The detection of psychiatric illness by questionnaire

Background— In 1994, an International Task Force proposed criteria for the clinical diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) that facilitated recognition and ...

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Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia Proposed Modification of the Task Force Criteria

Sponsors asked the IOM's Food and Nutrition Board and the Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families to review and update the IOM (1990) recommendations for weight gain during pregnancy and recommend ways to encourage their adoption through consumer education, strategies to assist practitioners, and public health strategies.The committee was asked to address the following tasks: 1. Review evidence on the relationship between weight gain patterns before, during, and after pregnancy and maternal and child health outcomes, with particular attention to the prevalence of maternal obesity racial/ethnic and age differences, components of GWG, and implications of weight during pregnancy on postpartum weight retention, maternal and child obesity, and later child health. 2. Within a life-stage framework consider factors in relation to GWG that are associated with maternal health outcomes such as lactation performance, postpartum weight retention, cardiovascular disease, metabolic processes including glucose and insulin-related issues, and risk of other chronic diseases; for infants and children, in addition to low birth weight, consider early developmental impacts and obesity-related consequences (e.g., mental health, diabetes). 3. Recommend revisions to the existing guidelines, where necessary, including the need for specific pregnancy weight guidelines for underweight, normal weight, and overweight and obese women and adolescents and women carrying twins or higher-order multiples. 4. Consider a range of approaches to promote appropriate weight gain, including: individual (behavior), psychosocial, community, health care, and health systems; timing and components of interventions; and ways to enhance awareness and adoption of the guidelines, including interdisciplinary approaches, consumer education to men and women, strategies to assist practitioners to use the guidelines, and public health strategies. 5. Identify gaps in knowledge and recommend research priorities.

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Weight Gain During Pregnancy: Reexamining the Guidelines

Context Maternal depressive symptoms during pregnancy have been reported in some, but not all, studies to be associated with an increased risk of preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR). Objective To estimate the risk of PTB, LBW, and IUGR associated with antenatal depression. Data Sources and Study Selection We searched for English-language and non–English-language articles via the MEDLINE, PsycINFO, CINAHL, Social Work Abstracts, Social Services Abstracts, and Dissertation Abstracts International databases (January 1980 through December 2009). We aimed to include prospective studies reporting data on antenatal depression and at least 1 adverse birth outcome: PTB ( Data Extraction Information was extracted on study characteristics, antenatal depression measurement, and other biopsychosocial risk factors and was reviewed twice to minimize error. Data Synthesis Pooled relative risks (RRs) for the effect of antenatal depression on each birth outcome were calculated using random-effects methods. In studies of PTB, LBW, and IUGR that used a categorical depression measure, pooled effect sizes were significantly larger (pooled RR [95% confidence interval] = 1.39 [1.19-1.61], 1.49 [1.25-1.77], and 1.45 [1.05-2.02], respectively) compared with studies that used a continuous depression measure (1.03 [1.00-1.06], 1.04 [0.99-1.09], and 1.02 [1.00-1.04], respectively). The estimates of risk for categorically defined antenatal depression and PTB and LBW remained significant when the trim-and-fill procedure was used to correct for publication bias. The risk of LBW associated with antenatal depression was significantly larger in developing countries (RR = 2.05; 95% confidence interval, 1.43-2.93) compared with the United States (RR = 1.10; 95% confidence interval, 1.01-1.21) or European social democracies (RR = 1.16; 95% confidence interval, 0.92-1.47). Categorically defined antenatal depression tended to be associated with an increased risk of PTB among women of lower socioeconomic status in the United States. Conclusions Women with depression during pregnancy are at increased risk for PTB and LBW, although the magnitude of the effect varies as a function of depression measurement, country location, and US socioeconomic status. An important implication of these findings is that antenatal depression should be identified through universal screening and treated.

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A Meta-analysis of Depression During Pregnancy and the Risk of Preterm Birth, Low Birth Weight, and Intrauterine Growth Restriction

Background In 1994, an International Task Force proposed criteria for the clinical diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) that facilitated recognition and interpretation of the frequently nonspecific clinical features of ARVC/D. This enabled confirmatory clinical diagnosis in index cases through exclusion of phenocopies and provided a standard on which clinical research and genetic studies could be based. Structural, histological, electrocardiographic, arrhythmic, and familial features of the disease were incorporated into the criteria, subdivided into major and minor categories according to the specificity of their association with ARVC/D. At that time, clinical experience with ARVC/D was dominated by symptomatic index cases and sudden cardiac death victims–the overt or severe end of the disease spectrum. Consequently, the 1994 criteria were highly specific but lacked sensitivity for early and familial disease.

Methods and Results Revision of the diagnostic criteria provides guidance on the role of emerging diagnostic modalities and advances in the genetics of ARVC/D. The criteria have been modified to incorporate new knowledge and technology to improve diagnostic sensitivity, but with the important requisite of maintaining diagnostic specificity. The approach of classifying structural, histological, electrocardiographic, arrhythmic, and genetic features of the disease as major and minor criteria has been maintained. In this modification of the Task Force criteria, quantitative criteria are proposed and abnormalities are defined on the basis of comparison with normal subject data.

Conclusions The present modifications of the Task Force Criteria represent a working framework to improve the diagnosis and management of this condition.

Clinical Trial Registration clinicaltrials.gov Identifier: NCT00024505.

https://rarediseases.info.nih.gov/files/abstractarvdcspecial%20report.pdf

Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia

Objectives: To evaluate: (1) the associations between maternal psychological stress, distress and low birth weight (LBW), prematurity and intrauterine growth retardation (IUGR); (2) the interactions between maternal stress, distress and smoking, alcohol and coffee intake; (3) the prevalences of stress and distress in pregnancy. Design: Longitudinal cohort study. Setting: Jundiai city, Sao Paulo state, Brazil. Subjects: A total of 865 pregnant women who attended antenatal care between September 1997 and August 2000. Methods: Measures of stress and distress were obtained, by interview, three times in pregnancy: at a gestational age (GA) lower than 16 weeks, from 20 to 26 weeks and from 30 to 36 weeks. Stress was investigated by the perceived stress scale, PSS, and distress by both the general health questionnaire, GHQ, and the State Trait Anxiety inventories, STAI. The outcomes were: LBW (birth weight <2500 g), prematurity (gestational age (GA) at birth <37 weeks) and IUGR (birth weight for GA ≤10th percentile of William's curve). The associations between the outcomes and the psychological measures were assessed in multiple logistic regression models. Results: Maternal distress was associated with LBW (RR=1.97, P=0.019) and prematurity (RR=2.32, P=0.015), respectively. There was an interaction between distress and smoking in the second interview (P=0.05). The prevalences of stress and distress in the different interviews of pregnancy varied from 22.1 to 52.9%. Conclusions: The present study has confirmed that distress is associated with both birthweight and GA. Further research is needed to evaluate the effectiveness of psychological interventions that can improve maternal and foetal well-being. Sponsorship: Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESP (grant no. 1998/00321-0).

Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation.

The psychometric properties of the Portuguese version of the Beck Depression Inventory were studied on a large Brazilian college student sample (N = 1,080; 845 women, 235 men). The BDI scores according to sociodemographic characteristics and mean individual item scores for total sample and by gender were compared. BDI scores tend to be higher for women, for those who work, and for the younger participants. The reliability of the inventory estimated by alpha coefficient was high for the total sample (.86) and subgroups. Factor analysis showed three factors for the total sample (low self-esteem, cognitive-affective, and somatic) and two for each gender. Women combined affective and low self-esteem whereas men combined somatic and low self-esteem in the same dimension. Discriminant analysis showed that BDI highly discriminates depressive symptomatology in college students and measures specific aspects of depression. © 1999 John Wiley & Sons, Inc. J Clin Psychol 55: 553–562, 1999.

Psychometric properties of the Portuguese version of the Beck Depression Inventory on Brazilian college students.

The psychometric properties of the Portuguese version of the trait form of the State-Trait Anxiety Inventory (STAI-T) and its relation to the Beck Depression Inventory (BDI) were evaluated in a large Brazilian college student sample containing 845 women and 235 men. STAI-T scores tended to be higher for women, singles, those who work, and subjects under 30 years. Factor analysis of the STAI-T for total sample and by gender yielded two factors: the first representing a mood dimension and the second being related to worrying or cognitive aspects of anxiety. In order to study the relation between anxiety and depression measures, factor analysis of the combination of the 21 BDI items and the 20 STAI-T items was also carried out. The analysis resulted in two factors that were analyzed according to the tripartite model of anxiety and depression. Most of the BDI items (measuring positive affectivity and nonspecific symptoms of depression) were loaded on the first factor and four STAI-T items that measure positive affectivity. The remaining STAI-T items, all of them measuring negative affect, remained in the second factor. Thus, factor 1 represents a depression dimension and factor 2 measures a moodworrying dimension. The findings of this study suggest that, although widely used as an anxiety scale, the STAI-T in fact measures mainly a general negative affect.

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Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory

Pathological Gambling is an impulse control disorder. Impulsivity has been investigated separately by neuropsychological tests and self-report scales. Although some studies have tried to correlate these approaches, their interaction has not been sufficiently explored among pathological gamblers (PG). In this study, we have compared 214 PG (162 with comorbidity and 52 with no comorbidity) to 82 healthy volunteers regarding the reaction time and number of errors at Go/No-go tasks, and scores on the Barratt Impulsiveness Scale (BIS). PG have committed more errors at the Go/No-go tasks and presented higher scores on the self-report scale. The neuropsychological tests and BIS composed a multinomial logistic model that discriminated PG from non-gamblers better than models having one or another type of measure. Impulsivity seems to be a multi-dimensional phenomenon, and PG a heterogeneous population in which different types of impulsivity are present. ( JINS , 2006, 12 , 907–912.)

Self-reported and neuropsychological measures of impulsivity in pathological gambling.

The phenology of six tree species was studied from October 1993 to October 1996, in a forest fragment (10 ha) located in the metropolitan region of Sao Paulo City (aproximately 46o43'W and 23o33'S; 750 m of mean altitude). Individuals of Alchornea sidifolia, Cecropia glaziouii, Cedrela fissilis, Cordia ecalyculata, Croton floribundus and Cupania oblongifolia were observed about the time of occurrence of flowering, fruiting, leaf fall, and flushing. Descriptive circular analysis was carried out for the time of occurrence, as well as multiple correlation coeficients were determined in order to investigate the relationship between temperature and rainfall and phenological events. The strongest relationship was found between the fruiting season and climate for C. ecalyculata, followed by C. floribundus. The factors related to the time of occurrence, duration, periodicity and sincrony of the phenological events are discussed.

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Rinaldo Artes

Papers

Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation.

Psychometric properties of the Portuguese version of the Beck Depression Inventory on Brazilian college students.

Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory

Self-reported and neuropsychological measures of impulsivity in pathological gambling.

Fenologia de árvores em fragmento de mata em São Paulo, SP