PurposeTo systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.MethodMedline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxie

http://www.medical-mastermind-community.com/uploads/63-Systematic_Review_of_Depression_Anxiety_and.9.pdf

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

Investigated agreement between mothers, fathers, teachers, and children on equivalent forms of a standardized measure of behavioral and emotional problems. Ninety-eight children, age 13 years, completed the Youth Self-Report (Achenbach, 1991d). Their mothers and fathers completed the Child Behavior Checklist (Achenbach, 1991b), and their teachers completed the Teacher Report Form (Achenbach, 1991c). Children generally reported the most problems and teachers the least. Agreement was highest between mothers and fathers on internalizing and externalizing problems, and lowest for rater pairs involving teachers on internalizing problems. Analyses of a multitrait-multimethod matrix for ratings of internalizing and externalizing problems indicated good convergent validity, large rater effects, and weaker discriminant validity. Conditional probabilities for agreement on deviant and nondeviant scores indicated that ratings by no informant could substitute for those of any other rater. Teacher ratings of externaliz...

Agreement Among Parents, Teachers, and Children on Internalizing and Externalizing Behavior Problems

https://jnnp.bmj.com/content/jnnp/37/11/1290.3.full.pdf

Wechsler's measurement and appraisal of adult intelligence

Background: Opioids are commonly used for preoperative pain management in patients undergoing spine surgery. The objective of this investigation was to assess whether preoperative opioid use predicts worse self-reported outcomes in patients undergoing spine surgery.

Methods: Five hundred and eighty-three patients undergoing lumbar, thoracolumbar, or cervical spine surgery to treat a structural lesion were included in this prospective cohort study. Self-reported preoperative opioid consumption data were obtained at the preoperative visit and were converted to the corresponding daily morphine equivalent amount. Patient-reported outcome measures were assessed at three and twelve months postoperatively via the 12-Item Short-Form Health Survey and the EuroQol-5D questionnaire, as well as, when appropriate, the Oswestry Disability Index and the Neck Disability Index. Separate multivariable linear regression analyses were then performed.

Results: At the preoperative evaluation, of the 583 patients, 56% (326 patients) reported some degree of opioid use. Multivariable analyses controlling for age, sex, diabetes, smoking, surgery invasiveness, revision surgery, preoperative Modified Somatic Perception Questionnaire score, preoperative Zung Depression Scale score, and baseline outcome score found that increased preoperative opioid use was a significant predictor (p < 0.05) of decreased 12-Item Short-Form Health Survey and EuroQol-5D scores, as well as of increased Oswestry Disability Index and Neck Disability Index scores at three and twelve months postoperatively. Every 10-mg increase in daily morphine equivalent amount taken preoperatively was associated with a 0.03 decrease in the 12-Item Short-Form Health Survey physical component summary and mental component summary scores, a 0.01 decrease in the EuroQol-5D score, and a 0.5 increase in the Oswestry Disability Index and Neck Disability Index score at twelve months postoperatively. Higher preoperative Modified Somatic Perception Questionnaire and Zung Depression Scale scores were also significant negative predictors (p < 0.05).

Conclusions: Increased preoperative opioid consumption, Modified Somatic Perception Questionnaire score, and Zung Depression Scale score prior to undergoing spine surgery predicted worse patient-reported outcomes. This suggests the potential benefit of psychological and opioid screening with a multidisciplinary approach that includes weaning of opioid use in the preoperative period and close opioid monitoring postoperatively.

Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Preoperative Opioid Use as a Predictor of Adverse Postoperative Self-Reported Outcomes in Patients Undergoing Spine Surgery.

This study investigated whether parent-adolescent disagreement regarding adolescents' behavioral and emotional problems predicted adverse outcome. A Dutch sample of 15- to 18-year-olds was prospectively followed across a 4-year interval. The Child Behavior Checklist (CBCL: T. M. Achenbach, 1997) and Youth Self-Report (YSR; T. M. Achenbach, 1991b) were administered at initial assessment, and the following signs of poor outcome were assessed 4 years later: police/judicial contacts, expulsion from school/job, suicidal ideation, unwanted pregnancy, suicide attempts, deliberate self-harm, referral to mental health services, report of having a behavioral or emotional problem, and feeling the need for professional help without actually receiving help. Twenty CBCL syndrome scores, 23 YSR syndrome scores, and 16 discrepancy scores were significant predictors of poor outcome. It was concluded that to determine the prognosis of psychopathology in adolescents, discrepancies between informants may be important.

Parent-adolescent disagreement regarding psychopathology in adolescents from the general population as a risk factor for adverse outcome.

This study examined the concurrent validity of the Zung Self-Rating Depression Scale (SDS) in relation to the Depression (D) scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and addressed a gap in the literature with respect to diagnostic discrimination. The participants were persons on probation or parole. Although women were more depressed than men on the SDS, gender did not interact with SDS as a predictor in a logistic regression analysis. The SDS was found to be the primary discriminating variable in distinguishing depressed from nondepressed participants. In addition, the SDS contributed significant incremental validity over the D scale and showed greater accuracy in identifying nondepressed individuals.

The Zung Self-Rating Depression Scale: convergent validity and diagnostic discrimination.

Studied hospitalized adolescent girls (mean age 15.7 years) and their maternal caregivers to ascertain the extent of correspondence between child and adult informant ratings of depression, delinquency, and aggression, using narrow-band subscales of the Youth Self-Report and Child Behavior Checklist. Modest evidence for convergent validity was found together with low discriminant validity and elevated method (rater) variance. Mothers also perceived higher levels of symptom severity than their daughters. Several alternative explanations for these findings were discussed. The findings were consistent with previous studies in which sex of participants was not a consideration.

Assessment of Adolescent Psychopathology: Comparison of Mother and Daughter Perspectives

(1980). Signs May Prompt Antisocial Behavior. The Journal of Social Psychology: Vol. 112, No. 2, pp. 309-310.

Signs may prompt antisocial behavior.

Item content of the Michigan Alcoholism Screening Test (MAST) was modified to make it more appropriate for young persons The resulting test was found to have lower internal consistency than the adult MAST, but the elimination of five items with comparatively poor psychometric properties yielded an acceptable alpha coefficient of 73 A unitary factor model for the adolescent MAST was not confirmed; indeed, the revised test appeared to be factorially complex Recommendations for further revisions are discussed

An adolescent version of the Michigan Alcoholism Screening Test.

A cognitive imbalance, in which intellectual functioning is elevated in the performance area in comparison to verbal IQ, has been posited as an antecedent condition in relation to antisocial behaviors. The current investigation was based on the notion of a developmental arrest in which verbal, analytical, controlling brain processes (analogous to verbal IQ) fail to develop commensurately with the more impulsive actions mediated by the motor areas of the cerebral cortex (analogous to performance IQ). The simple verbal IQ performance IQ discrepancy index used in prior studies was reformulated as a causal theoretical model consisting of shared and unique performance IQ variance. The participants were 325 adults including 141 prison inmates. They were administered the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Psychopathic Deviate (Pd) and Mania (Ma) scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). These were the manifest (measured) variables in the model tested by means of structural equation modeling procedures. Several statistical indices suggested an excellent model-data congruence.

Mark Snow

Papers

The Zung Self-Rating Depression Scale: convergent validity and diagnostic discrimination.

Assessment of Adolescent Psychopathology: Comparison of Mother and Daughter Perspectives

Signs may prompt antisocial behavior.

An adolescent version of the Michigan Alcoholism Screening Test.

Cognitive imbalance and antisocial personality characteristics