suitability of 'Respiratory involvement symptom checklist (Respicheck) as a clinically meaningful screening questionnaire for ventilatory impairment in patients with DM1 or DM2. Clinical assessments included a one-time pulmonary function test (spirometry and manometry) and the completion of the Respicheck. 172 participants were enrolled in this study (74 DM1, 72 DM2, 26 healthy controls). With a cut-off RespicheckCAT score of 4, the Respicheck can distinguish between patients with and without respiratory impairment with higher sensitivity and positive predictive value for DM1 than DM2 patients (DM1: sensitivity 77-87; positive predictive value 50-94%; DM2: sensitivity 67-80%; positive predictive value 14-38). In summary, our results confirm a clinically meaningful use of the Respicheck to detect respiratory impairments predominantly in DM1 patients.

Mental Health of Primary and Secondary School Teachers in the Remote Mountain Areas.

Background and objective: Teaching is widely recognized as a highly stressful profession. Job stress leads to emotional exhaustion, which in turn triggers teacher attrition. The cost is estimated as USD 2.2 billion annually for teacher dropouts. It is therefore important to understand the mental state of teachers and the factors that may influence it in order to provide the appropriate early intervention. In the past, more attention has been paid to the mental status of teachers in economically developed cities, but less research has been conducted in remote cities. In this study, we selected primary and secondary school teachers in a typical area to assess their mental health, thereby contributing to the development of effective mental health education programs for teachers in primary and secondary schools. Materials and methods: In this study, 1102 teachers from a typical city in Ningxia Province, characterized by remote mountain areas, minority communities, and a low economic level, participated. The mental status of the teachers was assessed by a Symptom Checklist-90 (SCL-90). The effects of gender, age, level of education, place of work, and marital status on the total SCL-90 score were recorded and compared. The subscale scores of the SCL-90 and the differences among the respondents with various characteristics were analyzed. Results: In total, 1025 data were valid and used for statistical analysis. The effective rate of this study was 93.01%. The analysis showed that 25.17% of the subjects had possible mental problems. There were significant differences in age and marital status (p < 0.001). The score of teachers less than 30 years old was lower than that of other teachers (p = 0.001 vs. 30-39; p < 0.001 vs. 40-49; p < 0.001 vs. ≥50). The no-marriage teachers had the lowest score than the married group or others (p < 0.001 vs. married; p < 0.05 vs. others). Compared to the norm, teachers' mental status was poor, especially in somatization (p < 0.001), obsessive-compulsive symptoms (p < 0.001), depression (p < 0.001), anxiety (p < 0.001), hostility (p < 0.001), phobic anxiety (p < 0.001), and psychosis (p < 0.001). There were gender differences in obsessive-compulsive symptoms (p < 0.05) and depression (p < 0.05). Conclusions: These data indicate that the mental status of these teachers is not optimistic, and married female teachers aged 40-55 years need to be given more attention. Mental health examinations can be incorporated into daily physical examination items to facilitate the timely detection and early intervention of negative emotions.

Prevalence of gastrointestinal symptoms and their association with psychological problems in youths.

BACKGROUND: Gastrointestinal symptoms and psychological problems are common in youths, which can negatively affect their lives on physical, mental, and social levels. This cross-sectional study aimed to determine the prevalence of gastrointestinal symptoms in youths and further explore their association with psychological problems. METHODS: Self-reported data on gastrointestinal symptoms and psychological problems in 692 sophomores who majored in education in a high vocational school and 310 recruits who were undergoing basic training in an army in China were retrospectively collected. The self-reported data included demographics, gastrointestinal symptoms, and Symptom Checklist 90 (SCL-90) used for the assessment of psychological problems. Gastrointestinal symptoms surveyed included nausea, emesis, abdominal pain, acid regurgitation, eructation, heartburn, anorexia, abdominal bloating, diarrhea, constipation, hematemesis, and hematochezia. Logistic regression analysis was performed to identify the independent risk factors associated with gastrointestinal symptoms. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. RESULTS: The prevalence of gastrointestinal symptoms was 36.7% (n=254) and 15.5% (n=48) in the sophomores and recruits, respectively. Participants with gastrointestinal symptoms had a significantly higher prevalence of total SCL-90 score beyond 160 than those without gastrointestinal symptoms in both sophomores (19.7% vs. 3.2%, P<0.001) and recruits (10.4% vs. 1.1%, P<0.001). Total SCL-90 score beyond 160 was independently associated with gastrointestinal symptoms in both sophomores (OR =5.467; 95% CI: 2.855-10.470; P<0.001) and recruits (OR =6.734; 95% CI: 1.226-36.999; P=0.028). CONCLUSIONS: Gastrointestinal symptoms may be common and strongly associated with psychological problems in youths. Prospective studies should be required to explore the impact of the correction of psychological problems on the improvement of gastrointestinal symptoms.

Identifying and responding to depression in adolescents in primary care: A quality improvement response.

The American Academy of Pediatrics (AAP) recommends adolescent depression screening and subsequent follow-up for those scoring at-risk. The current study assessed the outcomes of a Quality Improvement (QI) project that implemented these guidelines during annual well-child visits in a network of pediatric practices. This project used a two-stage screening process. First, adolescents were screened with the Pediatric Symptom Checklist (PSC-17). Second, adolescents who screened at-risk on the PSC-17 were asked to complete the Patient Health Questionnaire (PHQ-9). QI-participating providers received training on how to categorize the severity of their patient's depression based on PHQ-9 cut-off scores and clinical interview, and to implement and document appropriate options for follow-up. Patients in the QI group were significantly more likely to be screened with both the PSC-17 (93.8% vs. 89.1%, p < .001) and the PHQ-9 (54.8% vs. 16.4%, p < .001) compared to those in the non-QI group. Of the 80 adolescents in the QI group at-risk on the PSC-17 and with a completed PHQ-9, 65 (81.3%) received at least one type of referral for mental health, ranging from behavioral health services to lifestyle interventions. Findings support the feasibility of adolescent depression screening and referrals within pediatric primary care.

Screening Infants Through Adolescents for Social/Emotional/Behavioral Problems in a Pediatric Network.

OBJECTIVE: To assess changes in screening completion in a diverse, 7-clinic network after making annual screening for social/emotional/behavioral (SEB) problems the standard of care for all infant through late adolescent-aged patients and rolling out a fully automated screening system tied to the electronic medical record and patient portal. METHODS: In 2017, the Massachusetts General Hospital made SEB screening using the age-appropriate version of the Pediatric Symptom Checklist the standard of care in its pediatric clinics for all patients aged 2.0 months to 17.9 years. Billing records identified all well-child visits between January 1, 2016 and December 31, 2019. For each visit, claims were searched for billing for an SEB screen and the electronic data warehouse was queried for an electronically administered screen. A random sample of charts was reviewed for other evidence of screening. Chi-square analyses and generalized estimating equations assessed differences in screening over time and across demographic groups. RESULTS: Screening completion (billing and/or electronic) significantly increased from 2016 (37.2%) through 2019 (2017 [46.2%] vs 2018 [66.8%] vs 2019 [70.9%]; χ2 (3) =112652.33, P < .001), with an even higher prevalence found after chart reviews. Most clinics achieved screening levels above 90% by the end of 2019. Differences among demographic groups were small and dependent on whether data were aggregated at the clinic or system level. CONCLUSIONS: Following adoption of a best-practice policy and implementation of an electronic system, SEB screening increased in all age groups and clinics. Findings demonstrate that the AAP recommendation for routine psychosocial assessment is feasible and sustainable.

Analysis of scores of Symptom Checklist 90 (SCL-90) questionnaire of 182 parents of children with spinal muscular atrophy: a cross-sectional study.

Background: Spinal muscular atrophy (SMA) is a hereditary disorder characterized by progressive muscle weakness and atrophy in children. However, less attention is paid to psychiatric symptoms of SMA parents. Attention to the psychiatric symptoms of parents of SMA children can improve the comprehensiveness of family support for SMA children, which is beneficial to the rehabilitation of SMA children. Here, we conducted a survey on the psychiatric symptoms of SMA parents and analyzed its relevant factors, with an attempt to inform the psychological support for SMA parents. Methods: The Symptom Checklist 90 (SCL-90) and a self-designed basic information (such as parent's gender, household area, place of residence, education background, etc.) questionnaire (in electronic questionnaire) were distributed to parents of SMA children aged 0-18 in a charity WeChat group sponsored by the Meier Advocacy & Support Center for SMA during the period from August 1 to August 31, 2021. Parents completed the electronic questionnaires by mobile phone or computer voluntarily. A total of 188 questionnaires were obtained, of which 182 were valid. Comparisons were performed with the SCL-90 adult norms as the standards. The potential correlations between the general data of SMA parents and children and abnormal factors in the SCL-90 for SMA parents were analyzed. Results: The SCL-90 factors somatization (1.56±0.80, P=0.002), depression (1.78±0.98, P<0.001), anxiety (1.58±0.87, P=0.007), fear (1.39±0.74, P=0.003), and sleep and eating problems (1.67±0.87, P=0.014) of SMA parents were significantly higher than the national norms. Place of residence was correlated with sleep and eating problems (r=0.158, P=0.033). Increasing age [odds ratio (OR) =1.012, P=0.014] and continuous home-living status (OR =0.360, P=0.031) of SMA children increased the risk of depression in their parents, and the lack of rehabilitation management in SMA children increased the risk of anxiety of their parents (OR =0.409, P=0.038). Non-urban residence (OR =2.602, P=0.017) and poor physical health (OR =0.163, P=0.031) were the relevant factors for the increased risk of sleep and eating problems in SMA parents. Conclusions: SMA parents have a higher risk of developing psychiatric symptoms problems compared with the general population. Increasing age and the continuous home-living status of SMA children increase the risk of depression in their parents, and the lack of rehabilitation management increase the risk of anxiety in SMA parents.

Mild-to-moderate iodine deficiency and symptoms of emotional distress and depression in pregnancy and six months postpartum - Results from a large pregnancy cohort.

BACKGROUND: The relationship between iodine intake and depression is unknown. The aim of the present study was to investigate whether iodine intake was associated with symptoms of perinatal emotional distress and depression in a mild- to moderately iodine deficient population. METHODS: The study population comprised 67,812 women with 77,927 pregnancies participating in the Norwegian Mother, Father and Child Cohort Study. Self-reported emotional distress and depressive symptoms were reported in pregnancy and at six months postpartum. Iodine intake was assessed by a food frequency questionnaire in mid-pregnancy. Urinary iodine concentration (UIC) was available for 2792 pregnancies. RESULTS: The median iodine intake from food was 121 µg/day and the median UIC was 68 µg/L. The prevalence of high scores for emotional distress was 6.6 % in pregnancy and 5.8 % six months postpartum, and for high scores on postpartum depression it was 10.3 %. In non-users of iodine supplements (63 %), a low maternal iodine intake from food (lower than ~100-150 µg/day) was associated with increased risk of high scores of emotional distress and depression both in pregnancy and six months postpartum (p < 0.001). Iodine supplement use was associated with increased risk of high scores of emotional distress in pregnancy compared to no supplement use or use of supplements without iodine. LIMITATIONS: Observational design, self-report information, and short scales to assess symptoms of emotional distress and depression. CONCLUSION: A low habitual iodine intake was associated with increased prevalence of perinatal emotional distress and depression. The potential non-beneficial effect of iodine supplements may have biological explanations. More studies are needed.

Item response theory and differential test functioning analysis of the HBSC-Symptom-Checklist across 46 countries.

BACKGROUND: The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries. METHODS: Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined. RESULTS: Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low. CONCLUSION: HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.

Mental health status and associated contributing factors among the Hakka elderly in Fujian, China.

Purpose: Little is known about the mental health of the Hakka elderly. This study explores the status of, and factors associated with mental health among Hakka elderly populations from Fujian, China. Methods: This is a cross-sectional, community-based survey study containing a total of 1,262 valid samples. The Chinese version Symptom Checklist-90-R (SCL-90-R) was used to assess the mental health status of the Hakka elderly. We used t-tests to compare the differences for 10 dimensions of SCL-90-R scores between the Chinese national norm and the Hakka elderly. Univariate and multivariate analysis were performed by using linear regression analysis to identify the main socio-demographic factors that were most predictive of the total score of SCL-90-R in the Hakka elderly. Results: The scores of somatization (1.78 ± 0.55 vs. 1.40 ± 0.46, P < 0.001) and phobic anxiety (1.21 ± 0.36 vs. 1.17 ± 0.31, P < 0.001) for the Hakka elderly in Fujian appeared to be significantly higher than the Chinese norm. The higher total scores of SCL-90-R were found among females (ß = 0.030, P = 0.044), widowed persons (ß = 0.053, P = 0.021), those with parent(s) alive (ß = 0.047, P = 0.019), and those with poorer self-rated health status (ß = 0.110, P < 0.001). The lower total scores of SCL-90-R were found among those who were currently living in town, those with lower education level, those with higher average annual household incomes, and those who were living with spouse or children. Conclusion: The worse mental health conditions of the Hakka elderly in somatization and phobic anxiety were detected. The overall mental health status was shown to be worse among females, widowed persons, those who were living in village, those with lower education, and those with father or/and mother alive.

Development and psychometric evaluation of a teacher version of the Ontario child health study emotional behavioural scales (OCHS-EBS-T) for measuring selected DSM-5 disorders in elementary school-aged children.

This paper describes the development and psychometric properties of a teacher version of the Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS-T) for dimensional measurement of six psychiatric disorders in elementary school-aged children based on DSM-5 criteria. Psychometric evaluation of the item and scale properties was conducted in a large, general population study of elementary teacher assessments of 3,072 children aged 4 to 13 years in 2,354 families in Ontario, Canada. Content validity, internal construct validity and internal consistency reliability of the six disorder subscales were assessed. Structural equation modelling was used to assess measurement invariance, internal and external convergent and discriminant validity. Confirmatory factor analyses confirmed unidimensionality of subscales and adequate item-fit to all scales. Measurement equivalence was demonstrated fully for four subscales and partially for two. Internal consistency reliability for all subscales exceeded 0.78, except for the conduct disorder scale in 12- to 13-year-olds. Evidence of internal convergent validity was demonstrated in all cases. Discriminant validity was demonstrated in 27 out of 30 correlation comparisons. External convergent and discriminant validity was demonstrated when comparing the OCHS-EBS-T to a parent/caregiver measure of disorders in 48 out of 60 correlation comparisons. All subscales independently predicted child mental health-related service contact.

Addressing symptoms that affect patients' eating according to the Head and Neck Patient Symptom Checklist©.

PURPOSE: The purpose of this prospective study was to assess which nutritional impact symptoms (NIS) interfere with oral intake in patients with head and neck cancer (HNC) and how the symptoms interfere with body weight loss, up to 1 year after treatment. METHODS: This was a prospective study of 197 patients with HNC planned for treatment with curative intention. Body weight was measured before the start of treatment, at 7 weeks after the start of treatment, and at 6 and 12 months after completion of treatment. NIS and NIS interfering with oral intake at each follow-up were examined with the Head and Neck Patient Symptom Checklist© (HNSC©). RESULTS: At 7 weeks of follow-up, patients experienced the greatest symptom and interference burden, and 12 months after treatment the NIS scorings had not returned to baseline. One year after treatment, the highest scored NIS to interfere with oral intake was swallowing problems, chewing difficulties, and loss of appetite. At all 3 follow-ups, the total cumulative NIS and NIS interfering with oral intake were associated with body weight loss. Factors increasing the risk for a body weight loss of ≥ 10% at 12 months after treatment were pain, loss of appetite, feeling full, sore mouth, difficulty swallowing, taste changes, and dry mouth. Women scored higher than men in NIS and NIS interfering with oral intake. Furthermore, during the study period about half of the population had a body weight loss > 5%. CONCLUSION: Because both nutritional and clinical factors may affect body weight, this study highlights the importance of a holistic approach when addressing the patients' nutritional issues. TRIAL REGISTRATION: ClinicalTrials.gov NCT03343236, date of registration: November 17, 2017.

Depression scores and quality of life of vertiginous patients, suffering from different vestibular disorders.

PURPOSE: To contrast the quality of life (QoL) impairment and depression scores of patients suffering from different vestibular disorders. METHODS: 301 patients were examined due to vertiginous complaints at the Neurotology Centre of the Department of Otolaryngology and Head and Neck Surgery of Semmelweis University. These patients completed the Hungarian version of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory, and the Symptom Checklist-90-Revised questionnaires. RESULTS: According to neurotological examination, the distribution of the different diagnoses was as follows: Menière's disease (n = 101), central vestibular disorders (n = 67), BPPV (n = 47), vestibular neuritis (n = 39), other unilateral peripheral vestibulopathy (n = 18), PPPD (Persistent Postural-Perceptual Dizziness) (n = 16), vestibular migraine (n = 8), and vestibular Schwannoma (n = 5). The results of the DHI questionnaire have indicated worsened QoL in 86.4%, out of which 33.6% was defined as severe. The Beck scale has shown depressive symptoms in 42.3% of the cases, with severe symptoms in 6.3%. Significantly higher total DHI and Beck scale results were observed in patients with central vestibular disorders, vestibular migraine, PPPD and peripheral vestibulopathy, contrasted to the results of the other four diagnosis groups. The onset of the symptoms did not significantly affect the severity of QoL worsening and depression symptoms. CONCLUSION: In this study, the QoL of vertiginous patients was worse in general, with the occurrence of depression symptoms. A difference was observed in the case of the values of patients with different vestibular disorders, indicating the importance of different factors, e.g., central vestibular compensation, behavioural strategies and psychological factors.

Evaluating the procedural validity of the multilingual computer assisted self interview (MultiCASI) in a refugee population.

Multimedia-based administration of questionnaires, presenting items both in writing and spoken word, offers numerous potential benefits in transcultural psychiatry, such as improved comprehension of each question, ease of administration, prevention of missing or arbitrary responses, and obviating subsequent data entry. The concept has become known as "Computer-Assisted Self Interviewing" (CASI), and while preliminary results are promising, previous studies have not directly compared CASI to paper-and-pen administration in a large and representative sample of refugees. The aim of this study was to evaluate the procedural validity of multilingual CASI in comparison to paper-based-administration. The Hopkins Symptom Checklist-25 anxiety and depression subscales were administered in both modalities with a total of N = 281 participants from sites in Australia, New Zealand, and Denmark. We evaluated potential deviations in both the raw item and scale scores in each modality, while psychometric properties of each subscale were compared for an Arabic-speaking subsample (n = 125). Results showed no significant differences between raw item- or scale score across the two modalities, nor between the level of construct validity. In conclusion, this study supports a wider adaptation of multilingual CASI in the context of transcultural psychiatry, both for purposes of screening and treatment evaluation.

Practical assessment of DSM-5 alcohol use disorder criteria in routine care: High test-retest reliability of an Alcohol Symptom Checklist.

BACKGROUND: Alcohol use disorder (AUD) is underdiagnosed and undertreated in medical settings, in part due to a lack of AUD assessment instruments that are reliable and practical for use in routine care. This study evaluates the test-retest reliability of a patient-report Alcohol Symptom Checklist questionnaire when it is used in routine care, including primary care and mental health specialty settings. METHODS: We performed a pragmatic test-retest reliability study using electronic health record (EHR) data from Kaiser Permanente Washington, an integrated health system in Washington state. The sample included 454 patients who reported high-risk drinking on a behavioral health screen and completed two Alcohol Symptom Checklists 1 to 21 days apart. Subgroups of these patients who completed both checklists in primary care (n = 271) or mental health settings (n = 79) were also examined. The primary measure was an Alcohol Symptom Checklist on which patients self-reported whether they experienced each of the 11 AUD criteria within the past year, as defined by the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5). RESULTS: Alcohol Symptom Checklists completed in routine care and documented in EHRs had excellent test-retest reliability for measuring AUD criterion counts (ICC = 0.79, 95% CI: 0.76 to 0.82). Test-retest reliability estimates were also high and not significantly different for the subsamples of patients who completed both checklists in primary care (ICC = 0.82, 95% CI: 0.77 to 0.85) or mental health settings (ICC = 0.74, 95% CI: 0.62 to 0.83). Test-retest reliability was not moderated by having a past two-year AUD diagnosis, nor by the age or sex of the patient completing it. CONCLUSIONS: Alcohol Symptom Checklists can reliably and pragmatically assess AUD criteria in routine care among patients who screen positive for high-risk drinking. The Alcohol Symptom Checklist may be a valuable tool in supporting AUD-related care and monitoring AUD criteria longitudinally in routine primary care and mental health settings.