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BackgroundPredictD is a risk algorithm that was developed to predict risk of onset of major depression over 12 months in general practice attendees in Europe and validated in a similar population in Chile. It was the first risk algorithm to be developed in the field of mental disorders. Our objective was to extend predictD as an algorithm to detect people at risk of major depression over 24 months.MethodParticipants were 4190 adult attendees to general practices in the UK, Spain, Slovenia and Portugal, who were not depressed at baseline and were followed up for 24 months. The original predictD risk algorithm for onset of DSM-IV major depression had already been developed in data arising from the first 12 months of follow-up. In this analysis we fitted predictD to the longer period of follow-up, first by examining only the second year (12–24 months) and then the whole period of follow-up (0–24 months).ResultsThe instrument performed well for prediction of major depression from 12 to 24 months [c-index 0.728, 95% confidence interval (CI) 0.675–0.781], or over the whole 24 months (c-index 0.783, 95% CI 0.757–0.809).ConclusionsThe predictD risk algorithm for major depression is accurate over 24 months, extending it current use of prediction over 12 months. This strengthens its use in prevention efforts in general medical settings. [ABSTRACT FROM AUTHOR]

BackgroundThere are no risk models for the prediction of anxiety that may help in prevention. We aimed to develop a risk algorithm for the onset of generalized anxiety and panic syndromes.MethodFamily practice attendees were recruited between April 2003 and February 2005 and followed over 24 months in the UK, Spain, Portugal and Slovenia (Europe4 countries) and over 6 months in The Netherlands, Estonia and Chile. Our main outcome was generalized anxiety and panic syndromes as measured by the Patient Health Questionnaire. We entered 38 variables into a risk model using stepwise logistic regression in Europe4 data, corrected for over-fitting and tested it in The Netherlands, Estonia and Chile.ResultsThere were 4905 attendees in Europe4, 1094 in Estonia, 1221 in The Netherlands and 2825 in Chile. In the algorithm four variables were fixed characteristics (sex, age, lifetime depression screen, family history of psychological difficulties); three current status (Short Form 12 physical health subscale and mental health subscale scores, and unsupported difficulties in paid and/or unpaid work); one concerned country; and one time of follow-up. The overall C-index in Europe4 was 0.752 [95% confidence interval (CI) 0.724–0.780]. The effect size for difference in predicted log odds between developing and not developing anxiety was 0.972 (95% CI 0.837–1.107). The validation of predictA resulted in C-indices of 0.731 (95% CI 0.654–0.809) in Estonia, 0.811 (95% CI 0.736–0.886) in The Netherlands and 0.707 (95% CI 0.671–0.742) in Chile.ConclusionsPredictA accurately predicts the risk of anxiety syndromes. The algorithm is strikingly similar to the predictD algorithm for major depression, suggesting considerable overlap in the concepts of anxiety and depression. [ABSTRACT FROM PUBLISHER]

Objectives: 1. To find the scientific output on communication and health both in Spain and internationally. 2. To compare the two outputs according to the type of articles published and the design of the research., Design: Descriptive and bibliometric study., Material: The data bases MEDLINE (1995-2000) and IME (1990-2000) and the books summarising papers from semFYC Congresses (1995-2000) were used., Measurements: The number of articles on MEDLINE published and indexed with the description <>, plus a series of subject describers that could be included under the heading <>, were counted. On the IME and in the semFYC congress summaries the describers <> were used. The articles indexed on MEDLINE-IME were compared for their classification as original articles, clinical practice guidelines, review, editorial or letter to the editor. Original articles were classified in randomised and non-randomised trials, meta-analysis and observation studies., Main Results: 6766 articles were found on MEDLINE, 42 on the IME (0.046% of the total indexed) and 34 summaries from semFYC congresses (1.47% of the total). Among the most commonly studied questions were found patients' information and education, professional stress and psychological interviews; among the least studied were difficult and aggressive patients, negotiation and people accompanying patients. The original articles on MEDLINE and IME were 70% and 37%; and review articles, 11% and 44%. 1.4% of MEDLINE articles were randomised trials; and 0.08%, meta-analysis., Conclusions: Communication and health research is a young field that still requires descriptive studies. There is little scientific output in this area in Spain, with few original papers and too many reviews.

Objective: The aim of this study is to analyse the validity and reliability of the Apgar family questionnaire on family function., Design: A crossover and descriptive study., Setting: Urban health centre., Patients: 656 patients of the Zaidín-Sur health centre in Granada were interviewed at home. The questionnaire was repeated an average of 6 days later to 60 of the patients (30 with an interviewer and 30 filling in their own)., Measurements and Main Results: The within-class correlation coefficients for the 5 items in the Apgar-family we over 0.55, both for self-filled and interviewer questionnaires; the scale coefficients were 0.86 and 0.81, respectively. Item-scale correlation varied between 0.61 and 0.71. Crombach's alpha was 0.84 and none of the items, when taken out of the scale, increased the alpha. The factorial analysis isolated only one factor. 16% of the sample had dysfunctional Apgar-family: the average score was 8.4. After adjustment (multiple logistic regression), the following were significantly linked to family dysfunction: lack of social support; being widowed or separated/divorced; greater perception of susceptibility to, or seriousness of, illness; being an over-user of the health service; and being a woman., Conclusions: The Apgar-family questionnaire on family function is valid and reliable.

Objective: We set out to analyse factors which might affect the completion of the "static" register in the Primary Care clinical notes., Design: Crossover and observation study with a control of the confusion in data analysis., Setting: Albaycín Health Centre (Granada)., Patients and Other Participants: A random sample of 428 sets of Primary Care clinical notes., Measurements and Main Results: The "static" register showed over 50% observance in the sections on case history, allergies, tobacco and alcohol; whereas in housing (42%) and diet and physical activity (25%), the observance diminished until reaching its lowest level in counter-indicated medicines, anti-tetanus vaccination, a vaccine biography and family notes (< 10%). Age and gender variables showed virtually no association with the completion of the register. The static register was significantly better for husbands/wives as against children, for patients included in health programmes, for those included in adult rather than other types of programme, for those with smaller-sized families, for patients who used the Centre more and also for three of the doctors as against a fourth. Finally we constructed an overall indicator of the static register (OISR) which was submitted to a process of internal validation and was object of a multiple linear regression model which explained 51.3% of the variability., Conclusions: We underline the need to go deeper into those factors affecting the register as a first step towards understanding its completion. In this way we will find criteria for improving it or modifying the organisation of its observance and/or format. We discussed a method of overall indicators for tackling such a problematic.