global assessment of functioning scale

全球功能评估量表
  • 文章类型: Journal Article
    这项研究的目的是通过与专业的全球功能评估(GAF)比较,调查瑞典自我评估的36项世界卫生组织残疾评估计划(WHODAS)2.0的同时有效性。精神病门诊患者。
    从常规精神科门诊中招募了444名患者的横断面便利样本。患者填写了WHODAS2.0;他们的临床医生提供了临床信息,并对患者的评估进行了GAF评分。相关性分析,方差分量,和ROC曲线通过与GAF的比较来研究WHODAS2.0的有效性。差异成分分析包括工作状态,社会心理问题,诊断组的数量,和缓解状态。GAF等级分离为总计(GAF-T),症状(GAF-S),和功能(GAF-F)。
    WHODAS2.0总分和域得分与GAF-S之间存在显着相关性(p<0.001),GAF-F,和GAF-T评级。相关性从r=0.29到r=0.48不等,最高的是GAF-F评分和WHODAS2.0总分之间。重复对不同诊断组的分析重复了这些发现,虽然不是精神病患者,物质相关,和饮食失调。WHODAS2.0显示出在固定的GAF-T截止值70以下区分功能受损的良好能力(曲线下面积:0.74-0.78)。WHODAS2.0的解释方差低于GAF(38.9%vs.59.2%)。
    在精神病门诊患者中比较瑞典自行管理的36项WHODAS2.0版本与专家评估的GAF时,发现了并发有效性。
    UNASSIGNED: The aim of this study was to investigate concurrent validity of the Swedish self-rated 36-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 by comparison with professional Global Assessment of Functioning (GAF) ratings in psychiatric outpatients.
    UNASSIGNED: A cross-sectional convenience sample of 444 patients was recruited from their regular psychiatric outpatient settings. The patients filled out the WHODAS 2.0; their clinicians provided clinical information and performed GAF ratings blinded to the patients\' assessments. Analyses of correlations, variance components, and ROC curves were performed to investigate the validity of the WHODAS 2.0 through comparison with the GAF. The variance component analyses included working status, psychosocial problems, number of diagnostic groups, and remission status. GAF ratings were separated as total (GAF-T), symptoms (GAF-S), and functioning (GAF-F).
    UNASSIGNED: There was significant correlation (p < 0.001) between WHODAS 2.0 total and domain scores and GAF-S, GAF-F, and GAF-T ratings. The correlations varied from r = 0.29 to r = 0.48, with the highest being between GAF-F rating and WHODAS 2.0 total score. Repeating the analyses for separate diagnostic groups replicated the findings, though not for psychotic, substance-related, and eating disorders. The WHODAS 2.0 showed good ability to distinguish impaired functioning below a fixed GAF-T cut-off of 70 (area under the curve: 0.74-0.78). The explained variance was lower for the WHODAS 2.0 than for the GAF (38.9% vs. 59.2%).
    UNASSIGNED: Concurrent validity was found when comparing the Swedish self-administered 36-item version of WHODAS 2.0 with the expert-rated GAF in psychiatric outpatients.
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  • 文章类型: Journal Article
    背景:未经治疗的精神病(DUP)的持续时间已被证明与精神分裂症的短期和长期结局不良相关。即便如此,很少有研究使用功能神经影像学来研究精神分裂症中的DUP。在本研究中,我们使用近红外光谱(NIRS)研究了DUP对精神分裂症患者言语流畅性测试(VFT)时脑功能的影响.
    方法:共纳入62例精神分裂症患者。他们被分为短期治疗(≤6个月,n=33)或长期治疗(>6个月,n=29)组基于其治疗持续时间。使用多通道NIRS测量VFT期间额颞区的血液动力学变化。我们检查了每组DUP和血液动力学变化之间的关联,以探索DUP在不同治疗持续时间对大脑皮层活动的不同影响。
    结果:在长期治疗组中,我们发现在较长的DUP和大约在左额下回的皮质活动减少之间存在显著关联,左额中回,左中央后回,右中前回,双侧颞上回,和双侧颞中回,而在短期治疗组中未观察到DUP与大脑皮层活动之间的关联。
    结论:我们的研究结果表明,长期DUP时间延长可能与额颞区皮质活动水平降低有关。早期发现和干预缩短DUP的精神病可能有助于改善精神分裂症患者的长期预后。
    BACKGROUND: Duration of untreated psychosis (DUP) has been shown to be associated with both poor short-term and long-term outcomes in schizophrenia. Even so, few studies have used functional neuroimaging to investigate DUP in schizophrenia. In the present study, we used near-infrared spectroscopy (NIRS) to investigate the influence of DUP on brain functions during a verbal fluency test (VFT) in patients with schizophrenia.
    METHODS: A total of 62 patients with schizophrenia were included. They were categorized into either short treatment (≤6months, n=33) or long treatment (>6months, n=29) groups based on their duration of treatment. Hemodynamic changes over the frontotemporal regions during a VFT were measured using multi-channel NIRS. We examined the associations between DUP and hemodynamic changes in each group to explore if there were different effects of DUP on brain cortical activity at different treatment durations.
    RESULTS: In the long treatment group, we found significant associations between a longer DUP and decreased cortical activity approximately at the left inferior frontal gyrus, left middle frontal gyrus, left postcentral gyrus, right precentral gyrus, bilateral superior temporal gyrus, and bilateral middle temporal gyrus, whereas no associations between DUP and brain cortical activity were observed in the short treatment group.
    CONCLUSIONS: Our results indicated that longer DUP may be associated with decreased level of cortical activities over the frontotemporal regions in the long-term. Early detection and intervention of psychosis that shortens DUP might help to improve the long-term outcomes in patients with schizophrenia.
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