0000000000770749
AUTHOR
Juan Antonio Moriana
Factorial invariance of a computerized version of the GAD-7 across various demographic groups and over time in primary care patients.
Abstract Background The Generalized Anxiety Disorder 7-item scale (GAD-7) is commonly used by clinicians and researchers to screen for anxiety disorders and to monitor anxiety symptoms in primary care. However, findings regarding its factor structure are mixed, with most studies reporting a best-fitting for a one-factor structure, whereas others indicate a two-factor model. To be valid for comparisons, the GAD-7 should measure the same latent construct with the same structure across groups and over time. We aimed to examine the best-fit factor structure model of the GAD-7 among primary care patients and to evaluate its measurement invariance. Methods A total of 1255 patients completed the c…
Modelo jerárquico de diagnóstico y derivación de los trastornos mentales comunes en centros de atención primaria. Una propuesta a partir del ensayo clínico PsicAP
Resumen Los trastornos mentales comunes son los mas prevalentes en atencion primaria (AP) en Espana. Desgraciadamente existe un porcentaje elevado de casos que no son detectados correctamente, tanto por infradiagnostico como por sobrediagnostico. Una incorrecta deteccion de estos trastornos conlleva que los pacientes no sean derivados correctamente, asi como que un 39% no reciba ningun tratamiento y solo uno de cada 3 pacientes tratados siga un tratamiento minimamente basado en la evidencia. En el ensayo clinico PsicAP se han estudiado las propiedades psicometricas del Patient Health Questionnaire (PHQ) y sus diferentes modulos, de ansiedad (GAD-7), depresion (PHQ-9) y panico (PHQ-PD), asi …
Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7.
The aim of the study was to determine the criterion validity of a computerized version of the General Anxiety Disorder-7 (GAD-7) questionnaire to detect general anxiety disorder in Spanish primary care centers. A total of 178 patients completed the GAD-7 and were administered the Composite International Diagnostic Interview (CIDI) for DSM-IV Axis I Disorders, which was used as a reference standard. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. A cut-off of 10 yielded a sensitivity of .87, a specificity of .78, a positive predictive value of .93, a negative predictive value of .64, a positive likelihood ratio o…
Factor structure and measurement invariance across various demographic groups and over time for the phq-9 in primary care patients in spain
The Patient Health Questionnaire (PHQ-9) is a widely-used screening tool for depression in primary care settings. The purpose of the present study is to identify the factor structure of the PHQ-9 and to examine the measurement invariance of this instrument across different sociodemographic groups and over time in a sample of primary care patients in Spain. Data came from 836 primary care patients enrolled in a randomized controlled trial (PsicAP study) and a subsample of 218 patients who participated in a follow-up assessment at 3 months. Confirmatory factor analysis (CFA) was used to test one- and two-factor structures identified in previous studies. Analyses of multiple-group invariance w…
Latent structure and factor invariance of somatic symptoms in the patient health questionnaire (PHQ-15).
Abstract Background Somatic symptoms are highly prevalent in primary care although insufficiently understood. The Patient Health Questionnaire (PHQ-15) is a valuable screening test but it has not yet been possible to unequivocally demonstrate its latent structure and measurement invariance. Methods A total of 1,255 patients from 28 primary care centres suffering symptoms of anxiety, depression or somatisation participated in a clinical trial. They completed the PHQ-15 at baseline and 374 retook it at three months. Exploratory structural equation modelling (ESEM) was used to compare three models: 1) a single global factor for somatisation, 2) four specific correlated factors, and 3) a bifact…
Validity of Brief Scales for Assessing Transdiagnostic Cognitive Emotion Regulation Strategies in Primary Care Patients With Emotional Disorders
Abstract. Cognitive emotion regulation strategies have been proposed as an explanation for transdiagnostic vulnerability to emotional disorders, which are highly prevalent in the primary care setting. The use of brief psychological instruments to detect cognitive-emotional factors – such as worry, rumination, interpretative and attentional distortions, and metacognitions – could provide valuable clinical data to better guide treatment in primary care. The aim of the present study was to evaluate the psychometric properties of four brief scales derived from the full versions of four assessment instruments (PSWQ, RRS, IACTA, and MCQ-30). The brief scales were completed by 1,250 primary care …
Domain-specific associations between disability and depression, anxiety, and somatization in primary care patients
Abstract This study explores the associations between different disability domains and the most prevalent symptoms of mental disorders in primary care patients (i.e. depression, anxiety, and somatization). A total of 1241 participants from 28 primary care centres completed self-report measures of depression, anxiety, and somatization. This same sample also completed the Sheehan Disability Scale (SDS) to assess functional impairment in work, social life, and family life domains. Associations between the symptoms and each disability domain were examined using hierarchical regression analyses. Depression emerged as the strongest predictor of all three disability domains. Somatization was assoc…
Impacto económico y carga de los trastornos mentales comunes en España: una revisión sistemática y crítica
Resumen Trastornos mentales comunes hace referencia a los mas prevalentes, en especial trastornos de ansiedad, trastornos del animo y, a veces, somatizaciones. Se trata de desordenes emocionales muy presentes en Atencion Primaria, con un 49.2% de probables casos, presentando una frecuente asociacion con varias enfermedades cronicas. Por su alta prevalencia, asi como por el alto porcentaje de casos no tratados y el bajo porcentaje que siguen un tratamiento minimamente basado en la evidencia, generan los mayores costes y carga entre los trastornos mentales. Sin embargo, existen diferentes enfoques y metodologias a la hora de cuantificar su impacto. El objetivo de este estudio es llevar a cabo…