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Specific Disorders (specific + disorders)
Selected AbstractsMeta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviewsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2009David C. Rettew Abstract Standardized diagnostic interviews (SDIs) have become de facto gold standards for clinical research. However, because clinical practitioners seldom use SDIs, it is essential to determine how well SDIs agree with clinical diagnoses. In meta-analyses of 38 articles published from 1995 to 2006 (N = 15,967 probands), mean kappas (z -transformed) between diagnoses from clinical evaluations versus SDIs were 0.27 for a broad category of all disorders, 0.29 for externalizing disorders, and 0.28 for internalizing disorders. Kappas for specific disorders ranged from 0.19 for generalized anxiety disorder to 0.86 for anorexia nervosa (median = 0.48). For diagnostic clusters (e.g. psychotic disorders), kappas ranged from 0.14 for affective disorders (including bipolar) to 0.70 for eating disorders (median = 0.43). Kappas were significantly higher for outpatients than inpatients and for children than adults. However, these effects were not significant in meta-regressions. Conclusions: Diagnostic agreement between SDIs and clinical evaluations varied widely by disorder and was low to moderate for most disorders. Thus, findings from SDIs may not fully apply to diagnoses based on clinical evaluations of the sort used in the published studies. Rather than implying that SDIs or clinical evaluations are inferior, characteristics of both may limit agreement and generalizability from SDI findings to clinical practice. Copyright © 2009 John Wiley & Sons, Ltd. [source] The Galicia study of mental health of the Elderly II: the use of the Galician DISINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2000Professor R. Mateos Abstract Reports of epidemiological surveys do not always provide adequate careful descriptions of the methodology used and the sociocultural context involved. Galicia, a natural region in south-west Europe, possesses certain characteristics that differ from those in other communities within the Spanish state. Galician is a Romance language, which is, in fact, closer to Portuguese than it is to Spanish. The population (2.7 million inhabitants) is widely dispersed, with two-thirds of them living in the countryside. More than 18% are older than 65, and the educational level of this elderly population is low. A total of 681 persons over 60 years of age were interviewed in their homes using the DIS-III as the main diagnostic instrument during the second phase of the Galicia Study of Mental Health of the Elderly. This paper analyses some methodological implications of this epidemiological study, focusing on the translation of the DIS into Galician and its performance and acceptability in this community. The possible cultural bias that can affect the rates of prevalence in some specific disorders, the limitations of lifetime prevalence and the advantages of using six-month prevalence rates is discussed. Besides some interesting anecdotes, which are described in the article, the main result is the very high acceptance of DIS-III in this elderly population. Copyright © 2000 Whurr Publishers Ltd. [source] Experimental analysis of specific treatment factors: Efficacy and practice implicationsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2005Jeffrey M. Lohr Interest in the empirical demonstration of the clinical efficacy of psychosocial treatments has been rekindled by societal concerns over accountability and cost effectiveness of mental health services. The result has been the identification of specific treatments for specific disorders. The prescription of treatment content should be based on the theory of therapeutic action and/or the disorder to which it is applied. The demonstration of specific treatment efficacy requires experimental evidence showing the influence of specific procedures beyond nonspecific factors of treatment. We provide an analysis of these factors and their effects in evaluating the specific efficacy of prescriptive psychosocial treatments. Experimental procedures and designs that test the validity of specific treatments are described and applied to cognitive-behavioral treatments of generalized anxiety disorder. The empirical and professional implications of specific treatment efficacy in evidence-based practice are discussed. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 819,834, 2005. [source] Platelet functions beyond hemostasisJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 11 2009S. S. SMYTH Summary., Although their central role is in the prevention of bleeding, platelets probably contribute to diverse processes that extend beyond hemostasis and thrombosis. For example, platelets can recruit leukocytes and progenitor cells to sites of vascular injury and inflammation; they release proinflammatory and anti-inflammatory and angiogenic factors and microparticles into the circulation; and they spur thrombin generation. Data from animal models suggest that these functions may contribute to atherosclerosis, sepsis, hepatitis, vascular restenosis, acute lung injury, and transplant rejection. This article represents an integrated summary of presentations given at the Fourth Annual Platelet Colloquium in January 2009. The process of and factors mediating platelet,platelet and platelet,leukocyte interactions in inflammatory and immune responses are discussed, with the roles of P-selectin, chemokines and Src family kinases being highlighted. Also discussed are specific disorders characterized by local or systemic platelet activation, including coronary artery restenosis after percutaneous intervention, alloantibody-mediated transplant rejection, wound healing, and heparin-induced thrombocytopenia. [source] Specific and non-specific upper extremity musculoskeletal disorder syndromes in automobile manufacturing workersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2009Judith E. Gold ScD Abstract Objective A longitudinal cohort of automobile manufacturing workers (n,=,1,214) was examined for: (1) prevalence and persistence of specific upper extremity musculoskeletal disorders (UEMSDs) such as lateral epicondylitis and de Quervain's disease, and non-specific disorders (NSDs) defined in symptomatic individuals without any specific disorder, and (2) disorder prognoses based on symptom characteristics and other factors. Methods Eight specific disorders were identified through case definitions based on upper extremity physical examinations and symptom surveys administered on three occasions over 6 years. Results At baseline, 41% of the cohort reported upper extremity symptoms; 18% (n,=,214) of these had NSDs. In each survey, tendon-related conditions accounted for over half of the specific morbidity. Twenty-five percent had UEMSDs in multiple anatomical sites, and most with hand/wrist disorders had two or more hand/wrist UEMSDs. Persistence for all specific disorders decreased with length of follow-up. Specific UEMSDs were characterized by greater pain severity and functional impairment, and more lost work days than NSDs. Conclusions Upper extremity symptoms and diagnoses vary over time. NSDs may be the early stages of conditions that will eventually become more specific. NSDs and overlapping specific UEMSDs should be taken into account in UEMSD classification. Am. J. Ind. Med. 52:124,132, 2009. © 2008 Wiley-Liss, Inc. [source] A prospective study of computer users: II.AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2002Postural risk factors for musculoskeletal symptoms, disorders Abstract Background Despite widespread recommendations regarding posture during computer use, associations between specific postures and musculoskeletal health are not well characterized. Methods Six hundred and thirty-two newly hired computer users were followed prospectively to evaluate associations between posture and neck or shoulder (N/S) and hand or arm (H/A) musculoskeletal symptoms and musculoskeletal disorders. Participants' postures were measured at entry and they reported symptoms on weekly diaries. Participants reporting symptoms were examined for specific disorders. Multivariate Cox regression models were used to estimate associations between postural variables and risk of symptoms and disorders, controlling for confounding variables. Results Keying with an inner elbow angle,>,121°, greater downward head tilt, and presence of armrests on the participants chair were associated with lower risk of N/S symptoms or N/S disorders. Keying with elbow height below the height of the "J" key and the presence of a telephone shoulder rest were associated with a greater risk of N/S symptoms or N/S disorders. Horizontal location of the "J" key,>,12 cm from the edge of the desk was associated with a lower risk of H/A symptoms and H/A disorders. Use of a keyboard with the "J" key,>,3.5 cm above the table surface, key activation force,>,48 g, and radial wrist deviation of >,5° while using a mouse was associated with a greater risk of H/A symptoms or H/A disorders. The number of hours keying/week was associated with H/A symptoms and disorders. Conclusions The results suggest that the risk of musculoskeletal symptoms and musculoskeletal disorders may be reduced by encouraging specific seated postures. Am. J. Ind. Med. 41:236,249, 2002. © 2002 Wiley-Liss, Inc. [source] Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002,2003PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2005NORITO KAWAKAMI md Abstract, To estimate the prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) mental disorders in community populations in Japan, face-to-face household surveys were conducted in four community populations in Japan. A total of 1663 community adults responded (overall response rate, 56%). The DSM-IV disorders, severity, and treatment were assessed with the World Mental Health version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered psychiatric diagnostic interview. The prevalence of any WMH-CIDI/DSM-IV disorder in the prior year was 8.8%, of which 17% of cases were severe and 47% were moderate. Among specific disorders, major depression (2.9%), specific phobia (2.7%), and alcohol abuse/dependence (2.0%) were the most prevalent. Although disorder severity was correlated with probability of treatment, only 19% of the serious or moderate cases received medical treatment in the 12 months before the interview. Older and not currently married individuals had a greater risk of having more severe DSM-IV disorders if they had experienced any within the previous 12 months. Those who had completed high school or some college were more likely to seek medical treatment than those who had completed college. The study confirmed that the prevalence of DSM-IV mental disorders was equal to that observed in Asian countries but lower than that in Western countries. The percentage of those receiving medical treatment was low even for those who suffered severe or moderate disorders. Possible strategies are discussed. [source] Child and adolescent mental disorders: the magnitude of the problem across the globeTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 3 2008Myron L. Belfer Objective:, Describe objectively the global gaps in policy, data gathering capacity, and resources to develop and implement services to support child mental health. Methods:, Report on the World health Organization (WHO) child and adolescent mental health resources Atlas project. The Atlas project utilized key informants and was supplemented by studies that focused on policy. This report also draws on current epidemiological studies to provide a context for understanding the magnitude of the clinical problem. Results:, Current global epidemiological data consistently reports that up to 20% of children and adolescents suffer from a disabling mental illness; that suicide is the third leading cause of death among adolescents; and that up to 50% of all adult mental disorders have their onset in adolescence. While epidemiological data appears relatively uniform globally, the same is not true for policy and resources for care. The gaps in resources for child mental health can be categorized as follows: economic, manpower, training, services and policy. Key findings from the Atlas project include: lack of program development in low income countries; lack of any policy in low income countries and absent specific comprehensive policy in both low and high income countries; lack of data gathering capacity including that for country-level epidemiology and services outcomes; failure to provide social services in low income countries; lack of a continuum of care; and universal barriers to access. Further, the Atlas findings underscored the need for a critical analysis of the ,burden of disease' as it relates to the context of child and adolescent mental disorders, and the importance of defining the degree of ,impairment' of specific disorders in different cultures. Conclusions:, The recent finding of substantial gaps in resources for child mental health underscores the need for enhanced data gathering, refinement of the economic argument for care, and need for innovative training approaches. [source] | |||||||||||||