Family Accommodation Scale for Obsessive–Compulsive Disorder—Interviewer-Rated (FAS-IR), Brazilian Portuguese version: Internal consistency,reliability, and exploratory factor analysis

ObjectiveTo examine the psychometric properties of the Brazilian Portuguese version of the Family Accommodation Scale for Obsessive–Compulsive Disorder—Interviewer-Rated (FAS-IR).MethodA total of 114 family members of patients with obsessive–compulsive disorder (OCD) were assessed. The following analyses of the FAS-IR were carried out: internal consistency, inter-rater and test–retest reliability, and exploratory factor analysis.ResultsThe Brazilian Portuguese version of the FAS-IR showed excellent inter-rater reliability (intraclass correlation coefficient [ICC] = 0.94) and acceptable test–retest reliability (ICC = 0.77), with no significant differences in FAS-IR scores. Factor analysis produced three factors for the scale. However, factor loadings were not well defined within each factor, and the factors did not have distinct constructs. Thus, a global analysis approach was chosen, revealing good internal consistency of the scale as a whole (Cronbach’s α = 0.805).ConclusionsThe Brazilian Portuguese FAS-IR showed sound psychometric properties for the evaluation of family accommodation, and is, therefore, a reliable instrument for use in research and clinical practice.     

Prevalence and characteristics of psychotropic drug use in institutionalized children and adolescents with mild intellectual disability

Psychotropic drugs are a cornerstone in the treatment of psychopathology and/or behavioral problems in children with intellectual disability (ID), despite concerns about efficacy and safety. Studies on the prevalence of psychotropic drug use have mainly been focused on adults with ID or children without ID. Therefore the aim of this cross sectional study was to assess the prevalence and characteristics of psychotropic drug use in children with mild ID who were institutionalized in specialized inpatient treatment facilities in The Netherlands. Demographic data, psychiatric diagnoses, the nature of the behavioral problems, level of intellectual functioning, and medication data were extracted from medical records using a standardized data collection form. Adjusted relative risks (ARR) for the association between patient characteristics and psychotropic drug use were estimated with Cox regression analysis. Of the 472 included children, 29.4% (n = 139) used any psychotropic drug, of which 15.3% (n = 72) used antipsychotics (mainly risperidone), and 14.8% (n = 70) used psychostimulants (mainly methylphenidate). Age, sex, and behavioral problems were associated with psychotropic drug use. Boys had a 1.7 (95%CI 1.1–2.4) higher probability of using psychotropic drugs, compared to girls adjusted for age and behavioral problems. Having any behavioral problem was associated with psychotropic drug use with an ARR of 2.1 (95%CI 1.3–3.3), adjusted for sex and age. The high prevalence of psychotropic drug use in children with ID is worrisome because of the lack of evidence of effectiveness (especially for behavioral problems) at this young age, and the potential of adverse drug reactions.     

The individual and societal effects of non-psychotic serious mental disorders on earnings in Belgium

PurposeThe purpose of this study is to examine the association between non-psychotic serious mental disorders and earnings in the general population of Belgium on both the individual- and society-level.Subjects and methodsData stem from a cross-sectional population study of the non-institutionalized adult (between 18 and 64) population from Belgium (N = 863). The third version of the Composite International Diagnostic Interview (CIDI-3.0) was administered to assess 12-month non-psychotic serious mental disorders and annual earnings. Multivariate approaches were used to estimate the observed and estimated annual earnings for persons with serious mental disorders, controlling for sociodemographic variables and alcohol disorders.ResultsOn the individual-level, 12-month serious mental disorders significantly predicted the probability of having any earnings (OR = 0.32; 95%CI = 0.14–0.74). Respondents with serious mental disorders had 12-month earnings of 5969€ less than expected in the absence of serious mental disorders. Taking into account the prevalence of serious mental disorders (i.e. 4.9%), the society-level effects of serious mental disorders in 2002 can be estimated at about 1797 million € per year for the Belgian general population.DiscussionNon-psychotic serious mental disorders had considerable impact on annual earnings.ConclusionThis is the first study in Belgium that addresses the association between mental illness and earnings. Serious mental disorders are associated with individual- and societal-level impairments and loss of human capital.     

Challenging behavior and co-morbid psychopathology in adults with intellectual disability and autism spectrum disorders

We investigated the relationship between challenging behavior and co-morbid psychopathology in adults with intellectual disability (ID) and autism spectrum disorders (ASDs) (N = 124) as compared to adults with ID only (N = 562). All participants were first time referrals to specialist mental health services and were living in community settings. Clinical diagnoses were based on ICD-10 criteria and presence of challenging behavior was assessed with the Disability Assessment Schedule (DAS-B). The analyses showed that ASD diagnosis was significantly associated with male gender, younger age and lower level of ID. Challenging behavior was about four times more likely in adults with ASD as compared to non-ASD adults. In those with challenging behavior, there were significant differences in co-morbid psychopathology between ASD and non-ASD adults. However, after controlling for level of ID, gender and age, there was no association between co-morbid psychopathology and presence of challenging behavior. Overall, the results suggest that presence of challenging behavior is independent from co-morbid psychopathology in adults with ID and ASD.     

Gender differences in co-morbid psychopathology and clinical management in adults with autism spectrum disorders

The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N = 90) on ratings of psychopathology and autism-related symptoms. All participants were referrals to specialist mental heath services for people with ID. Clinical diagnoses of psychopathology and ASD were based on ICD-10 criteria. Key informants also completed the Psychopathology Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) checklist. The analysis showed that there were statistically significant differences in rates of co-morbid psychopathology and clinical management between males and females with ASD, although there were no significant differences in level of ID and age. More specifically, personality disorder and schizophrenia were more common among males, where as dementia was more common among females. Regarding clinical management, males were more likely to be prescribed a combination of medication and females were more likely to receive sedation. Overall, the results suggest that male and female patients with ASD have, at least to some extent, different mental health needs.     

Development and validation of the Intrinsic Religiousness Inventory (IRI)

ObjectiveThe role of religious involvement in mental health has been increasingly investigated in psychiatric research; however, there is a shortage of scales on religiousness in Portuguese. The present study aimed to develop and validate a brief instrument to assess intrinsic religiosity (Intrinsic Religiousness Inventory - IRI) in two Brazilian samples.MethodThe initial version was based on literature review and experts' suggestions. University students (sample 1; n = 323) and psychiatric patients (sample 2; n = 102) completed the Duke Religiosity Index (DUREL), the IRI, an instrument of spirituality measurement (WHOQOL-SRPB), as well as measurements of anxiety and depressive symptoms.ResultsThe IRI showed adequate internal consistence reliability in sample 1 (Cronbach's α = 0.96; 95% CI; 0.95–0.97) and sample 2 (α = 0.96; 95% CI; 0.95–0.97). The IRI main component analyses indicated a single factor, which explained 73.7% and 74.9% of variance in samples 1 and 2, respectively. Strong correlations between IRI and intrinsic subscale of the DUREL were observed (Spearman's r ranging from 0.87 to 0.73 in samples 1 and 2, respectively, p < 0.001). The IRI showed good test-retest reliability (intraclass correlation coefficients > 0.70).ConclusionThese data indicate that the IRI is a valid instrument and may contribute to study intrinsic religiosity in Brazilian samples.     

Cultural translation and Tunisian validation of the Drug Attitude Inventory (DAI-30) in outpatients with schizophrenia

BackgroundNon-adherence to treatment in patients with schizophrenia is associated with increased hospitalization, higher health care costs, and poorer long-term outcomes in terms of relapse rates. It is established that a negative drug attitude was a risk factor for non-adherence in long-term schizophrenia. The scale “Drug Attitude Inventory" is one of the scales designed to assess this concept. It has been translated and validated in different languages. However, its psychometric properties have not yet been studied in our sociocultural context.ObjectivesThe aims of this study were to translate into Tunisian Arabic dialect the scale “Drug Attitude Inventory" with 30 dichotomous items (DAI-30) and validate it in Tunisian sociocultural context in patients with schizophrenia.Materials and methodsThis study was performed in 234 outpatients with schizophrenia, recruited through a random drawing. These patients are in remission and meet remission criteria proposed by “The Remission in schizophrenia Working Group". We recruited 30 patients for pretest and 204 patients for linguistic validation.Forward and backward translation of the DAI-30 was performed according to the protocol of the “MAPI Research Institute". This final version was submitted to 24 experts and followed by a pretest.Construct validity has been established by performing a principal component analysis factor on a sample of 204 patients. Internal consistency was assessed by Cronbach alpha coefficient and inter-rater reliability was assessed by the use of Intra-Class Correlation coefficient (ICC). For the test–retest reliability evaluation, the “r” Pearson's coefficient was used between the DAI scores obtained in the initial evaluation and those obtained at 15 days.ResultsRegarding construct validity, factor analysis revealed seven factors that were responsible for 59.9% of the variance. The study of internal consistency between the 30 items was rated good (α = 0.88). The test–retest reliability was satisfactory (r = 0.99, p < 10⁻³), as well as inter-rater reliability (ICC = 0.99).ConclusionIn the Tunisian cultural context, the DAI-30 presented seven factors with good consistency and an inter-rater reliability.     

Suicide risk among individuals with sleep disturbances in Japan: a case–control psychological autopsy study

ObjectiveThis case–control psychological autopsy study aimed to explore a relationship between sleep disturbances and suicide among Japanese, as well as determine the importance and usability of screening for sleep disturbances in suicide prevention.MethodsA semi-structured interview was conducted with the close family members of 49 adult suicide completers and 145 gender-, age-, and residential municipality-matched living controls. The survey included sections on demographics, sleep disturbances, and mental disorders. Conditional logistic regression analyses were performed to compare sleep disturbance prevalence between the two groups.ResultsA significantly higher prevalence of sleep disturbances was found among the suicide group (75.5%) compared to the controls (11.0%) (odds ratio [OR]=21.6, p < 0.001). The association remained significant after adjusting for mental disorders (OR = 12.7, p < 0.001). The population attributable risk percent of suicide associated with sleep disturbances and mental disorders was estimated to be 56.4% and 35.3%, respectively.ConclusionsThe study confirmed that sleep disturbances are an important risk factor of suicide, independent of mental disorders. Sleep disturbances accounted for a greater proportion of suicide cases than did mental disorders in the Japanese population given the higher prevalence, and could thus be considered an important target in suicide prevention in Japan.     

Prevalence and clinical implications of psychopathology in adults with epilepsy seen in an outpatient clinic in Nigeria

BackgroundThe psychopathological and clinical characteristics of adult patients with epilepsy attending our neurology clinic were evaluated to determine prevalence of psychopathology and its associated factors towards improving services and initiating collaborative care which is currently nonexistent.MethodsThe study was a two-stage procedure conducted over 1 year using the General Health Questionnaire in the first stage and Schedule for Clinical Assessment in Neuropsychiatry in the second stage. Diagnosis of psychiatric disorders was based on International Classification of Diseases: 10th Revision criteria.ResultsSixty-three patients were interviewed. Mean age was 34.43 ± 13.7 years; more than half of the patients had less than one seizure episode per month. Fourteen patients (22.2%) had partial epilepsy; 40 (63.5%), generalized; and 9 (14.3%), unclassified seizures. The rate of psychiatric morbidity was found to be 28.6%. Depressive disorders were the most common (66.7%), followed by psychotic disorders (11.1%), anxiety disorders (11.1%) and dementia (11.1%). Psychopathology was more common in women (P= .007), those older than 40 years (P= .038) and those with partial epilepsy (P= .017).ConclusionAbout one third of patients with epilepsy studied had undetected and untreated psychopathology. Our neurology clinic urgently needs currently nonexistent collaborative care involving neurologists, psychiatrists and primary care physicians in order to improve the mental health of the patients with epilepsy.     

Reliability and validity of the Japanese version of the Modified Checklist for autism in toddlers (M-CHAT)

Early detection and intervention is essential for children with autism spectrum disorders (ASD). Therefore, we examined the reliability and validity of the Japanese version of the Modified Checklist for autism in toddlers (M-CHAT), a 23-item, yes–no questionnaire regarding early autistic symptoms completed by parents of children at 18–24 months of age. Herein, the reliability of the M-CHAT was investigated for children 4–20 months of age. The M-CHAT score (the number of failed items) was found to be significantly correlated among 24 mother–father pairs (Pearson's r = .933), representing good inter-rater reliability. The test–retest reliability was satisfactory, with 22 mothers providing almost equal M-CHAT scores on two different occasions (r = .990). Significant correlations were observed between the M-CHAT score and the Childhood Autism Rating Scale-Tokyo version score in 25 two-year-old children (r = .581), indicating good concurrent validity. The M-CHAT score was significantly higher in 20 children later diagnosed with ASD compared with reference children (n = 1167), revealing sufficient discriminant validity. A short version of the M-CHAT using 9 items was proposed and effectively differentiated children with ASD from reference children. The efficacy of the Japanese version of the M-CHAT was demonstrated for first-level screening in the general population.     

Prévalence des troubles mentaux dans une communauté rurale à Parakou au nord Bénin

BackgroundThe burden of mental disorders is high in sub-Saharan Africa but the reliable epidemiological data for its prevalence are too scarce in this setting. We aimed to determine the prevalence of major mental disorder in a rural community in northern Benin.MethodsIt was a cross-sectional study with a door-to-door survey and included all people aged more than 18 years in the Tourou rural community in northern Benin. The face-to-face interview were done with respect the confidentiality. The French version of Composite International Diagnostic Interview (CIDI) was used for the screening of mental disorders. The data were analyzed by using EPI-INFO 7.1 software. The prevalence of each disorders were determined and their 95% confidence interval.ResultsA total of 603 subjects were included, including 62.23% of men and 18 to 77 years old with an average of 27.29 years ± 9.24 years. Among them, 327 subjects had at least one mental disorder with an overall prevalence of 54.22% [95% CI: 41.56–69.14]. The prevalences of the major mental disorders were for the current major depressive episode (MDE) 32.34% [28.65–36.26%]; past MDE 11.61% [9.22–14.50%]; current social phobia 14.26% [11.62–17.37%]; Current Obsessive Compulsive Disorders 20.73% [17.61–24.23%]; generalized anxiety 9.62% [7.44–12.33%]; psychotic syndrome whole life 30.18% [26.57–34.05%]; antisocial personality disorders 5.47% [7.44–12.33%]; alcohol dependence 3.98% and drug dependence 1.33%.ConclusionThese findings suggest an increased incidence of mental illness in rural community in northern Benin and calls for urgent prevention and community care.     

Exposure to pesticides and mental disorders in a rural population of Southern Brazil

IntroductionExposure to pesticides has been associated with mental disorders, especially in occupationally exposed populations, such as farmers. This effect has been attributed to the neurotoxic and endocrine-disrupting activity of pesticides, as suggested by experimental studies.ObjectiveTo determine the prevalence of common mental disorders and self-reported depression, and analyze their association with the exposure to pesticides in a rural population resident in the municipality of Dom Feliciano, Rio Grande do Sul, where tobacco farming is the main economic activity.MethodologyA cross-sectional study evaluating the prevalence of common mental disorders and self-reported depression in a sample of 869 adult individuals resident in Dom Feliciano, between October 2011 and March 2012 was performed. The evaluation of common mental disorders was performed using the Self-Reporting Questionnaire (SRQ-20), setting a cutoff point of 8 for both genders. A standardized questionnaire was used to obtain information on self-reported depression upon prior diagnosis by a health professional, and self-reported exposure to pesticide. In order to evaluate the association between exposure to pesticides and mental disorders, a non-conditional multivariate logistic regression analysis was performed.ResultsThe prevalence of common mental disorders and self-reported depression in the sample population were 23% and 21%, respectively. Among individuals who reported depression, an increase of 73% was observed in the odds of pesticide exposure at an age equal to or less than 15 years. There was a positive association between self-reported pesticide poisoning and common mental disorders (OR = 2.63; 95% CI, 1.62-4.25) as well as self-reported depression (OR = 2.62; 95% CI, 1.63⿿4.21). Individuals who reported depression had a greater odds of exposure to pyrethroids (OR = 1.80; 95% CI, 1.01⿿3.21) and aliphatic alcohol (OR = 1.99; 95% CI, 1.04⿿3.83). An SRQ⿿20 ⿥ 8 was associated with an approximately seven times higher odds of exposure to aliphatic alcohol (95% CI, 1.73⿿27.53). Self-reported depression positively correlated with a greater period of exposure to dinitroaniline (OR = 2.20; 95% CI, 1.03⿿4.70) and sulphonylurea (OR = 4.95; 95% CI, 1.06⿿23.04).ConclusionThe results suggest that exposure to pesticides could be related mental disorders. However, other common risk factors in tobacco farming, the main local economic activity, cannot be excluded.     

Metabolic profiles in adults with autism spectrum disorder and intellectual disabilities

IntroductionLow levels of blood cholesterol have been found in some children with autism spectrum disorders (ASD). Psychotropic medications, commonly used by people with ASD and people with intellectual disabilities (ID) are frequently associated with altered metabolic profiles.PurposeWe aimed to compare metabolic features of adults with ASD or ID with those of a community-based population.Subjects and methodsData on blood fasting glucose (FBG), lipid profile, liver enzyme profile, TSH, BMI, medications and diagnoses of 80 adults with ASD, 77 adults with ID and 828 control adults were drawn from medical charts/database. Candidates that used glucose or lipid lowering medications were not included.ResultsTotal-cholesterol levels of people with ASD and ID were significantly lower than those of the controls (168.3 ± 32.78, 168.2 ± 32.91, 185.4 ± 40.49 mg/dL, respectively, P < 0.001) but after adjusting for gender, age and BMI and using Bonferroni correction, the significance was lost. Compared to controls, ASD and ID had significantly lower FBG (by –14.45 ± 1.81, –14.58 ± 1.54 mg/dl, respectively; P < 0.001 for both) and liver enzymes, despite using psychotropic medications.Discussion and conclusionIn contrast to other psychiatric patients receiving similar medications, people with ASD and ID have unaltered lipid profiles and lower glucose and liver enzyme levels compared to a community-based population.     

Factor structure and temporal stability of the Vancouver Obsessional Compulsive Inventory–Mental Contamination Scale (VOCI-MC) and psychometric properties of its Italian version

ObjectiveThe Vancouver Obsessional Compulsive Inventory–Mental Contamination Scale (VOCI-MC) is a self-report instrument that assesses symptoms of mental contamination. The aim of this study was to investigate the psychometric properties of the Italian version of the VOCI-MC in non-clinical and clinical samples.MethodFactor structure, internal consistency, temporal stability, construct and criterion validity were investigated in 541 participants from the general population, 120 participants diagnosed with OCD and 31 participants diagnosed with other anxiety disorders (OAD). For some of these analyses, our OCD sample was subdivided into those with contamination-related symptoms and concerns (n = 39) and those whose OCD excluded concerns related to contamination fear (n = 81). Exploratory and confirmatory factor analyses supported the expected one-factor structure of the VOCI-MC both in non-clinical and OCD sample.ResultsVOCI-MC scores showed good internal consistency, temporal stability, construct validity and criterion validity. In particular, the VOCI-MC successfully discriminated between those with OCD who reported contamination-related concerns and all other groups of participants.ConclusionThese findings suggest that the Italian version of the VOCI-MC retains the adequate psychometric properties of the original, provide preliminary evidence of its one-factor structure and temporal stability, and suggest that it can be confidently used as an assessment tool of mental contamination symptoms in both clinical and research settings.     

Validation of the Sleep Disturbance Scale for Children and prevalence of parent-reported sleep disorder symptoms in Chinese children

ObjectiveTo translate and validate the Sleep Disturbance Scale for Children (SDSC), a promising questionnaire for use among children in epidemiological studies, in Chinese children.MethodsIn total, 3525 children aged 5–16 years were randomly selected from five primary schools in Shenyang. Internal consistency, reliability and factor analyses were undertaken to assess the construct validity of the SDSC.ResultsInternal consistency indicated adequate reliability (Cronbach’s α = 0.81). Factor analytic results indicated a six-factor solution (ie, six types of sleep disorder) based on parent-reported sleep disorder symptoms. The mean total score of the SDSC was 39.28 ± 7.83 and 156 (4.43%) children were identified as suffering from parent-reported sleep disorder. The prevalence for each sleep type disorder ranged from 3.46% to 6.30% with the highest for sleep hyperhidrosis (SHY) and the lowest for disorders of initiating and maintaining sleep. Significant differences were found between boys and girls in the prevalence of sleep breathing disorders (6.51% vs 3.72%), SHY (8.62% vs 4.00%) and parent-reported sleep disorders (5.19% vs 3.67%).ConclusionsThe SDSC is reliable and useful in screening for parent-reported sleep disorders in Chinese children. Compared with other countries, parent-reported sleep disorders among Chinese elementary school children were at a relatively low level of prevalence.     

Development of traditional Chinese version of World Health Organization Disability Assessment Schedule 2.0 36 – item (WHODAS 2.0) in Taiwan: Validity and reliability analyses

BackgroundWorld Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed.AimsTo describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test–retest reliability of this instrument.MethodsThe study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version.ResultsThe reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73–0.99 and 0.8–089, respectively. The content validity was good (r = 0.7–0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p < 0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status.ConclusionFor disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.     

Reliability and validity of the 6-min walk test in adults and seniors with intellectual disabilities

IntroductionAdults with intellectual disabilities (ID) have significantly lower rates of physical activity and fitness than adults without ID. The 6-min walk test (6MWT) is an inexpensive and simple way to test mobility and submaximal work capacity.PurposeTo evaluate the test–retest reliability and validity of the 6MWT in adults and seniors with ID and explore factors contributing to the 6MWT distance (6MWD).Methods46 participants with mild, moderate and severe ID levels (age = 41 ± 11 years) performed the 6MWT three times (T1; T2; T3) to determine test–retest reliability. To test validity, peak oxygen uptake (VO₂ peak) was measured using a treadmill protocol. To analyze factors contributing to the 6MWD, sex, height, fat mass % and fat free mass %, ID level, isometric leg strength and relative VO₂ peak were also measured.ResultsThe walking distances for T1, T2 and T3 were 460.3 ± 76.9; 489.4 ± 81.2 and 491.4 ± 77.9 m, respectively. The 6MWDs between T1–T2 and T1–T3 were significantly different (p < 0.001), but T2 and T3 were not different. The intraclass correlation coefficient between T2 and T3 was 0.96 indicating high reliability. Relative VO₂ peak and isometric leg strength significantly contributed to the 6MWD (R² = 0.55).ConclusionsThe 6MWT is an easy, inexpensive, reliable and valid test in adults and seniors with ID. Familiarization is necessary to obtain reliable values. Relative VO₂ peak and leg strength have significant impact on the distance walked.     

L’effet de l’âge et de la durée d’incarcération sur la santé mentale des détenus âgés

Inmate aging is considered to start at the age of 50, which is early in relation to aging in the general population. The aging of the criminal population in France poses a real public health problem. There is very little research on the mental health (mental and cognitive disorders) of older inmates.ObjectivesThe objective of this study was to evaluate the effect of age and time spent in prison on mental disorders and cognitive performance of elderly prison inmates. We put forward the hypothesis that age and amount of time spent in prison are associated with the deterioration of older inmates’ mental health, that is, an increase in the prevalence of psychiatric disorders and a decrease in cognitive performance.MethodsWe recruited 138 men aged 50 and over in seven French prisons. The research protocol included a semi-directive interview, the Mini International Neuropsychiatric Interview (MINI DSM-IV) for the assessment of mental disorders, as well as the Rapid Battery for Frontal Efficiency (BREF) and the Mini Mental State Examination (MMSE) for the evaluation of cognitive performance.ResultsThe average age of the inmates (N = 138) was 59.7 years (range 50–84, SD = 8.02). The average sentence was approximately 13.5 years (SD = 7) and the average time spent in prison was 6.9 years (SD = 5.9). The results showed a very high prevalence of mental disorders, notably depression and anxiety, and cognitive disorders. However, the probability of occurrence of certain psychiatric diagnoses decreases with age (major depressive episode, agoraphobia, post-traumatic stress disorder and generalized anxiety). In addition, logistic regression estimates showed no significant relationship between time spent in prison and mental disorders. However, there is a significant link between time spent in prison and cognitive impairment.ConclusionOur hypothesis is partially validated. Indeed, age is not associated with mental or cognitive disorders. However, the amount of time spent in prison has an effect on the deterioration of certain cognitive functions. It appears that after the age of 50, it is not chronological age but environmental factors that mainly explain cognitive decline. Our study shows that the longer the detention period, the greater the inmate's cognitive decline. These results highlight the very high vulnerability of elderly prisoners in terms of mental health and emphasize the importance of implementing appropriate detection and care measures to address the needs of this segment of the criminal population. Routine screening for cognitive impairment in all older prisoners should be carried out by caregivers in penitentiary institutions. Furthermore, better follow-up and cognitive assessment of prisoners aged 50 or more and whose length of incarceration exceeds five years could make it possible to detect subjects at risk and to propose appropriate activities to reduce and/or delay the effects of aging in detention.     

The Spanish version of the Insomnia Severity Index: a confirmatory factor analysis

ObjectiveTo examine the psychometric properties of the Spanish version of the Insomnia Severity Index (ISI) and to determine its factor structure with confirmatory factor analysis (CFA).MethodsSelf-reported information was collected from a sample of 500 adults (mean age 39.13 [standard deviation 15.85] years) drawn from a population of medical students and their social networks. Together with the ISI, a measure of the subjective severity of insomnia, subjects completed the Pittsburg Sleep Quality Index, the Epworth Sleepiness Scale, and the Profile of Mood States to study concurrent validity of the ISI. CFA was used to test alternative models to ascertain the factorial structure of the ISI.ResultsThe Spanish version of the ISI showed adequate indices of internal consistency (Cronbach’s α = 0.82). CFA showed that a three-factor structure provided a better fit to the data than one-factor and two-factor structures. The ISI was significantly correlated with poor sleep quality, fatigue, anxiety, and depression, and discriminated between good and poor sleepers.ConclusionsThe ISI is a reliable and valid instrument to assess the subjective severity of insomnia in Spanish-speaking populations. Its three-factor structure (i.e., night-time sleep difficulties, sleep dissatisfaction and daytime impact of insomnia) makes it a psychometrically robust and clinically useful measure.