19 results on '"de Azevedo Marques JM"'
Search Results
2. Machine learning-based risk prediction for major adverse cardiovascular events in a Brazilian hospital: Development, external validation, and interpretability.
- Author
-
Shimizu GY, Schrempf M, Romão EA, Jauk S, Kramer D, Rainer PP, Cardeal da Costa JA, de Azevedo-Marques JM, Scarpelini S, Suzuki KMF, César HV, and de Azevedo-Marques PM
- Subjects
- Humans, Brazil epidemiology, Female, Male, Middle Aged, Retrospective Studies, Risk Assessment methods, Aged, Algorithms, Hospitals, Risk Factors, Reproducibility of Results, Machine Learning, Cardiovascular Diseases epidemiology
- Abstract
Background: Studies of cardiovascular disease risk prediction by machine learning algorithms often do not assess their ability to generalize to other populations and few of them include an analysis of the interpretability of individual predictions. This manuscript addresses the development and validation, both internal and external, of predictive models for the assessment of risks of major adverse cardiovascular events (MACE). Global and local interpretability analyses of predictions were conducted towards improving MACE's model reliability and tailoring preventive interventions., Methods: The models were trained and validated on a retrospective cohort with the use of data from Ribeirão Preto Medical School (RPMS), University of São Paulo, Brazil. Data from Beth Israel Deaconess Medical Center (BIDMC), USA, were used for external validation. A balanced sample of 6,000 MACE cases and 6,000 non-MACE cases from RPMS was created for training and internal validation and an additional one of 8,000 MACE cases and 8,000 non-MACE cases from BIDMC was employed for external validation. Eight machine learning algorithms, namely Penalized Logistic Regression, Random Forest, XGBoost, Decision Tree, Support Vector Machine, k-Nearest Neighbors, Naive Bayes, and Multi-Layer Perceptron were trained to predict a 5-year risk of major adverse cardiovascular events and their predictive performance was evaluated regarding accuracy, ROC curve (receiver operating characteristic), and AUC (area under the ROC curve). LIME and Shapley values were applied towards insights about model interpretability., Findings: Random Forest showed the best predictive performance in both internal validation (AUC = 0.871 (0.859-0.882); Accuracy = 0.794 (0.782-0.808)) and external one (AUC = 0.786 (0.778-0.792); Accuracy = 0.710 (0.704-0.717)). Compared to LIME, Shapley values suggest more consistent explanations on exploratory analysis and importance of features., Conclusions: Among the machine learning algorithms evaluated, Random Forest showed the best generalization ability, both internally and externally. Shapley values for local interpretability were more informative than LIME ones, which is in line with our exploratory analysis and global interpretation of the final model. Machine learning algorithms with good generalization and accompanied by interpretability analyses are recommended for assessments of individual risks of cardiovascular diseases and development of personalized preventive actions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Shimizu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...
- Published
- 2024
- Full Text
- View/download PDF
Catalog
3. INTERMED's reliability to assess health complexity in primary care: A Brazilian cross-section study.
- Author
-
de Oliveira CA, Weber B, de Camargo LL, Balco EM, Barros MA, Zanetti ACG, Lobo E, Rzewuska M, and de Azevedo-Marques JM
- Subjects
- Humans, Brazil, Reproducibility of Results, Surveys and Questionnaires, Cross-Sectional Studies, Psychometrics, Primary Health Care
- Published
- 2023
- Full Text
- View/download PDF
4. Excess mortality in a cohort of Brazilian patients with a median follow-up of 11 years after the first psychiatric hospital admission.
- Author
-
da Roza DL, de Rezende MG, Barros REM, de Azevedo-Marques JM, Santos JLF, Morais LCC, Ferreira CEC, Waldvogel BC, Menezes PR, and Del-Ben CM
- Subjects
- Infant, Newborn, Humans, Male, Female, Brazil epidemiology, Follow-Up Studies, Risk Factors, Cause of Death, Hospitals, Psychiatric, Substance-Related Disorders
- Abstract
Purpose: To estimate the mortality rates of a cohort of Brazilian patients after their first psychiatric admission and determine the possible risk factors associated with excess mortality., Methods: The study included a cohort of psychiatric patients hospitalised from Jan 1, 2002 to Dec 31, 2007 in the catchment area of Ribeirão Preto, São Paulo state, Brazil. Data were linked to deaths that occurred between Jan 1, 2002 and Dec 31, 2016 from the SEADE Foundation (state data analysis system of São Paulo). The mortality rate (MR), age-sex-standardised mortality ratio (SMR), life expectancy at birth, and years of life lost (YLL) were computed. The factors associated with mortality were analysed by survival analysis using a Cox proportional hazards regression model., Results: Of 4019 patients admitted (54.76% male), 803 died (69.74% male) during the follow-up (median = 11.25 years). Mortality rates were approximately three-fold higher than expected (SMR = 2.90, 95% CI 2.71-3.11). The highest mortality rate was noted in men with alcohol-related disorders (SMR = 5.50, 95% CI 4.87-6.19). Male sex (adjusted hazard ratio (aHR) = 1.62, 95% CI 1.37-1.92), higher age (aHR = 21.47, 95% CI 13.48-34.17), and unemployment (aHR = 1.22, 95% CI 1.05-1.43) significantly increased the mortality risk from all causes. The average YLL was 27.64 years with the highest YLL noted in nonalcohol substance-related disorders (39.22 years). The life expectancy at birth in this cohort was 47.27 years. Unnatural causes of death were associated with nonwhite skin colour and substance-related disorders., Conclusion: An excess of mortality and a significant reduction in life expectancy of mentally disordered patients who were first admitted to psychiatric beds was noted, particularly patients admitted for substance-related disorders, which should represent a priority in mental health policies., (© 2022. The Author(s).) more...
- Published
- 2023
- Full Text
- View/download PDF
5. Health complexity assessment in primary care: A validity and feasibility study of the INTERMED tool.
- Author
-
Oliveira CA, Weber B, Dos Santos JLF, Zucoloto ML, de Camargo LL, Zanetti ACG, Rzewuska M, and de Azevedo-Marques JM
- Subjects
- Adult, Algorithms, Data Collection methods, Humans, Needs Assessment, Health Status Indicators, Primary Health Care standards
- Abstract
Background: Health complexity includes biological, psychological, social, and health systems. Having complex health needs is associated with poorer clinical outcomes and higher healthcare costs. Care management for people with health complexity is increasingly recommended in primary health care (PHC). The INTERMED complexity assessment grid showed adequate psychometric properties in specialized settings. This study aimed to evaluate INTERMED's validity and feasibility to assess health complexity in an adult PHC population., Method: The biopsychosocial health care needs of 230 consecutive adult patients from three Brazilian PHC services were assessed using the INTERMED interview. Participants with a total score >20 were classified as "complex". Quality of life was measured using the World Health Organization Quality of Life BREF (WHOQOL-BREF); symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); social support using the Medical Outcomes Study-Social Support Survey (MOS-SSS); comorbidity levels using the Charlson Comorbidity Index (CCI). We developed two questionnaires to evaluate health services use, and patient perceived feasibility of INTERMED., Results: 42 participants (18.3%) were classified as "complex". A moderate correlation was found between the total INTERMED score and the total scores of WHOQOL-BREF (rho = - 0.59) and HADS (rho = 0.56), and between the social domains of INTERMED and MOS-SSS (rho = -0.44). After adjustment, the use of PHC (β = 2.12, t = 2.10, p < 0.05), any other health care services (β = 3.05, t = 3.97, p < 0.01), and any medication (β = 3.64, t = 4.16, p < 0.01) were associated with higher INTERMED scores. The INTERMED internal consistency was good (ω = 0.83), and the median application time was 7 min. Patients reported satisfaction with the questions, answers, and application time., Conclusion: INTERMED displayed good psychometric values in a PHC population and proved promising for practical use in PHC., Competing Interests: The authors have declared that no competing interests exist. more...
- Published
- 2022
- Full Text
- View/download PDF
6. Predictors of Expressed Emotion in First Episode Psychosis.
- Author
-
da Silva AHS, de Souza Tressoldi L, de Azevedo-Marques JM, Shuhama R, Del-Ben CM, Galera SAF, da Silva Gherardi-Donato EC, Vedana KGG, and Zanetti ACG
- Subjects
- Brazil, Caregivers, Cross-Sectional Studies, Humans, Expressed Emotion, Psychotic Disorders
- Abstract
This article evaluated the predictors of EE and its components, EOI and CC, in relatives of first episode psychosis patients (FEP) in Brazil. Cross-sectional observational study conducted with 82 dyads of FEP patients and their relatives. Data collection instruments: sociodemographic and clinical data questionnaire , Family Questionnaire , Zarit Burden Interview and Morisky Medication Adherence Scale . Logistic and linear regression models were used. Our results indicate that patient's age, relative's sex, daily time spent together, and family burden were predictors of EE and its components. Our findings may be helpful in planning nursing interventions to reduce EE and prevent psychotic relapses. more...
- Published
- 2020
- Full Text
- View/download PDF
7. Expressed emotion and socio-demographic and clinical factors in families of Brazilian patients with schizophrenia.
- Author
-
Zanetti ACG, Vedana KGG, Pereira CCM, de Azevedo Marques JM, da Silva AHS, Martin IDS, Dantas RAS, de Souza J, Galera SAF, and Gherardi-Donato ECDS
- Subjects
- Adult, Brazil, Cross-Sectional Studies, Demography, Female, Humans, Male, Middle Aged, Regression Analysis, Expressed Emotion, Family psychology, Family Relations, Schizophrenia diagnosis
- Abstract
Background: Families are the main caregivers of people with schizophrenia. Family dynamic and expressed emotion (EE) of relatives are fundamental determinants on the course of schizophrenia., Method: This study analyzed socio-demographic and clinical factors related to EE components. A total of 94 dyads (patients with schizophrenia and their relatives) were recruited from three mental health clinics. A form containing socio-demographic and clinical variables and the Brazilian version of Family Questionnaire were used and the data were analyzed through regression model., Results: Results showed that factors such as patients' occupation status and patients' age, as well as relatives' gender and the degree of relatedness, were related to emotional overinvolvement and critical comments levels., Conclusion: This is the first study in the Brazilian cultural context that evaluates EE components and related factors on families of patients with schizophrenia. Other studies concerning EE on different cultural contexts and possible interventions must be carried out to help health professionals to improve patient and family care. more...
- Published
- 2019
- Full Text
- View/download PDF
8. Mental Health Needs and Psychoactive Drug Use in a User Population of the Family Health Strategy (FHS) in Ribeirão Preto, São Paulo, Brazil.
- Author
-
Luis MAV, Barbosa SP, de Souza J, Vedana KGG, Zanetti ACG, and de Azevedo Marques JM
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Brazil epidemiology, Cross-Sectional Studies, Diagnosis, Dual (Psychiatry), Family Health, Female, Humans, Male, Mental Health, Middle Aged, Needs Assessment, Risk Factors, Sex Distribution, Social Support, Substance-Related Disorders drug therapy, Substance-Related Disorders epidemiology, Surveys and Questionnaires, Young Adult, Mental Disorders drug therapy, Mental Disorders epidemiology, Psychotropic Drugs therapeutic use
- Abstract
This cross-sectional study was conducted in Family Health Care's field of Ribeirão Preto city, São Paulo, Brazil to identify the prevalence of substance-related disorders and mental distress among patients with mental disorders. We also aimed to identify sociodemographic and social support risk factors. The data collection was done using medical records, the Social Support Questionnaire (SSQ-6), Self Report Questionnaire (SRQ-20) and home visits. Of the 272 families studied, 211 contained individuals with mental disorders, and 61 included individuals who had substance-related disorders, or both. The mental disorders recorded in these families were most frequently mood disorders, followed by neurotic disorders, stress-related disorders and somatoform disorders. Women received twice as many psychotropic prescriptions associated with non-psychiatric medication. A significant relationship was established between education and mental distress as measured using the SRQ-20 (p = 0.024). The SSQ-6 revealed a family presence of social support in all of the conditions established by the six questions. more...
- Published
- 2018
- Full Text
- View/download PDF
9. Correction to: Mental Health Needs and Psychoactive Drug Use in a User Population of the Family Health Strategy (FHS) in Ribeirão Preto, São Paulo, Brazil.
- Author
-
Luis MAV, Barbosa SP, de Souza J, Vedana KGG, Zanetti ACG, and de Azevedo Marques JM
- Abstract
The original version of this article unfortunately published without acknowledgement. The funding information and grant number is given below: Funding Research supported by Research in Public for the National Health Care System (PP-SUS), Grant number 12/51732-9. more...
- Published
- 2018
- Full Text
- View/download PDF
10. Expressed emotion and family burden in relatives of patients in first-episode psychosis.
- Author
-
Zanetti ACG, Souza TMP, Tressoldi LS, de Azevedo-Marques JM, Corrêa-Oliveira GE, Silva AHSD, Martin IDS, Vedana KGG, Cardoso L, Galera SAF, and Gherardi-Donato ECDS
- Subjects
- Adult, Brazil, Caregivers, Cross-Sectional Studies, Female, Humans, Male, Psychiatric Nursing, Surveys and Questionnaires, Expressed Emotion physiology, Family psychology, Psychotic Disorders nursing, Schizophrenia nursing
- Published
- 2018
- Full Text
- View/download PDF
11. Impact of different approaches of primary care mental health on the prevalence of mental disorders.
- Author
-
Moscovici L, de Azevedo-Marques JM, Bolsoni LM, Rodrigues-Junior AL, and Zuardi AW
- Subjects
- Adolescent, Adult, Brazil epidemiology, Clinical Competence, Female, Health Services Research, Humans, Interview, Psychological, Male, Middle Aged, Prevalence, Residence Characteristics, Health Services Accessibility, Mental Disorders epidemiology, Primary Health Care statistics & numerical data
- Abstract
AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders., Background: Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment., Methods: Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders. more...
- Published
- 2018
- Full Text
- View/download PDF
12. Predictive Validity of the Brazilian Portuguese Version of the Family Questionnaire for Relapse in Patients With Schizophrenia.
- Author
-
Zanetti ACG, Ciol MA, Wiedemann G, de Azevedo-Marques JM, Dantas RAS, Gherardi-Donato ECDS, Vedana KGG, and Galera SAF
- Subjects
- Adolescent, Adult, Aged, Brazil, Expressed Emotion, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Reproducibility of Results, Young Adult, Family, Schizophrenia diagnosis, Surveys and Questionnaires, Translations
- Abstract
Background and Purpose: The Family Questionnaire-Brazilian Portuguese Version (FQ-BPV) has been preliminarily validated in the Brazilian population. This study assessed the predictive validity of the FQ-BPV for relapse in patients with schizophrenia., Methods: Ninety-four dyads (patients with schizophrenia and their relatives) were recruited from three mental health clinics. Expressed emotion was assessed using the FQ-BPV. Presence of relapse was assessed at 6-, 9-, 12-, and 18-month follow-ups and analyzed through logistic regressions., Results: The critical comments (CC) domain of the FQ-BPV was statistically significant at 18 months. However, the model was not sufficiently robust to classify individuals correctly into relapse or no relapse categories., Conclusion: The FQ-BPV did not predict relapse well and we cannot recommend it for that purpose in Brazil without further studies. more...
- Published
- 2017
- Full Text
- View/download PDF
13. Epidemiology of multimorbidity within the Brazilian adult general population: Evidence from the 2013 National Health Survey (PNS 2013).
- Author
-
Rzewuska M, de Azevedo-Marques JM, Coxon D, Zanetti ML, Zanetti AC, Franco LJ, and Santos JL
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Brazil epidemiology, Cross-Sectional Studies, Female, Humans, Male, Mental Disorders epidemiology, Middle Aged, Prevalence, Young Adult, Chronic Disease epidemiology, Comorbidity, Health Surveys
- Abstract
Middle-income countries are facing a growing challenge of adequate health care provision for people with multimorbidity. The objectives of this study were to explore the distribution of multimorbidity and to identify patterns of multimorbidity in the Brazilian general adult population. Data from 60202 adults, aged ≥18 years that completed the individual questionnaire of the National Health Survey 2013 (Portuguese: "Pesquisa Nacional de Saúde"-"PNS") was used. We defined multimorbidity as the presence of two or more chronic conditions, including self-reported diagnoses and responses to the 9-item Patient Health Questionnaire for depression. Multivariate Poisson regression analyses were used to explore relationship between multimorbidity and demographic factors. Exploratory tetrachoric factor analysis was performed to identify multimorbidity patterns. 24.2% (95% CI 23.5-24.9) of the study population were multimorbid, with prevalence rate ratios being significantly higher in women, older people and those with lowest educational level. Multimorbidity occurred earlier in women than in men, with half of the women and men aged 55-59 years and 65-69 years, respectively, were multimorbid. The absolute number of people with multimorbidity was approximately 2.5-fold higher in people younger than 65 years than older counterparts (9920 vs 3945). Prevalence rate ratios of any mental health disorder significantly increased with the number of physical conditions. 46.7% of the persons were assigned to at least one of three identified patterns of multimorbidity, including: "cardio-metabolic", "musculoskeletal-mental" and "respiratory" disorders. Multimorbidity in Brazil is as common as in more affluent countries. Women in Brazil develop diseases at younger ages than men. Our findings can inform a national action plan to prevent multimorbidity, reduce its burden and align health-care services more closely with patients' needs., Competing Interests: The authors have no competing interests to report. more...
- Published
- 2017
- Full Text
- View/download PDF
14. A web-based information system for a regional public mental healthcare service network in Brazil.
- Author
-
Yoshiura VT, de Azevedo-Marques JM, Rzewuska M, Vinci AL, Sasso AM, Miyoshi NS, Furegato AR, Rijo RP, Del-Ben CM, and Alves D
- Abstract
Background: Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network., Case Presentation: After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding., Conclusion: We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation. more...
- Published
- 2017
- Full Text
- View/download PDF
15. Are low doses of antipsychotics effective in the management of psychomotor agitation? A randomized, rated-blind trial of 4 intramuscular interventions.
- Author
-
Mantovani C, Labate CM, Sponholz A Jr, de Azevedo Marques JM, Guapo VG, de Simone Brito dos Santos ME, Pazin-Filho A, and Del-Ben CM
- Subjects
- Adult, Antipsychotic Agents administration & dosage, Antipsychotic Agents adverse effects, Basal Ganglia Diseases epidemiology, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, Humans, Linear Models, Logistic Models, Male, Single-Blind Method, Time Factors, Treatment Outcome, Young Adult, Antipsychotic Agents therapeutic use, Basal Ganglia Diseases chemically induced, Psychomotor Agitation drug therapy
- Abstract
Background: Psychomotor agitation can be associated with a wide range of medical conditions. Although clinical practice advocates the use of several drugs for the management of psychomotor agitation, there are still very few controlled studies comparing the profiles of action and the adverse effects of different drugs that induce tranquilization., Objectives: The purpose of this study was to compare the efficacy and safety of 4 low-dose pharmacological interventions used to control psychomotor agitation guided by the clinical response., Methods: Using a randomized, rated-blind design, 100 agitated patients were assigned to receive 1 of 4 treatments: haloperidol (2.5 mg) + promethazine (25 mg) (HLP + PMZ), haloperidol (2.5 mg) + midazolam (7.5 mg) (HLP + MID), ziprasidone (10 mg) (ZIP), or olanzapine (10 mg) (OLP). Patients were evaluated just before the intervention and after 30, 60, and 90 minutes, using the Agitation-Calmness Evaluating Scale. Adverse effects were assessed within 24 hours after the intervention, using selected items from the UKU Scale (Ugvalg Klinisk Undersgelser Side Effect Scale). According to the clinical indication, medication could be repeated twice after the first injection. Data were analyzed using general linear model with repeated measures and logistic regression., Results: All treatment options promoted a reduction in agitation, without causing excessive sedation, although a lower reduction in agitation was observed with HLP + PMZ and ZIP compared with HLP + MID and OLZ. The need for an additional dose of medication was observed in 22 patients, and only 8 remained agitated during the entire 90-minute period. A higher risk for the development of extrapyramidal symptoms within the following 24 hours was observed with HLP + PMZ., Discussion: Low doses of haloperidol combined with midazolam can be as effective as olanzapine in reducing psychomotor agitation without increasing the risk of extrapyramidal effects. Because of the higher risk for the occurrence of extrapyramidal symptoms, the combination of haloperidol with promethazine should be considered a second-line treatment option. more...
- Published
- 2013
- Full Text
- View/download PDF
16. Cultural adaptation and psychometric properties of the family questionnaire in a Brazilian sample of relatives of schizophrenia outpatients.
- Author
-
Zanetti AC, Wiedemann G, Dantas RA, Hayashida M, de Azevedo-Marques JM, and Galera SA
- Subjects
- Brazil, Humans, Adaptation, Psychological, Culture, Family, Outpatients, Psychometrics, Schizophrenia
- Abstract
Aims and Objectives: To evaluate the internal reliability and validity of the Brazilian Portuguese version of the Family Questionnaire among families of schizophrenia outpatients., Background: The main studies about the family environment of schizophrenia patients are related to the concept of Expressed Emotion. There is currently no instrument to evaluate this concept in Brazil that is easily applicable and comparable with studies from other countries., Design: Methodological and cross-sectional research design., Method: A convenience sample of 130 relatives of schizophrenia outpatients was selected. The translation and cultural adaptation of the instrument involved experts in mental health and experts in the German language and included back translation, semantic evaluation of items and pretesting of the instrument with 30 relatives of schizophrenia outpatients. The psychometric properties of the instrument were studied with another 100 relatives, which fulfilled the requirements for the Brazilian Portuguese version of the instrument. The psychometric properties of the instrument were assessed by construct validity (using an analysis of its key components, comparisons between distinct groups-convergent validity with the Antonovsky's Sense of Coherence Scale) and reliability (checking the internal consistency of its items and its test-retest reproducibility)., Results: The analysis of main components confirmed dimensionality patterns that were comparable between the original and adapted versions. In two domains of the instrument, critical comments and emotional over-involvement had moderate and significant correlations, respectively, with Antonovsky's Sense of Coherence Scale, appropriate values of Cronbach's alpha and strong and significant correlations, respectively, in test-retest reproducibility. We observed significant differences between distinct groups of parents in the category of emotional over-involvement., Conclusion: We conclude that the Portuguese-adapted version of the Family Questionnaire is valid and reliable for the study sample., Relevance to Clinical Practice: This study provided evidence that the Family Questionnaire is a reliable and valid instrument for assessing expressed emotion. It is easy and practical to use and is acceptable for use in a Brazilian cultural population., (© 2012 Blackwell Publishing Ltd.) more...
- Published
- 2013
- Full Text
- View/download PDF
17. COOP/WONCA charts as a screen for mental disorders in primary care.
- Author
-
de Azevedo-Marques JM and Zuardi AW
- Subjects
- Adolescent, Adult, Attitude of Health Personnel, Female, Humans, Interviews as Topic, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Reproducibility of Results, Young Adult, Mass Screening methods, Mental Disorders diagnosis, Primary Health Care methods, Surveys and Questionnaires
- Abstract
Purpose: Most people with mental disorders receive treatment in primary care. The charts developed by the Dartmouth Primary Care Cooperative Research Network (COOP) and the World Organization of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (WONCA) have not yet been evaluated as a screen for these disorders, using a structured psychiatric interview by an expert or considering diagnoses other than depression. We evaluated the validity and feasibility of the COOP/WONCA Charts as a mental disorders screen by comparing them both with other questionnaires previously validated and with the assessment of a mental health specialist using a structured diagnostic interview., Methods: We trained community health workers and nurse assistants working in a collaborative mental health care model to administer the COOP/WONCA Charts, the 20-item Self-Reporting Questionnaire (SRQ-20), and the World Health Organization-Five Well-Being Index (WHO-5) to 120 primary care patients. A psychiatrist blinded to the patients' results on these questionnaires administered the SCID, or Structured Clinical Interview for the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition)., Results: The area under the receiver operating characteristic curve was at least 0.80 for single items, a 3-item combination, and the total score of the COOP/ WONCA Charts, as well as for the SRQ-20 and the WHO-5, for screening both for all mental disorders and for depressive disorders. The accuracy, sensitivity, specificity, and positive and negative predictive values of these measures ranged between 0.77 and 0.92. Community health workers and nurse assistants rated the understandability, ease of use, and clinical relevance of all 3 questionnaires as satisfactory., Conclusions: One-time assessment of patients with the COOP/WONCA Charts is a valid and feasible option for screening for mental disorders by primary care teams. more...
- Published
- 2011
- Full Text
- View/download PDF
18. Is the full version of the AUDIT really necessary? Study of the validity and internal construct of its abbreviated versions.
- Author
-
Meneses-Gaya C, Zuardi AW, Loureiro SR, Hallak JE, Trzesniak C, de Azevedo Marques JM, Machado-de-Sousa JP, Chagas MH, Souza RM, and Crippa JA
- Subjects
- Adult, Alcohol-Related Disorders psychology, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Psychometrics, Young Adult, Alcohol-Related Disorders diagnosis, Surveys and Questionnaires standards
- Abstract
Background: This study was aimed at assessing the psychometric qualities of the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT-3, AUDIT-4, AUDIT-C, AUDIT-PC, AUDIT-QF, FAST, and Five-Shot) and at comparing them to the 10-item AUDIT and the CAGE in 2 samples of Brazilian adults., Methods: The validity and internal consistency of the scales were assessed in a sample of 530 subjects attended at an emergency department and at a Psychosocial Care Center for Alcohol and Drugs. The Structured Clinical Interview for DSM-IV was used as the diagnostic comparative measure for the predictive validity assessment. The concurrent validity between the scales was analyzed by means of Pearson's correlation coefficient., Results: The assessment of the predictive validity of the abbreviated versions showed high sensitivity (of 0.78 to 0.96) and specificity (of 0.74 to 0.94) indices, with areas under the curve as elevated as those of the AUDIT (0.89 and 0.92 to screen for abuse and 0.93 and 0.95 in the screening of dependence). The CAGE presented lower indices: 0.81 for abuse and 0.87 for dependence. The analysis of the internal consistency of the AUDIT and its versions exhibited Cronbach's alpha coefficients between 0.83 and 0.94, while the coefficient for the CAGE was 0.78. Significant correlations were found between the 10-item AUDIT and its versions, ranging from 0.91 to 0.99. Again, the results for the CAGE were satisfactory (0.77), although inferior to the other instruments., Conclusions: The results obtained in this study confirm the validity of the abbreviated versions of the AUDIT for the screening of alcohol use disorders and show that their psychometric properties are as satisfactory as those of the 10-item AUDIT and the CAGE. more...
- Published
- 2010
- Full Text
- View/download PDF
19. Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil.
- Author
-
de Azevedo Marques JM and Zuardi AW
- Subjects
- Adolescent, Adult, Age Distribution, Brazil, Clinical Competence statistics & numerical data, Curriculum, Family Practice methods, Female, Humans, Internship and Residency methods, Male, Middle Aged, Primary Health Care statistics & numerical data, Psychiatry education, Psychometrics education, Reproducibility of Results, Sex Factors, Family Practice education, Internship and Residency statistics & numerical data, Psychiatric Status Rating Scales statistics & numerical data
- Abstract
Objective: To evaluate the validity and applicability of the Mini International Neuropsychiatric Interview (MINI) used by family medicine residents in primary health care (PHC) in Brazil., Methods: Training for administrating the MINI was given as part of a broad psychiatry education program. Interviews were held with 120 PHC patients who were at least 15 years old. MINI was administered by 25 resident physicians, while the Structured Clinical Interview for Diagnosis (SCID) was administered by a psychiatrist blind to patients' results on the MINI, and the diagnoses on both interviews were compared. The resident physicians answered questions on the applicability of the MINI., Results: Concordance levels for any mental disorder, the broader current diagnostic categories and the most common specific diagnoses were analyzed. Kappa coefficients ranged between 0.65 and 0.85; sensitivity, between 0.75 and 0.92; specificity, between 0.90 and 0.99; positive predictive values (PPV), between 0.60 and 0.86; negative predictive values (NPV), between 0.92 and 0.99; and accuracy, between 0.88 and 0.98. The resident physicians considered MINI comprehensibility and clinical relevance satisfactory., Conclusions: These good psychometric results in a real-world setting may be related to a special training program, which is more frequent, intensive and diversified. In these conditions, the MINI is a useful tool for general practitioners. more...
- Published
- 2008
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.