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Biomedical subjects

A Mackinnon

Publications and source records attributed to A Mackinnon.

At least 19 recordsLinked to original sources
PubMed2005

Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy.

Associations between psychopathology and gender, duration of MS, disability and therapy with beta-interferons were studied in multiple sclerosis (MS) outpatients. A controlled descriptive epidemiological study was carried out in two Italian outpatient MS centres on 50 outpatients with clinically definite relapsing-remitting MS presenting for regular follow-up and 50 healthy controls matched for sex, age and educational level. Subjects were assessed with the Structured Clinical Interview for DSM-IV (SCID I), the Beck Depression Inventory (BDI) and the State Trait Anxiety Inventory (STAI). MS patients reported a higher prevalence of psychiatric disorders (odds ratio 3.17), with 46% (n=23) suffering from major depressive disorder. The risk of suffering from any non-mood psychiatric disorder was also higher in MS patients than in controls (odds ratio 2.67). Risk factors for depression were female sex and severity of disability, but not therapy with interferon beta or longer duration of illness. Disability level, but not therapy with beta-interferons, is a risk factor for depression in MS outpatients. Regular screening for depression in this population is appropriate.

Anxiety↗
PubMed2003

Assessment of change with the Developmental Behaviour Checklist.

BACKGROUND: The Developmental Behaviour Checklist (DBC) is a 96-item instrument designed for assessing behavioural and emotional problems among young people with intellectual disability. METHODS: The present study investigated the validity of the DBC as a measure of change. Changes in individual's DBC scores were correlated with changes in expert clinicians' ratings of the same subjects. RESULTS: A high correlation was found between expert clinician ratings of change in behaviour and change in the total behaviour problem score of the DBC. CONCLUSIONS: The DBC is able to measure changes in behaviour and emotions which are recognized by an experienced clinician who is following the progress of a child with ID.

Adolescent↗
PubMed2001

The Psychogeriatric Assessment Scales (PAS): psychometric properties in French and German speaking populations.

OBJECTIVES: To investigate the structure and measurement properties of the Psychogeriatric Assessment Scales (PAS) in a community sample, to study the performance of French and German translations of the PAS, and to determine the power of PAS scales to discriminate dementia and depression diagnosed to DSM-IV criteria. Design and measures The measures were gathered as part of a large community survey. Responses to PAS items were obtained in the course of the administration of the 'Canberra Interview for the Elderly'. Demographic variables, the mini-mental state examination and measures of premorbid intelligence robust to current intellectual impairment were also gathered in the course of the survey. SETTING: A community survey in the cities of Zurich and Geneva, Switzerland. PARTICIPANTS: Subjects were residents of the two cities aged 65 years or older. There were 465 participants from Zurich and 456 from Geneva. Interviews with an informant who knew the subject well were also obtained. Subjects from Zurich were interviewed in German, subjects from Geneva in French. RESULTS: Confirmatory factor analyses of PAS scales showed close agreement between sites and with results obtained in the sample used to construct the instrument. Correlations with demographic and validating variables also showed this pattern. The PAS cognitive impairment and cognitive decline scales were shown to be good discriminators of DSM-IV dementia while the depression scale discriminated DSM-IV major depressive episode. CONCLUSIONS: This study supports the PAS as a valid and reliable summary of the status of older persons with respect to the impairments, changes and symptomatology that lie at the core of dementing and depressive disorders. This study not only supports the results found in the original development sample, but demonstrates that it performs well against DSM-IV diagnostic criteria and amongst speakers of French and German.

Aged↗
PubMed2001

Why are we weighting? The role of importance ratings in quality of life measurement.

Many Quality of Life (QoL) instruments ask respondents to rate a number of life domains in terms of satisfaction and personal importance, and derive weighted satisfaction scores by multiplying the two ratings. This paper demonstrates that this practice is both undesirable and unnecessary. QoL domains are selected on the basis of their inherent importance, rendering separate importance rating partially redundant. Weighted scores present difficulties in interpretation. Further, we show that multiplicative composites have undesirable psychometric properties. There is evidence that multiplicative composites have little or no advantage over unweighted ratings in correlational or predictive studies. Apart from the face validity and the intuitive appeal of multiplying satisfaction ratings by importance ratings, there appear to be no sound reasons for doing so, and several good reasons not to do so.

Humans↗
PubMed2000

A spreadsheet for the calculation of comprehensive statistics for the assessment of diagnostic tests and inter-rater agreement.

While advances in statistical methods allow greater insight into the characteristics of diagnostic tests and of raters, researchers frequently rely on incomplete or inappropriate indices of performance. Lack of available computer software is probably an important barrier to optimal use of data collected to evaluate diagnostic tests and agreement between raters. A spreadsheet has been designed to provide comprehensive statistics for the assessment of diagnostic tests and inter-rater reliability when these investigations yield data that can be summarized in a 2x2 table. As well as a wide range of indices of test or rater performance, confidence intervals for these quantities are also calculated by the spreadsheet.

Confidence Intervals↗
PubMed2000

Item bias in the Center for Epidemiologic Studies Depression Scale: effects of physical disorders and disability in an elderly community sample.

The Center for Epidemiologic Studies Depression Scale (CES-D) is frequently used in studies of elderly individuals. One controversy regarding its use turns on the issue of whether the effect of physical disorder on the CES-D total score reflects genuine effects on depression or item-level artifacts. The present article addresses this issue using medical examination data from 506 community-dwelling individuals aged 75 or older. A form of structural equation modeling, the MIMIC model, is used, enabling the effect of a physical disorder on CES-D total score to be partitioned into bias and genuine depression components. The results show substantial physical disorder-related artifacts with the CES-D total score. Caution is required in the use of CES-D (and possibly other) depression scales in groups in which physical disorders are present, such as in elderly individuals.

Aged↗
PubMed1999

Detecting anxiety and depression in hospitalised elderly patients using a brief inventory.

This study validated a French language version of an inventory designed to detect symptoms of depression and anxiety [Goldberg et al, 1987] in a sample of elderly French-speaking inpatients at risk for one of these disorders. Latent trait analysis was used to replicate the structure of the symptoms in the inventory, and receiver operating characteristic analysis was used to assess the performance of the inventory as a screening measure for Major Depressive Episode and Generalised Anxiety Disorder according to DSM-IV criteria. Reflecting the ascertainment of individuals in the sample as being at risk for a disorder, prevalence of individual symptoms was high although the general structure of the inventory was found to be comparable to that found in samples of both community elderly and younger medical patients. ROC analyses showed that the subscales of inventory performed satisfactorily as screening measures for anxiety or depression but lacked specificity for each disorder. In addition to providing further evidence for the utility of this inventory to detect general psychiatric distress in elderly persons, this study provides a valid means of detecting symptoms of depression and anxiety in French speaking groups.

Aged↗
PubMed1998

Occupation type as a predictor of cognitive decline and dementia in old age.

OBJECTIVE: To assess whether an individual's main occupation predicts cognitive decline or dementia. METHODS: The data were taken from a longitudinal study of 518 men aged 70 or over. Main occupation was coded into one of John Holland's six occupational categories. The subjects completed four cognitive tests and were diagnosed for dementia on two occasions three and a half years apart. The cognitive tests were the Mini-Mental State Examination, Episodic Memory Test, Symbol-Letter Modalities Test and National Adult Reading Test. Informants also completed the Informant Questionnaire on Cognitive Decline in the Elderly. Dementia was diagnosed by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised (DSM-III-R) and ICD-10 criteria using the Canberra Interview for the Elderly. RESULTS: Cross-sectional analysis of the wave 1 data showed that the realistic occupations, which include trade, technical and some service occupations, had poorer cognitive performance and a higher prevalence of DSM-III-R dementia. These differences held even when age, education and native English were statistically controlled. The greatest occupational difference was on the National Adult Reading Test, which estimates pre-morbid ability. By contrast, there were no occupational differences in longitudinal change in cognitive test performance, informant reports of cognitive decline or incident cases of dementia over three and a half years. CONCLUSION: Cross-sectional occupational differences on cognitive tests and in dementia prevalence are due to differences in pre-morbid ability rather than to differences in rate of cognitive decline.

Aged↗
PubMed1998

The Center for Epidemiological Studies Depression Scale in older community samples in Indonesia, North Korea, Myanmar, Sri Lanka, and Thailand.

Cultural differences in the reporting of depressive symptoms among older people were examined using the Center for Epidemiological Studies Depression (CES-D) scale in five Southeast Asian countries: Indonesia, Korea, Myanmar, Sri Lanka, and Thailand. Previous work in Asian samples--principally North American immigrants--suggested differential functioning of the CES-D. The four-factor solution established in the original studies of the CES-D was replicated for all countries using a confirmatory factor analytic approach. It was, however, demonstrated that little information was lost in considering full-scale scores rather than the four subscales separately. The behavior of the CES-D in older Asian populations was found to be comparable to results obtained in North American and European cultures. Significant somatization of depression in these Asian samples was not found. There appears to be a general factor measuring depressed mood across older populations. The results support the validity of comparing responses on the CES-D across cultures.

Affect↗
PubMed1998

Combining cognitive testing and informant report to increase accuracy in screening for dementia.

OBJECTIVE: Cognitive testing and an informant report questionnaire were combined to determine whether their use in combination could improve accuracy in screening for the diagnosis of dementia over either test used alone. Methods of combining test scores that can be readily applied in clinical settings were developed and assessed. METHOD: The subjects were 106 patients admitted to the geriatric hospital or outpatients assessed at the memory clinic of the university hospital system in Geneva, Switzerland. The instruments used were the Mini-Mental State and the short form of the Informant Questionnaire on Cognitive Decline in the Elderly. The diagnosis of dementia was made according to DSM-IV criteria. RESULTS: Logistic regression demonstrated that the combination of the Mini-Mental State and the Informant Questionnaire on Cognitive Decline in the Elderly resulted in more accurate prediction of caseness than either test alone. The performance of logical "or" and "and" combinations of test results and a weighted sum of scores on the two tests as screens for dementia were investigated by using receiver operating characteristic analysis. By using suitable cutoff points, both the "or" rule and the weighted sum were shown to be capable of improving performance over that of either test used alone. CONCLUSIONS: This study shows that informant report can be formally incorporated into assessment for dementia in such a way as to increase the accuracy of detection of cases and noncases. A graphical method was developed that enables the most robust approach to be applied to individual cases without any calculation.

Aged↗
PubMed1998

No association between the serotonin transporter-linked promoter region polymorphism and either schizophrenia or density of the serotonin transporter in human hippocampus.

BACKGROUND: Allelic association case-control analysis of a deletion/insertion polymorphism in the serotonin transporter-linked polymorphic region (5-HTTLPR) has suggested associations with unipolar disorder, bipolar disorder, depression, and Alzheimer's disease. Moreover, the heterozygous long form of the 5-HTTLPR has been associated with increased levels of mRNA for the serotonin transporter (5-HTT) and increased serotonin uptake in lymphoblastic cell lines. This study attempts to determine whether there is an association between 5-HTTLPR genotype and schizophrenia or the binding of [3H]paroxetine to the human hippocampal 5-HTT. MATERIALS AND METHODS: DNA from the cerebellum from 58 schizophrenic and 62 control subjects was used to genotype the 5-HTTLPR. In addition, the relationship between 5-HTTLPR genotype and the affinity and density of [3H]paroxetine binding to the hippocampal 5-HTT was assessed. RESULTS: There were no associations between 5-HTTLPR allotype or genotype and/or the parameters of [3H]paroxetine binding to the hippocampal 5-HTT. CONCLUSIONS: Our data suggest that 5-HTTLPR genotype neither confers an increased susceptibility for schizophrenia nor dictates the expression of the 5-HTT in the human hippocampus.

Carrier Proteins↗
PubMed1997

Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample.

Data from a two-wave longitudinal study of an elderly community sample were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.

Aged↗
PubMed1997

A quantitative review of cognitive deficits in depression and Alzheimer-type dementia.

Meta-analysis was used to examine the performance of depressed and Alzheimer-type dementia (DAT) patients on standard and experimental clinical tests of cognitive function. Deficits were found for depression on almost every psychological test. Relative to nondepressed controls, the average deficit was 0.63 of a standard deviation, but the magnitude of the effect varied with the type of test. DAT patients performed worse than depressed patients, with an average effect size of 1.21 standard deviations, but the size of the effect depended on the clinical test. Effect sizes for the comparison between depressives and controls were significantly affected by age, treatment setting, ECT use, severity of depression, and the source of diagnostic criteria, but not by the type of depression. Effect sizes in the comparison of depressives to DAT patients were influenced by age, the severity of depression, and ECT. Depressives performed proportionately worse than controls on tasks with pleasant or neutral, compared with unpleasant content, on speeded compared with nonspeeded tasks, and on vigilance tasks. However, there were no differences in the magnitude of effect size for tests using recall compared with recognition, using categorical compared with noncategorical word lists, on story compared with word comprehension, and using verbal compared with visual material. Relative to DAT patients, depressives performed no better on recall compared to recognition tasks, or verbal compared to visual material. The findings of the review are not consistent with the hypothesis that depression is associated with deficits in effortful processing. A model of psychological deficit in depression as a deficit in speed or attention has more promise.

Aged↗
PubMed1996

A comparison of alternative methods of screening for dementia in clinical settings.

OBJECTIVE: To compare 3 approaches to screening for dementia: cognitive testing, informant report, and neurovisual assessment in a clinical environment. SETTING: A university hospital in Geneva, Switzerland. PATIENTS: Subjects were 76 patients admitted to the Geriatric Hospital or outpatients assessed at the Memory Clinic of the Hospitals of the University of Geneva School of Medicine in Geneva, Switzerland. Thirty-three met criteria for dementia and 11 for depression based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. MAIN OUTCOME MEASURES: Performance in French-language versions of the Mini-Mental State Examination, the Informant Questionnaire on Cognitive Decline in the Elderly, and the Clinical Antisaccadic Eye Movement Test. RESULTS: All tests significantly discriminated cases of dementia from noncases. The receiver operator characteristic analysis demonstrated that the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly were more efficient screening measures for dementia than the Antisaccadic Eye Movement Test in this setting. Unlike the Mini-Mental State Examination, the Informant Questionnaire on Cognitive Decline in the Elderly was unrelated to patients' educational attainment or premorbid intelligence. The previously reported strong relationship between the Mini-Mental State Examination and the Antisaccadic Eye Movement Test was not replicated in these patients. CONCLUSIONS: Both cognitive testing and informant report are efficient methods of screening for dementia in clinical settings. Factors such as sensorimotor disability or informant availability may dictate the viability of each approach in individual application. The performance of the Antisaccadic Eye Movement Test precludes recommending its use as a screen for dementia without further research into its performance.

Aged↗
PubMed1996

Patients' strategies for coping with auditory hallucinations.

Many patients with psychotic disorders experience persistent auditory hallucinations despite rigorous pharmacological treatment. The experience of auditory hallucinations can heighten anxiety and depression. The high risk of suicide among patients experiencing auditory hallucinations is well recognized. Research in this area has been restricted to small samples or has collected information only on the use of such strategies without investigating their efficacy. The Mental Health Research Institute Unusual Perceptions Schedule incorporates a module focusing on coping strategies. This schedule was administered to 100 subjects, with the aim of investigating the relationship between strategy use and effectiveness, as well as the characteristics of subjects and their disorders. Eighty-one percent of the subjects were worried or upset by their hallucinations. The majority (66%) of the subjects reported they had ways of managing the voices, and 69% of them described at least some success using one or more strategies. There was a striking lack of correspondence between the number of subjects using a method and its related efficacy. No relationship was found between length of illness and number of strategies used. Multidimensional scaling of use and efficacy data revealed three groups of strategies. These groups do not correspond to previous classifications made on the basis of features of the strategies themselves. The pattern of results also suggests that training methods might be used to increase the options for patients troubled by auditory hallucinations.

Adaptation, Psychological↗
PubMed1996

Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests

Formal assessment of cognitive decline with cognitive tests can be difficult, requiring either two measurement points or a comparison of 'hold' with 'don't hold' tests. Informant-based assessment provides an alternative approach because informants can adopt a longitudinal perspective and directly rate cognitive change. A study was carried out to assess the validity of informant ratings collected by means of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). A community sample of 500 subjects aged 74 or over underwent four cognitive tests on two occasions 3½ years apart. On the second occasion, informants filled out the IQCODE. Subjects rated as having moderate or severe decline were found to have greater change on the cognitive tests. These findings support the validity of informant ratings of cognitive decline.

Journal Article↗