Biomedical subjects

M W Koeter

Publications and source records attributed to M W Koeter.

At least 19 recordsLinked to original sources

PubMed2001

The Lancashire Quality of Life Profile: modification and psychometric evaluation.

BACKGROUND: Although widely used in Europe, the conceptual and psychometric qualities of the Lancashire Quality of Life Profile (LQoLP) have not been thoroughly examined. Four issues need attention: coverage, scale construction, systematic missing data, and psychometric properties. METHOD: Concept mapping was used to examine the coverage, and exploratory factor analysis to examine the empirical scale structure of the LQoLP. Data of 518 long-term patients from ten different mental health care settings were used. Modifications to the LQoLP were proposed on the basis of these findings, and its psychometric properties were tested. Thirty-one respondents participated in a test-retest reliability study (T1-T2: 2 weeks). RESULTS: The modified LQoLP covers the quality of life-concept in a more comprehensive manner. Internal consistency, test-retest reliability and validity are good. CONCLUSIONS: The modified version of the LQoLP now covers ten domains, paying specific attention to patients' definition of quality of life (autonomy, coping, self-worth). Domains are now based on factor analysis. The problem of systematic missing data is solved. Psychometric properties are good. Because of moderate alphas, two domains need further investigation.

Adult↗

PubMed2001

Predicting self-damaging and suicidal behaviors in female borderline patients: reasons for living, coping, and depressive personality disorder.

The aims of this study are to examine (1) whether reasons for living predict self-damaging and suicidal behaviors, (2) the associations of reasons for living with coping strategies and depressive personality disorder (PD), and (3) the unique predictive validity of reasons for living in a multivariate predictor model. Reasons for living (RFL), coping strategies, and depressive personality disorder were measured at baseline in 38 patients who met DSM-IV criteria for borderline personality disorder (BPD). Frequency of self-damaging and suicidal behaviors in the 6-month period following baseline was measured prospectively at 3- and 6-month follow-ups. The RFL has only one subscale that predicts parasuicidal behaviors (i.e. Survival and Coping Beliefs [SCB]). Participants who scored low on this subscale were 6.8 times more likely to exhibit self-damaging and suicidal behaviors in the follow-up period than their high-scoring counter-parts. However, SCB was substantially correlated with the coping strategies "reassuring thoughts," "active coping," and "palliative reaction pattern," as well as with depressive personality traits. In a multivariate model, the predictive power of SCB appeared to be accounted for by reassuring thoughts and depressive PD. Coping scales might be preferable over the RFL as a predictor of self-damaging and suicidal behaviors in borderline patients.

Adaptation, Psychological↗

PubMed2000

The prevalence of mental health problems in Rwandan and Burundese refugee camps.

OBJECTIVE: We examined the prevalence of mental health problems in refugees living in camps that emerged in Tanzania during the Rwanda crisis that started in 1994. METHOD: Using the 28-item version of the General Health Questionnaire (GHQ-28), we examined two samples: a random sample (n = 854) and a sample of clients of a psychosocial support programme in these camps (n = 23). Sensitivity, specificity and positive- and negative predictive values were estimated for several cut-off scores of the GHQ-28. RESULTS: The prevalence of serious mental health problems was estimated at 50% (SE 12%). When using the GHQ-28 as a screener, a cut-off score of 14 is recommended. CONCLUSION: Given the high prevalence of mental health problems, psychosocial programmes for large refugee populations should aim at strengthening community structures and supporting groups instead of focusing at individuals. The screening capacity of the GHQ-28 could be used to identify mentally vulnerable groups.

Adolescent↗

PubMed1999

Antisocial alcoholic patients show as much improvement at 14-month follow-up as non-antisocial alcoholic patients.

The authors investigated the impact of DSM-III-R adult criteria for antisocial personality disorder (and co-occurrence of childhood conduct or mood disorder) on one-year changes of multi-domain problem severity in 309 alcoholic patients. Adult antisocial traits were associated with more drug, legal, and psychiatric problems at baseline and with more drug problems at follow-up. However, patients with antisocial traits showed at least as much improvement from baseline through follow-up as their non-antisocial counterparts. Furthermore, the co-occurrence of childhood conduct disorder or mood disorder among the antisocial alcoholics did not define prognostically relevant subgroups. These findings suggest that antisocial alcoholics benefit from treatment at least as much as non-antisocial alcoholics.

Adult↗

PubMed1998

Family caregiving in schizophrenia: domains and distress.

This article focuses on (1) the dimensionality of the caregiving concept; (2) the relation between the identified caregiving dimensions and characteristics of the patient, the caregiver, and their relationship; and (3) the relation between caregiving dimensions and caregiver distress. Findings are based on data from 480 members of the Dutch family organization for patients with schizophrenia/chronic psychosis who completed (1) the Involvement Evaluation Questionnaire (IEQ), which assesses general information (e.g., household characteristics), caregiving, help seeking, coping and distress, and (2) a questionnaire comprising questions on onset and course of the patient's disorder and symptoms characteristic of schizophrenic disorders. Four caregiving domains were found: tension, supervision, worrying, and urging. These domains were strongly related to the patient's symptomatology, contact between the relative and the patient's mental health professional, and the number of hours of mutual contact between the patient and the relative. The connection between patient, caregiver, and relationship variables and the caregivers' distress could be explained substantially by the overall caregiving score. Our findings suggest that caregiving tasks and problems may be diminished and related distress lowered by reducing the patient's symptomatology, increasing relatives' coping capacities, and decreasing the number of contact hours. If distress is reduced, relatives may use less psychotropic medication and may visit their general practitioner less often.

Adaptation, Psychological↗

PubMed1998

Temporal stability of diagnostic criteria for antisocial personality disorder in male alcohol dependent patients.

We evaluated the temporal stability of diagnostic criteria for antisocial personality disorder in 432 male alcohol dependent patients. Indicators for temporal stability were criterion continuation (i.e., the proportion of current or recent diagnoses among those with a lifetime diagnosis) and criterion duration (i.e., the length of time between the first occurrence and the last occurrence). In addition, the effect of diagnostic status (ASPD- versus ASPD+) on stability was examined. Among the criteria, "no regard for the truth" showed consistently high stability; "recklessness" showed moderate to high stability; "inconsistent work behavior," "failure to meet financial obligations," "failure to plan ahead" and "parental irresponsibility" showed consistently low stability. The continuation and duration parameters diverged with respect to "nonconformism" and "irritability/aggressiveness." Temporal stability for "nonconformism" was consistently greater among those with ASPD than among those without. It was concluded that both continuation and duration rates clearly differentiated among criteria. This new criterion-based approach seems to be useful as a strategy for improving the ASPD criteria set.

Adult↗

PubMed1998

The effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics.

UNLABELLED: OBJECTIVE. In a recent review of empirical studies on the prevalence of DSM-III-R personality disorders among substance abusers, wide ranges of prevalence rates for overall Axis II, antisocial personality disorder (APD) and borderline personality disorder (BPD) were shown. Utilizing subsamples from within a single study population, the current report explores the effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics. METHOD: Personality disorders were assessed with the Personality Diagnostic Questionnaire Revised (PDQR) at two times of measurement (Time 1 n = 459; Time 2 n = 90). In addition, APD was measured with the Composite International Diagnostic Interview (CIDI; n = 587). Finally, an unselected subgroup (n = 136) was interviewed with the International Personality Disorder Examination (IPDE). RESULTS: There were few differences between inpatients or outpatients or between males and females. Using the IPDE, the exclusion of substance-related pathology did not affect the prevalence estimate. However, the prevalence rates according to the PDQR varied greatly across age groups. In a representative subsample (n = 109), the prevalence rates also varied greatly across assessment methods (PDQR, 52% vs IPDE, 31%). The prevalence estimate of APD according to the CIDI was related to setting, gender, age group and the applied time-frame. CONCLUSIONS: These findings indicate the examined factors to be necessary qualifiers of prevalence estimates and, consequently, support the use of a multiple-criteria/multimethod assessment battery in research as well as in clinical work.

Adult↗

PubMed1997

Long-term mental health effects of the Chernobyl disaster: an epidemiologic survey in two former Soviet regions.

OBJECTIVE: This study assessed the long-term mental health effects of the nuclear accident at Chernobyl. METHOD: Two population samples (N = 3,044), one from the Gomel region, close to the accident site, and one from Tver, 500 miles away, were studied 6 1/2 years after the event with the use of a variety of self-report questionnaires and a standardized psychiatric interview. RESULTS: The prevalence of psychological distress and DSM-III-R psychiatric disorders was exceptionally high in both regions. Scores on the self-report scales were consistently higher in the exposed region; however, a higher risk of DSM-III-R psychiatric disorders could be demonstrated only among women with children under 18 years of age in the exposed region. CONCLUSIONS: A substantial long-term mental health effect of the Chernobyl incident was demonstrated, mainly at a subclinical level.

Adolescent↗

PubMed1996

Screening for psychiatric disorders in an area affected by the Chernobyl disaster: the reliability and validity of three psychiatric screening questionnaires in Belarus.

The reliability and criterion validity of Russian versions of three psychiatric screening questionnaire (the General Health Questionnaire, 12-item version; the Goldberg scales for anxiety and depression; and, the Bradford Somatic Inventory) were assessed in the Gomel region (Belarus), one of the most severely contaminated areas that resulted from the nuclear power plant explosion at Chernobyl in 1986. All instruments were found to have good internal reliability indices. Retest reliability of the GHQ, not tested for in the other instruments, was modest. Criterion validity, using a semi-structured interview on the basis of the Munich Diagnostic Checklist for DSM-III-R as external criterion, was good for the Goldberg scales, but modest for the two other instruments.

Adolescent↗

PubMed1994

The inventory for déjà vu experiences assessment. Development, utility, reliability, and validity.

In this article the development, utility, reliability, and validity of the Inventory for Déjà vu Experiences Assessment (IDEA) are described. The IDEA is a 23-item self-administered questionnaire consisting of a general section of nine questions and qualitative section of 14 questions. The latter questions comprise 48 topics. The questionnaire appeared to be a user-friendly instrument with satisfactory to good reliability and validity. The IDEA permits the study of quantitative and qualitative characteristics of déjà vu experiences.

Adolescent↗

PubMed1993

The relationship between social dysfunctioning and psychopathology among primary care attenders.

The extent of social dysfunctioning and its relationship to psychological disorders among Dutch primary care patients was examined. Social dysfunctioning in these patients was rather limited, but was more pronounced in patients with a psychological disorder than in those without. Disabilities were largely restricted to the occupational and social roles, with family role functioning and self-care relatively intact. Social dysfunctioning was moderately related to psychopathology, with higher levels of dysfunctioning in more severe and depressed cases. The extent of social dysfunctioning among patients with both anxiety and depression was similar to that of patients with a single diagnosis of depression. Depressed patients had a similar level of dysfunctioning to non-psychotic psychiatric out-patients. Analyses regarding the effects of diagnosis and severity on social dysfunctioning revealed considerable overlap between these two aspects of psychopathology. This study supports the need for a simultaneous but separate assessment of psychopathology and social dysfunctioning. However, future research should incorporate additional predictors of social dysfunctioning (e.g. personality, life events, long-term difficulties, physical disorders), and prospective studies should be conducted to clarify the temporal sequences of symptom severity, diagnosis, and comorbidity on the one hand, and social dysfunctioning on the other.

Activities of Daily Living↗

PubMed1992

Validity of the GHQ and SCL anxiety and depression scales: a comparative study.

This article presents the results of a comparison between the validity of the SCL anxiety, phobic anxiety and depression scales and the GHQ-28 anxiety-/insomnia and severe depression scales in a psychiatric outpatient population. Validity was studied at a categorical level with DSM-III diagnosis, and at a dimensional level with a prototypical anxiety and a prototypical depression scale. The SCL anxiety and depression scales and the GHQ depression scale all showed good convergent and divergent validity, however the GHQ anxiety/insomnia scale showed neither convergent nor divergent validity. It is concluded that as a screening instrument, the relative shortness of the GHQ-28 is a considerable advantage over the SCL-90. However, the GHQ-12 may be an even better alternative. As a multi dimensional measure of psychopathology, the SCL-90 is to be preferred, because it covers more dimensions. If one is interested in anxiety, the SCL-90 also seems the better choice.

Adult↗

PubMed1992

The relationship between depression and anxiety: construction of a prototypical anxiety and depression scale.

The question of the relationship between anxiety and depression remains to be solved. The fact that clinical pictures show substantial overlap makes it difficult, using conventional instruments, to distinguish between the co-occurrence of anxiety and depression and overlap in definitions and measurement of the two syndromes. This calls for the construction of scales which exclude symptoms common to both syndromes and incorporate symptoms specific only to anxiety or only to depression; i.e. scales with maximum discriminant validity. This article describes the construction of two such scales based on PSE symptoms; a prototypical anxiety scale and a prototypical depression scale. In a sample of 134 non-psychotic psychiatric out-patients these scales show good reliability and validity, both as a measure of severity and as a screening device. Compared to the Hamilton anxiety and depression scales (HARS and HRSD), the correlation between the prototypical anxiety and depression scales is low.

Adult↗

PubMed1991

Recognition, management, and course of anxiety and depression in general practice.

This article addresses the issues of recognition of psychiatric disorders by general physicians (GPs) and the effects of recognition on management and course. Among 1994 patients who were screened with the General Health Questionnaire and who were rated by their GP, 1450 (72.7%) had not been identified by the GP as having a psychiatric disorder in the year before the index visit. Among these "new" patients, 557 (38.4%) had positive General Health Questionnaire scores. Only 47% of the new patients who met Bedford College diagnostic criteria for anxiety, depression, or ill-defined disorder had their psychiatric disorder recognized by their GP. Among patients who met Bedford College criteria, mean episode durations were longer for anxiety disorders (20 to 22 months) than for depressive disorders (9 to 10 months). Among the new patients, those with psychiatric disorders recognized by the GP were more likely to receive mental health interventions. Recognition was associated with shorter episode duration among patients with an anxiety disorder, but not among patients with depressive or ill-defined disorders.

Anxiety Disorders↗

PubMed1990

Recognition, management and outcome of psychological disorders in primary care: a naturalistic follow-up study.

This article addresses the issues of recognition and labelling of psychological disorders (PDs) by general practitioners (GPs), and the association of recognition with management and outcome. Nearly 2000 attenders of 25 GPs were screened with the GHQ and a stratified sample of 296 patients was examined twice, using the Present State Examination (PSE) and Groningen Social Disability Schedule (GSDS). Prevalence rates of PDs according to the GHQ, GP and PSE were 46%, 26% and 15% respectively. For the 1450 'new' patients, i.e. patients who had no PD diagnosed by their GP in the 12 months prior to the enrollment visit, these rates were 38%, 14%, and 10%. GPs missed half of the PSE cases and typically assigned non-specific diagnoses to recognized cases. Depressions were more readily recognized than anxiety disorders, and the detection rates for severe disorders were higher than those for less severe disorders. Recognition was strongly associated with management and outcome. Recognized as compared to non-recognized cases were more likely to receive mental health interventions from their GP and had better outcomes in terms of both psychopathology and social functioning. Initial severity, psychological reasons for encounter, recency of onset, diagnostic category, and psychiatric comorbidity were related to both better recognition and outcome. However, these variables could not account for the association of recognition with management and outcome, but some did modify the association. A causal model of the relationships is presented and possible reasons for non-recognition and for the beneficial effects of recognition are discussed.

Anxiety Disorders↗

PubMed1989

Psychiatric diagnosis in an outpatient population. A comparative study of PSE-Catego and DSM-III.

Two diagnostic systems are compared in a psychiatric outpatient population of 175 patients. The Present State Examination (PSE)-Catego system identified 121 patients (69%) as "cases," whereas DSM-III identified 152 patients (87%) as cases. The two systems converged in 115 patients, yielding a kappa coefficient of only .32. Approximately one third of the DSM-III cases that were not detected by the PSE-Catego system was due to the restricted coverage of the latter system; the remaining two thirds could be attributed to differences in threshold and time framing. Compared with DSM-III, the PSE-Catego system showed a strong bias toward depression, and the system was extremely insensitive to the detection of social phobias and obsessive-compulsive disorders. Only 58% of cases of depression and 46% of cases of anxiety were diagnosed by both systems. The results are compared with other studies, and some consequences are discussed.

Adult↗

PubMed1989

Measuring change with the General Health Questionnaire (GHQ). The problem of retest effects.

The available evidence suggests that the GHQ is a valid case-finding and screening instrument and a reasonable measure of severity of functional non-psychotic psychopathology. However, recently Henderson et al. (1981) have demonstrated a substantial retest effect for the GHQ, which may affect its usefulness in longitudinal population and outcome studies. In a three-wave longitudinal study among 175 new psychiatric outpatients, we examined whether retest effects can also be found in treatment settings and what its likely causes might be. A substantial retest effect was found, and the social desirability and legitimation hypotheses appeared to offer the most likely explanations. The implications of the findings for longitudinal and treatment evaluation studies are discussed.

Anxiety Disorders↗

PubMed1989

Concurrent validity of GHQ-28 and PSE as measures of change.

Substantial cross-sectional correlations have been reported between the GHQ and PSE (and CIS) total scores. Although necessary, this is not a sufficient condition for assuming good validity of the GHQ as a severity measure in longitudinal and health care evaluation studies. For this purpose the GHQ should also accurately reflect changes in severity over time. To examine their concurrent validity, GHQ and PSE scores were compared, in a three-wave longitudinal study, among 175 new psychiatric out-patients. Using a longitudinal structural equation model that takes measurement error into account, the strength of both the cross-sectional and longitudinal relationship between GHQ and PSE were estimated. The GHQ performed remarkably well; changes in severity as defined by PSE-ID and PSE total score were clearly reflected by changes in GHQ scores. The revised scoring method of the GHQ proposed by Goodchild and Duncan-Jones did not yield superior results.

Adult↗