| 1. |
- Lindstrom, Eva, et al.
(author)
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Development and validation of the Fast Assessment in Acute Treatment of Psychosis-Observation Rating Scale (FAST-O)
- 2011
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In: International Journal of Psychiatry in Clinical Practice. - : Informa UK Limited. - 1471-1788 .- 1365-1501. ; 15:3, s. 180-195
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Journal article (peer-reviewed)abstract
- Objectives. There is a need for an observation scale for assessment and monitoring of acutely psychotic patients. Milestones based on such ratings should be defined, similar to the PANSS-based Remission criteria. FAST-O is such an instrument (11 items and a CGI rating). Methods. Reliability, validity and factor structure were analyzed in four separate studies-most importantly in one study of 33 chronic forensic in-patients rated concurrently by three independent raters, and another study of 91 Psychiatric Intensive Care Units patients and 20 newly admitted forensic patients, rated twice, each time by two independent raters. Results. The factor structure was simple, two factors and an orphan item (Depression). Reliability was adequate on item (>0.75) as well as scale (>0.85) level. There was no bias related to the rater's professional background. The instrument was sensitive to change. Percentile-based algorithms allow characterization of patients and groups. Tentative treatment milestones are defined; a clinical state "half-way" between the acute state and remission. Conclusions. FAST-O is a reliable, valid and easy to implement observation scale for patients with a psychotic illness, which can be used without bias by all staff.
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| 2. |
- Lindström, Eva, et al.
(author)
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PECC-Factor structure and findings in three longitudinal cohorts of patients with schizophrenia
- 2012
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In: Nordic Journal of Psychiatry. - : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 66:1, s. 33-39
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Journal article (peer-reviewed)abstract
- Background: Symptom control by drug treatment is the most important task in routine clinical care of patients with schizophrenia. Structured assessment methods are needed in this task but not used much. The US-developed Positive and Negative Syndrome Scale (PANSS) is a standard tool for symptom assessment. The Psychosis Evaluation tool for Common use by Caregivers (PECC) was constructed in Europe some years ago, with the intent to overcome some of the PANSS drawbacks. Aims and methods: To validate PECC on three longitudinal cohorts of schizophrenic patients representative of Swedish outpatients (n = 225, six assessments over 5 years), international forensic patients (n = 186) and matched non-forensic controls (n = 116), five assessments over 2 years for both. Results: The factor structure of PECC appears to be highly robust. Norm values (in percentiles) were calculated on the materials. Such data provides for analyses of symptom profiles and improvement over time measured in absolute numbers. Forensic patients appear to have a much lower symptom load (except for cognitive symptoms) than the other groups. Forensic controls had much shorter inpatient times than any other group and never caught up with respect to symptom control, even after 2 years. These differences suggest that the scale is clinically valid. Conclusion: PECC has a more robust factor structure than PANSS and is simpler to use. Percentile norms have been constructed for outpatients with schizophrenia in general and forensic psychiatry. Percentile scores are accessed readily by the net. PECC is available in many languages. Its separate self-harm item may improve assessments of suicide risk among patients with schizophrenia
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| 3. |
- Dalteg, Arne, et al.
(author)
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Psychosis in adulthood is associated with high rates of ADHD and CD problems during childhood
- 2014
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 68:8, s. 560-566
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Journal article (peer-reviewed)abstract
- Background: Patients diagnosed with schizophrenia display poor premorbid adjustment (PPA) in half of the cases. Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common child psychiatric disorders. These two facts have not previously been linked in the literature. Aims: To determine the prevalence of ADHD/CD problems retrospectively among patients with psychoses, and whether and to what extent the high frequency of substance abuse problems among such patients may be linked to ADHD/CD problems. Method: ADHD and CD problems/diagnoses were retrospectively recorded in one forensic (n = 149) and two non-forensic samples (n = 98 and n = 231) of patients with a psychotic illness: schizophrenia, bipolar or other, excluding drug-induced psychoses. Results: ADHD and CD were much more common among the patients than in the general population-the odds ratio was estimated to be greater than 5. There was no significant difference in this respect between forensic and non-forensic patients. Substance abuse was common, but substantially more common among patients with premorbid ADHD/CD problems. Conclusions: Previous views regarding PPA among patients with a psychotic illness may reflect an association between childhood ADHD/CD and later psychosis. The nature of this association remains uncertain: two disorders sharing some generative mechanisms or one disorder with two main clinical manifestations. Childhood ADHD and particularly CD problems contribute to the high frequency of substance abuse in such groups.
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| 4. |
- Michel, Steven F., et al.
(author)
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Using the HCR-20 to Predict Aggressive Behavior among Men with Schizophrenia Living in the Community: Accuracy of Prediction, General and Forensic Settings, and Dynamic Risk Factors
- 2013
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In: International Journal of Forensic Mental Health. - : Informa UK Limited. - 1932-9903 .- 1499-9013. ; 12:1, s. 1-13
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Journal article (peer-reviewed)abstract
- The HCR-20 is widely used to assess risk of violence among patients with schizophrenia. Further understanding of the accuracy and changes over time in C and R scores is needed. Using prospectively collected data on 248 men with schizophrenia, the present study found that the HCR-20 significantly predicted aggressive behavior over 24 months. The H, C, R, HCR-20 total, and final risk judgment scores were unable to predict aggressive behavior better than chance among the general psychiatric patients in the first six months after discharge. Changes in three C items, the total R score, and in three R items significantly predicted changes in aggressive behavior.
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| 5. |
- Stjernswärd, Sigrid, et al.
(author)
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A modified Drug Attitude Inventory used in long-term patients in sheltered housing
- 2013
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In: European Neuropsychopharmacology. - : Elsevier. - 0924-977X .- 1873-7862. ; 23:10, s. 1296-1299
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Journal article (peer-reviewed)abstract
- The self-report Drug Attitude Inventory (DAI), in 30- and 10-item versions, provides unique information of clinical relevance for monitoring treatment adherence among people diagnosed with schizophrenia. The primary purpose of this paper was to evaluate the 10-item version among patients living in sheltered housing. Data were collected among 68 persons living in sheltered housing, most of them (82%) diagnosed with schizophrenia, 6% with non-organic psychoses, and 12% with other diagnoses. The dichotomic response format of the original DAI-10 was replaced by a 4-point Likert scale, in order to improve the resolution of the scale. Over 90% of the participants produced meaningful scores. A factor analysis suggested a 2-factor orthogonal structure: one highly homogenous factor (5 items) reflected wanted effects of the drug and displayed a bimodal distribution; one factor (3 items) reflected side effects. One item concerned the perceived control over one's drug treatment, which is a key clinical issue. One item was conceptually ambiguous and displayed no correlations with the other items. On the basis of the results we suggest cut-off scores which indicate the need for three kinds of adherence-improving interventions. Summing up, by dropping one item and using a Likert scale response format, the resulting instrument, DAI-9, appears to be an easy-to-use self-report instrument for monitoring drug attitudes and to identify needs for treatment adherence interventions among seriously ill patients.
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