Search

Objectives: Differentiating schizophrenia from mania in acutely psychotic patients can be difficult, but is important in determining immediate and subsequent management. Such differentiation is generally addressed by clinical interviews, but an observational approach may assist. This paper therefore describes the development of a relevant observational measure. Methods: We developed a provisional list of 49 items (weighting features with suggested specificity to schizophrenia and mania) for independent completion by two nurses and judged its ability to predict diagnosis provided by consultant psychiatrists. Results: Eighty-seven psychotic patients were recruited, and 173 completed data sets were analysed. We refined the item set to two sets of 10 items that best-differentiated schizophrenia from mania and vice versa. Optimal differentiation was achieved with a score of at least 7 on both the schizophrenia and mania item sets. Difference scores (i.e. schizophrenia items affirmed minus mania items affirmed) were also generated, with a difference score of +1 (i.e. one or more schizophrenia items being affirmed than mania items) showing optimal differentiation (sensitivity 0.67, specificity 0.82) between the two conditions. Evaluating all potential difference scores, we demonstrated that, as difference scores increased, diagnostic accuracy in identifying each condition was very high. Conclusion: Analyses allow the properties of an observational measure (the 20-item Sydney Psychosis Observation Tool) to be described. While a single cut-off difference score was derived with acceptable discriminatory ability, we also established the capacity of varying difference scores to assign both schizophrenia and mania diagnoses with high accuracy. [ABSTRACT FROM AUTHOR]

Objectives: Anorexia nervosa is a severe psychiatric disorder with high mortality rates. While its aetiology is poorly understood, there is evidence of a significant genetic component. The Anorexia Nervosa Genetics Initiative is an international collaboration which aims to understand the genetic basis of the disorder. This paper describes the recruitment and characteristics of the Australasian Anorexia Nervosa Genetics Initiative sample, the largest sample of individuals with anorexia nervosa ever assembled across Australia and New Zealand. Methods: Participants completed an online questionnaire based on the Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) eating disorders section. Participants who met specified case criteria for lifetime anorexia nervosa were requested to provide a DNA sample for genetic analysis. Results: Overall, the study recruited 3414 Australians and 543 New Zealanders meeting the lifetime anorexia nervosa case criteria by using a variety of conventional and social media recruitment methods. At the time of questionnaire completion, 28% had a body mass index ⩽ 18.5 kg/m2. Fasting and exercise were the most commonly employed methods of weight control, and were associated with the youngest reported ages of onset. At the time of the study, 32% of participants meeting lifetime anorexia nervosa case criteria were under the care of a medical practitioner; those with current body mass index < 18.5 kg/m2 were more likely to be currently receiving medical care (56%) than those with current body mass index ⩾ 18.5 kg/m2 (23%). Professional treatment for eating disorders was most likely to have been received from general practitioners (45% of study participants), dietitians (42%) and outpatient programmes (42%). Conclusions: This study was effective in assembling the largest community sample of people with lifetime anorexia nervosa in Australia and New Zealand to date. The proportion of people with anorexia nervosa currently receiving medical care, and the most common sources of treatment accessed, indicates the importance of training for general practitioners and dietitians in treating anorexia nervosa. [ABSTRACT FROM AUTHOR]

Objective: Self-efficacy can be conceptualised as a person’s perception of their own ability to produce a desired outcome. Low self-efficacy has been reported to be a mediating variable in developing depression. The Self-Efficacy Questionnaire for Depressed Adolescents (SEQ-DA) is a 12-item inventory, designed to measure self-perceived ability of the young person to cope with depressive symptoms. This paper presents further information on the psychometric properties of the SEQ-DA in a clinical sample of depressed adolescents.Method: The SEQ-DA was administered to a clinical sample of 130 adolescents with a depressive disorder at baseline, at the end of 3 months of therapy and 6 months following therapy. A diagnosis of depression was made using the Schedule for Affective Disorders and Schizophrenia for School Aged Children. The ability of the SEQ-DA to identify those adolescents who had a diagnosis of major depressive disorder at baseline, following treatment and at 6-month follow-up was evaluated. Receiver operating characteristic (ROC) analysis of the SEQ-DA in this clinical sample of depressed adolescents was undertaken to establish cut-off scores of the SEQ-DA.Results: The SEQ-DA score at baseline of < 36 and following treatment of < 43 were predictive of a depressive disorder.Conclusions: The SEQ-DA is a very simple self-report measure that can be used to predict which adolescents treated for depression are likely to remain depressed, thus prompting more intensive treatment and follow-up. [ABSTRACT FROM PUBLISHER]