Propiedades psicométricas de una versión española breve de 30 ítems del Cuestionario de Ansiedad y Depresión (MASQE30) / Psychometric Properties of the Spanish Version of 30-Item Brief Depression and Anxiety Symptoms Questionnaire (MASQS30)

Resumen Se presenta en esta investigación una versión corta de 30 ítems del Mood and Anxiety Symptoms Questionnaire ([MASQ]; Cuestionario de Síntomas de Ansiedad y del Humor) diseñado para medir las tres dimensiones del modelo tripartito de la ansiedad y la depresión, a saber, el Afecto Negativo (AN), el Afecto Positivo (AP) y la Ansiedad Somática (AS). Esta adaptación es una versión holandesa que se administró a una muestra de la población general canaria. Los objetivos propuestos son conocer la validez de constructo del MASQE30, mediante análisis factoriales exploratorio y confirmatorio, así como sus propiedades psicométricas y la validez convergente, discriminante y predictiva con ansiedad y depresión evaluadas con cuestionarios. Los resultados confirman la adecuada validez de constructo del MASQE30, así como coeficientes de consistencia interna que oscilan entre 0.88 y 0.92 y una estabilidad temporal que va desde 0.47 a 0.68. Los resultados corroboran que el AN y AS son compartidos por la ansiedad y la depresión, y el AP es específico de la depresión. El AN y AP corroboran las predicciones del modelo, pero no el resultado de AS. Se propone el MASQE30 como un instrumento adecuado para el estudio dimensional de la depresión y la ansiedad en población clínica y comunitaria.

Abstract In this investigation, we present a short 30-item version of the Mood and Anxiety Symptoms Questionnaire (MASQS30), designed to measure the three dimensions of the tripartite model of anxiety and depression, namely, negative affect (NA), positive affect (PA), and somatic anxiety (SA). This adaptation is from a Dutch version that we administered to a sample of the general canarian population. The proposed goals are to determine the construct validity of the MASQS30 through exploratory and confirmatory factor analysis, as well as its psychometric properties, and convergent, discriminant, and predictive validity with anxiety and depression as assessed through questionnaires. The results confirm adequate construct validity of the MASQS30, as well as internal consistency coefficients ranging between 0.88 and 0.92, and temporal stability, ranging from 0.47 to 0.68. The results corroborate that NA and SA are shared by anxiety and depression, whereas PA is specific to depression. NA and PA corroborate the predictions of the model, but the result of SA does not. The MASQS30 is proposed as an adequate instrument for the dimensional study of depression and anxiety in clinical and community population.

Insomnia with physiological hyperarousal is associated with hypertension.

Previous studies have suggested that insomnia with objective short sleep duration is associated with a higher risk of hypertension, and it has been speculated that the underlying mechanism is physiological hyperarousal. In this study, we tested whether insomnia with physiological hyperarousal measured by Multiple Sleep Latency Test (MSLT), a standard test of sleepiness/alertness, is associated with increased risk of hypertension. Two hundred nineteen chronic insomniacs and 96 normal sleepers were included in this study. Chronic insomnia was defined based on standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent 1 night in laboratory polysomnography followed by a standard MSLT. We used the median mean MSLT value (ie, >14 minutes) and the 75th percentile of mean MSLT value (ie, >17 minutes) to define hyperarousal. Hypertension was defined based either on blood pressure measures or on diagnosis treatment by a physician. After controlling for age, sex, body mass index, apnea-hypopnea index, diabetes mellitus, smoking, alcohol, and caffeine use, insomnia combined with MSLT >14 minutes increased the odds of hypertension by 300% (odds ratio=3.27; 95% confidence interval=1.20-8.96), whereas insomnia combined with MSLT >17 minutes increased even further the odds of hypertension by 400% (odds ratio=4.33; 95% confidence interval=1.48-12.68) compared with normal sleepers with MSLT ≤14 minutes. Insomnia associated with physiological hyperarousal is associated with a significant risk of hypertension. Long MSLT values may be a reliable index of the physiological hyperarousal and biological severity of chronic insomnia.

Insomnia with Short Sleep Duration: Nosological, Diagnostic, and Treatment Implications.

The diagnosis of insomnia is based solely on subjective complaints. This has contributed to the low reliability and validity of the current nosology of insomnia as well as to its lack of firm association with clinically relevant outcomes such as cardiometabolic and neurocognitive morbidity. We review evidence that insomnia with objective short sleep duration is associated with physiological hyperarousal, higher risk for hypertension, diabetes, neurocognitive impairment, and mortality as well as with a persistent course. It also appears that objective short sleep duration in poor sleepers is a biological marker of genetic predisposition to chronic insomnia. In contrast, insomnia with objective normal sleep duration is associated with cognitive-emotional and cortical arousal and sleep misperception but not with signs of physiological hyperarousal or medical complications. Thus, short sleep duration in insomnia may be a reliable marker of the biological severity and medical impact of the disorder. We propose that (a) objective measures of sleep be included in the diagnosis of insomnia and its subtypes, (b) objective measures of sleep obtained in the home environment of the patient would become part of the routine assessment and diagnosis of insomnia in a clinician's office setting, and (c) insomnia with short sleep duration may respond better to biological treatments, whereas insomnia with normal sleep duration may respond primarily to psychological therapies.