网络成瘾（Internet Addiction，IA）是一个宽泛的概念，包含了大量的行为问题和冲动控制问题。1986年美国纽约市的心理医生Goldberg将网络成瘾定义为：希望增加上网时间，渴望上网，失去网络联系会有不良的情绪反应，有持续的生理、心...网络成瘾（Internet Addiction，IA）是一个宽泛的概念，包含了大量的行为问题和冲动控制问题。1986年美国纽约市的心理医生Goldberg将网络成瘾定义为：希望增加上网时间，渴望上网，失去网络联系会有不良的情绪反应，有持续的生理、心理和社会问题等等。匹兹堡大学的Young结合自己对成瘾的研究，根据DSM-IV中关于赌博的判断标准，提出“病理性网络使用”（Pathological Internet Use，PIU）一词。展开更多
Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress ...Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress are useful tools for research and clinical practice. The present study seeks to investigate whether only a few questionnaire items from the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item (SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire 12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its performance in different diagnostic entities. We also assessed the correlation, sensitivity and specificity between the 4 instruments. All the instruments were administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high properties for identifying mental distress. The AUC for overall mental distress was 0.925 while that for depression and anxiety were 0.915 and 0.849 respectively. Conclusion: This validation showed that in moving from SRQ with 10 or 20 items to one with merely 5 items, we do not seem to lose the screening prowess of the instrument. The SRQ-5 represents a simplified and less time-consuming screening instrument with strong performance characteristics. We therefore recommend it for inclusion into existing patient assessment protocols, thus enhancing case finding at primary health care level.展开更多
Background: Patients with generalized anxiety disorder (GAD) are among the highest users of healthcare resources. The broadening of the DSM-IV criteria for GAD has been a subject of controversy in the literature, but ...Background: Patients with generalized anxiety disorder (GAD) are among the highest users of healthcare resources. The broadening of the DSM-IV criteria for GAD has been a subject of controversy in the literature, but its consequences have not been analyzed to date. Objective: The purpose of this study was to analyze how the broadening of the DSM-IV criteria affects healthcare resource utilization and related costs. Methods: A multicentre, prospective, observational study was conducted in randomly selected outpatient psychiatric clinics between October 2007 and April 2008. Patients diagnosed according to DSM-IV or broader criteria (1 month of excessive or non-excessive worry and only 2 associated DSM-IV symptoms) for the first time were consecutively enrolled. Socio-demographic data, healthcare resources and corresponding costs were collected over a 6-month period. Results: A total of 3549 patients were systematically recruited, 1815 in the DSM-IV criteria group (DG) and1264 inthe broad criteria group (BG). Treatments prescribed were similar for antidepressants in both groups (77.0% in the DG vs. 75.3% in the BG, p = 0.284), and slightly higher in the DG for benzodiazepines (71.5% vs. 67.2% respectively, p = 0.011) and anticonvulsants (72.1% vs. 67.0% respectively, p = 0.002). Healthcare resource utilization was statistically reduced to a similar extent in both groups as a consequence of treatment, yielding a reduction in the cost of illness of €1196 (SD = 1158) and €1112 (SD = 874) respectively;p = 0.304, over a 6-month period. Conclusion: The broadening of the GAD criteria could lead to earlier diagnosis not necessarily associated with an increase in healthcare resource utilization or costs to the National Health System in the six-month follow-up.展开更多
文摘网络成瘾（Internet Addiction，IA）是一个宽泛的概念，包含了大量的行为问题和冲动控制问题。1986年美国纽约市的心理医生Goldberg将网络成瘾定义为：希望增加上网时间，渴望上网，失去网络联系会有不良的情绪反应，有持续的生理、心理和社会问题等等。匹兹堡大学的Young结合自己对成瘾的研究，根据DSM-IV中关于赌博的判断标准，提出“病理性网络使用”（Pathological Internet Use，PIU）一词。
文摘Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress are useful tools for research and clinical practice. The present study seeks to investigate whether only a few questionnaire items from the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item (SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire 12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its performance in different diagnostic entities. We also assessed the correlation, sensitivity and specificity between the 4 instruments. All the instruments were administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high properties for identifying mental distress. The AUC for overall mental distress was 0.925 while that for depression and anxiety were 0.915 and 0.849 respectively. Conclusion: This validation showed that in moving from SRQ with 10 or 20 items to one with merely 5 items, we do not seem to lose the screening prowess of the instrument. The SRQ-5 represents a simplified and less time-consuming screening instrument with strong performance characteristics. We therefore recommend it for inclusion into existing patient assessment protocols, thus enhancing case finding at primary health care level.
文摘Background: Patients with generalized anxiety disorder (GAD) are among the highest users of healthcare resources. The broadening of the DSM-IV criteria for GAD has been a subject of controversy in the literature, but its consequences have not been analyzed to date. Objective: The purpose of this study was to analyze how the broadening of the DSM-IV criteria affects healthcare resource utilization and related costs. Methods: A multicentre, prospective, observational study was conducted in randomly selected outpatient psychiatric clinics between October 2007 and April 2008. Patients diagnosed according to DSM-IV or broader criteria (1 month of excessive or non-excessive worry and only 2 associated DSM-IV symptoms) for the first time were consecutively enrolled. Socio-demographic data, healthcare resources and corresponding costs were collected over a 6-month period. Results: A total of 3549 patients were systematically recruited, 1815 in the DSM-IV criteria group (DG) and1264 inthe broad criteria group (BG). Treatments prescribed were similar for antidepressants in both groups (77.0% in the DG vs. 75.3% in the BG, p = 0.284), and slightly higher in the DG for benzodiazepines (71.5% vs. 67.2% respectively, p = 0.011) and anticonvulsants (72.1% vs. 67.0% respectively, p = 0.002). Healthcare resource utilization was statistically reduced to a similar extent in both groups as a consequence of treatment, yielding a reduction in the cost of illness of €1196 (SD = 1158) and €1112 (SD = 874) respectively;p = 0.304, over a 6-month period. Conclusion: The broadening of the GAD criteria could lead to earlier diagnosis not necessarily associated with an increase in healthcare resource utilization or costs to the National Health System in the six-month follow-up.
