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Biomedical subjects

Juan E Mezzich

Publications and source records attributed to Juan E Mezzich.

At least 19 recordsLinked to original sources
PubMed2006

Validation study of the Multicultural Quality of Life Index (MQLI) in a Peruvian sample.

OBJECTIVE: The Multicultural Quality of Life Index is a concise instrument for comprehensive, culture-informed, and self-rated assessment of health-related quality of life. It is composed of 10 items (from physical well-being to global perception of quality of life). Each item is rated on a 10-point scale. The objective was to evaluate the reliability (test-retest), internal structure, discriminant validity, and feasibility of the Multicultural Quality of Life Index in Lima, Peru. METHOD: The reliability was studied in general medical patients (n = 30) hospitalized in a general medical ward. The Multicultural Quality of Life Index was administered in two occasions and the correlation coefficients ("r") between both interviews were calculated. Its discriminant validity was studied statistically comparing the average score in a group of patients with AIDS (with presumed lower quality of life, n = 50) and the average score in a group of dentistry students and professionals (with presumed higher quality of life, n = 50). Data on its applicability and internal structure were compiled from the 130 subjects. RESULTS: A high reliability correlation coefficient (r = 0.94) was found for the total score. The discriminant validity study found a significant difference between mean total score in the samples of presumed higher (7.66) and lower (5.32) quality of life. The average time to complete the Multicultural Quality of Life Index was less than 4 minutes and was reported by the majority of subjects as easily applicable. A high Cronbach's a (0.88) was also documented. CONCLUSIONS: The results reported that the Multicultural Quality of Life Index is reliable, has a high internal consistency, is capable of discriminating groups of presumed different quality of life levels, is quite efficient, and easy to use.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Purposes and models of diagnostic systems.

Emerging efforts at developing new international classification and diagnostic systems require a careful and fresh review and conceptualization of the meanings, purposes and models of diagnostic systems. Such meanings include both an informative statement as well as a process or activity. The purposes of diagnostic systems can be clustered under understanding of a case and planning effective clinical care and public health interventions. The models designed to give form to a diagnostic system must pay attention to the informational domains to be covered (from illness to positive health), the descriptive or measurement tools to be utilized (categories, dimensions, narratives), the evaluators to be engaged (clinicians, patient, family) and the structural schemas (single- or multilevel) required to accommodate meanings and purposes of interest.

Diagnosis, Differential↗
PubMed2005

Concepts of disease: their relevance for psychiatric diagnosis and classification.

To deal effectively with the understanding, description and classification of mental morbid conditions, we must address the intricate concept of disease, illness or disorder in mental health. To do so, one needs to consider biological, psychological and social frameworks. These levels of analysis can offer avenues for greater understanding of the bases of illness as well as better ways of formulating its description and classification. Conceptual, epistemological and empirical data analyses are relevant and necessary. All these efforts should be aimed at serving and advancing the main purposes of classification and diagnosis, the chief encompassing one being enhancement of clinical care and public health. Although no definition of mental disorder may strictly embrace every condition of concern, some flexible definitional guidelines within a biopsychosocial framework may be helpful for advancing psychiatric nosology.

Cultural Characteristics↗
PubMed2005

Positive health: conceptual place, dimensions and implications.

Positive health combines with pathology or illness to yield a broader concept of health, etymologically anchored on the concept of wholeness and enshrined in WHO's constitution. The most recognized aspects of positive health include functioning/resilience, resources/supports and quality of life. Systematic assessments of positive health are being incorporated into comprehensive diagnostic models that by attending to the totality of the person who consults may enhance effectiveness and ethics in diagnosis and care. Health, a precious human concern, constitutes a wide-ranging condition and experience. However, pathology, one of its important domains, has tended to monopolize attention when professionals discuss health and carry out health care. This short paper examines the concept of positive health, as opposed to ill-health, as well as some of its aspects or dimensions and its implications for comprehensive diagnosis and care.

Attitude to Health↗
PubMed2005

A new beginning.

Explore the source record for details and available documents.

Journal Article↗
PubMed2003

From financial analysis to policy development in mental health care: the need for broader conceptual models and partnerships.

International mental health economics is emerging as a significant field in the increasingly intricate and interactive world in which we live. In line with this, the conceptualisation and gathering of pertinent data for international studies such as WHO's Atlas Project pose considerable methodological challenges. This paper outlines the need for broader conceptual models and partnerships and discusses some promising endeavours.

Global Health↗
PubMed2002

Impact of concurrent alcohol misuse on symptom presentation of acute mania at initial evaluation.

OBJECTIVES: The aim of this study was to evaluate the impact of current alcohol misuse on symptom presentation of acute mania. METHODS: The impact of concurrent alcohol misuse on symptom presentation of acute mania was examined by comparing comorbid subjects with acute bipolar mania complicated by current alcohol misuse (n=60) with subjects with acute bipolar mania without current alcohol misuse (n=196). RESULTS: Age- and gender-controlled analysis revealed that the comorbid group presented with more severe psychopathology, as indicated by higher number of total mood-related symptoms as well as of higher total number of manic symptoms. Specifically, they presented with significantly higher rates of mood lability and impulsivity, and also demonstrated higher rates of violent behavior, and other drug use. CONCLUSIONS: Acute mania complicated by current alcohol misuse is differentiated from acute mania without alcohol misuse by the presence of higher numbers of manic symptoms and increased high risk behavior such as mood lability, impulsivity, violence, and other drug abuse.

Adult↗
PubMedDate not supplied

International surveys on the use of ICD-10 and related diagnostic systems.

Several interesting surveys on the use of diagnostic systems have been conducted over the past two decades, initially focused on ICD-9 and DSM-III and then on more recent editions of these systems. They have reported on the extent and perceived value of their use as well as offered recommendations for future systems. The widest survey to date is that on ICD-10 and related systems recently conducted by the WHO Committee on Evaluating and Updating the ICD-10 Mental Health Component and the WPA Section on Classification and Diagnostic Assessment. It involved the participation of 205 psychiatrists from 66 different countries across all continents. Comparing the two most visible diagnostic systems, it found that ICD-10 was more frequently used and more valued for clinical diagnosis and training and that DSM-IV was more valued for research. Accessibility to diagnostic manuals and training appeared limited, particularly concerning the research criteria, primary care, and multiaxial versions of ICD-10. It also elicited structural and strategic recommendations for the elaboration of new diagnostic systems. It is suggested that it may be useful to widen the scope of future surveys, to additionally include policy makers, patients and families, and to conduct naturalistic studies of clinical care.

Attitude of Health Personnel↗
PubMedDate not supplied

Comprehensive diagnosis: a conceptual basis for future diagnostic systems.

A discussion of the objectives of diagnosis, participants and architecture leads to the consideration of diagnostic schemas of increasing complexity. Examined first is the conventional case of single-label diagnosis. The case of multiple illness formulation is considered concerning the plurality of mental disorders as well as of general medical disorders. The formulation of a whole clinical condition where contextualized pathology and problems are described is then followed by the consideration of positive aspects of health as well as quality of life. Finally, a comprehensive diagnostic model is reviewed. It integrates a standardized multiaxial formulation (illness, disabilities, contextual factors and quality of life) and an idiographic personalized formulation (culturally informed and contextualized clinical problems, patient's assets pertinent to care, and expectations of health restoration and promotion as jointly understood by clinician, patient and family). Such integrative diagnostic schemas may offer a richer informational basis for clinical description and care as well as a more effective focus for the surveillance of population health.

Comorbidity↗
PubMedDate not supplied

Latin American Guide for Psychiatric Diagnosis (GLDP).

Culturally competent diagnostic systems are necessary for an effective and ethical clinical practice, as cultural diversity of patients increase around the world. Latin American psychiatrists hold a long-standing commitment to this enterprise. Recently, two main Latin American adaptations to the international psychiatric classification have emerged: the Cuban Glossary of Psychiatry, and the project of the Latin American Guide for Psychiatric Diagnosis (GLADP). Keeping ICD-10 as the basis for nosological organization, GLADP is being developed with contributions by mental health professionals from Latin American countries. GLADP comprises 4 parts: (1) historical and cultural framework, (2) comprehensive diagnosis and formulation, (3) psychiatric nosology and (4) appendixes.

Cross-Cultural Comparison↗