Assessment of self-reported anger expression in pre- and early-adolescent African Americans: psychometric considerations

This study examined the psychometric properties of the Speilberger state-trait anger expression inventory (STAXI) and Framingham (FAS) anger scales in 86 African American youth. Significant gender differences were not observed for the STAXI or FAS subscales scores (all p>0.17). Inter-scale correlations revealed that the anger-in and anger-out subscales of the STAXI and FAS were measuring similar, yet different constructs. For the STAXI, intra-scale correlations indicated that the anger-in and anger-out subscales were not independent (p<0.001), whereas the anger-in and anger-out subscales (FAS) were not statistically related (p>0.05). The component structures for the anger-control subscale (STAXI) and the anger subscales (FAS) were similar to those reported by the scale authors.     

Frequency of bullying at work, physiological response, and mental health

Objective

The present study aimed to elucidate the relationship between bullying at work and cortisol secretion. Of particular interest was to examine whether frequently and occasionally bullied persons differed from nonbullied persons.

Methods

The study included 1944 employees (1413 women and 531 men) from 55 workplaces in Denmark (16 private and 39 public workplaces). During a work day three saliva samples were collected at awakening, +30 min later, and at 20:00 hours, and analyzed for cortisol concentrations. Mental health was assessed using items on somatic, cognitive, stress, and depressive mood.

Results

Of the 1944 employees, 1.1% was frequently bullied and 7.2% occasionally bullied. Frequently bullied persons reported poorer mental health and had a 24.8% lower salivary cortisol concentration compared with the nonbullied reference group. Occasionally bullied persons had a poorer self-reported mental health, but their cortisol concentrations did not deviate from the group of nonbullied persons. The associations remained significant even after controlling for age, gender, exact time of sampling, mental health, and duration of bullying. Bullying occurred at 78% of the workplaces (43 workplaces); frequent bullying occurred at 21% of the workplaces (40%).

Conclusion

Frequent bullying was associated with lower salivary cortisol concentrations. No such association was observed for occasional bullying. Whether the generally lower secretion of cortisol among the frequently bullied persons indicate an altered physiological status remains to be evaluated in future studies. Yet, the physiological response seems to underscore the possibility that bullying indeed may have measurable physiological consequences. Hence, the physiological response supports the mental symptoms found among the frequently bullied.     

Quality of life after pulmonary embolism as assessed with SF-36 and PEmb-QoL

Introduction

Although quality of life (QoL) is recognized as an important indicator of the course of a disease, it has rarely been addressed in studies evaluating the outcome of care for patients with pulmonary embolism (PE). This study primarily aimed to evaluate the QoL of patients with acute PE in comparison to population norms and to patients with other cardiopulmonary diseases, using a generic QoL questionnaire. Secondary, the impact of time period from diagnosis and clinical patient characteristics on QoL was assessed, using a disease-specific questionnaire.

Methods

QoL was assessed in 109 consecutive out-patients with a history of objectively confirmed acute PE (mean age 60.4 ± 15.0 years, 56 females), using the generic Short Form-36 (SF-36) and the disease specific Pulmonary Embolism Quality of Life questionnaire (PEmb-QoL). The score of the SF-36 were compared with scores of the general Dutch population and reference populations with chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), a history of acute myocardial infarction (AMI), derived from the literature. Scores on the SF-35 and PEmb-QoL were used to evaluate QoL in the short-term and long-term clinical course of patients with acute PE. In addition, we examined correlations between PEmb-QoL scores and clinical patient characteristics.

Results

Compared to scores of the general Dutch population, scores of PE patients were worse on several subscales of the SF-36 (social functioning, role emotional, general health (P < 0.001), role physical and vitality (P < 0.05)). Compared to patients with COPD and CHF, patients with PE scored higher (= better) on all subscales of the SF-36 (P ≤ 0.004) and had scores comparable with patients with AMI the previous year. Comparing intermediately assessed QoL with QoL assessed in long-term follow-up, PE patients scored worse on SF-36 subscales: physical functioning, social functioning, vitality (P < 0.05), and on the PEmb-QoL subscales: emotional complaints and limitations in ADL (P ≤ 0.03). Clinical characteristics did not correlate with QoL as measured by PEmb-QoL.

Conclusion

Our study demonstrated an impaired QoL in patients after treatment of PE. The results of this study provided more knowledge about QoL in patients treated for PE.     

Relationships between perceived teachers' controlling behaviour,psychological need thwarting,anger and bullying behaviour in high-school students

We tested a model of the associations between students' perceptions of their physical education teacher's controlling behaviour, perceptions of basic psychological need thwarting, anger and bullying behaviour. School students (N = 602; M age = 12.88, SD = 1.37) from 10 schools completed measures of perceived teachers' controlling behaviour and perceived thwarting of the psychological needs for autonomy, competence, and relatedness in physical education context and self-reported bullying and anger. A well-fitting structural equation model demonstrated that students' perceptions of the negative conditional regard and intimidation exhibited by the teacher had significant indirect effect on students' feelings of anger and bullying behaviour through the perceived psychological need thwarting in physical education. Findings suggest that physical education teachers who avoid the use of negative conditional regard and intimidation in their classes have students who perceive less need thwarting and report less bullying behaviour.     

Quality of life in chronic daily headache: a study in a general population

OBJECTIVE: To analyze the quality of life (QoL) of subjects with chronic daily headache (CDH) in the general population. METHODS: QoL was studied, using the generic instrument Short Form-36 (SF-36), in 89 unselected subjects from an epidemiologic study in the general population who fulfilled CDH criteria. SF-36 scores were adjusted for comorbid conditions. A total of 89 healthy matched subjects were recruited as a control group. An additional matched group of 89 otherwise healthy subjects with episodic migraine was recruited as controls only to those with transformed migraine (TM). RESULTS: CDH subjects showed a significant decrease in each health-related concept of the SF-36 as compared with healthy subjects. The highest decreases were seen for role physical, bodily pain, vitality, and social functioning. There was no significant difference in SF-36 scores in subjects with chronic tension-type headache as compared with TM subjects. TM individuals showed lower values in each health-related concept when compared with patients with episodic migraine, these decreases being significant for general health, vitality, and mental health. Finally, CDH subjects without analgesic overuse showed higher values in each concept of the SF-36 than those with analgesic overuse. Despite the low proportion of abusers in this study, differences were significant for physical functioning and bodily pain. CONCLUSIONS: In the general population, CDH reduced all QoL aspects studied with the SF-36. This reduction in QoL was most marked in subjects with analgesic overuse. QoL was affected more by the chronicity than by the intensity of pain.     

Patients' assessment of quality of life instruments: a randomised study of SIP, SF-36 and SEIQoL-DW in patients with amyotrophic lateral sclerosis.

The evaluation of quality of life (QoL) plays an increasingly important role in clinical research and drug trials in ALS. However, most of the scales employed so far are based on a fixed external value system, and may therefore not reflect the patients' subjective perception of QoL accurately. In addition, many ALS patients complain about the psychological distress inflicted by QoL questionnaires which focus on functional status, as they constantly remind patients of their deterioration. We therefore asked 42 ALS patients to assess, using visual analogue scales, their subjective perception of the validity of three QoL instruments as well as the emotional distress caused by them. The scales were: the Sickness Impact Profile (SIP), the Short Form 36 (SF-36), and the Schedule for the Evaluation of Individual QoL-Direct Weighting (SEIQoL-DW). Patients were examined at least three times at two-month intervals. The SIP was filled out by all patients, the SF-36 and the SEIQoL-DW were assigned at random. The validity of the SEIQoL-DW was rated higher than that of the SIP (p<0.001) and of the SF-36 (p<0.001). The SIP imparted a higher emotional distress to patients than the SEIQoL-DW (p<0.005), with a trend in the same direction for the SF-36 (p=0.082). The most frequently mentioned QoL-relevant domains in the SEIQoL-DW were family (100%), health (53%), and profession (50%). These results should prompt further discussion and investigation on the most appropriate way to assess QoL in patients with ALS.     

Quality of life in multiple sclerosis: influence of interferon-beta1 a (Avonex) treatment

BACKGROUND: Numerous data argue for initiating treatment with interferon-beta (IFN-beta) at an early stage in multiple sderosis (MS). The consequences of its use may negatively influence the MS patient's quality of life (QoL). OBJECTIVE: To evaluate the QoL of MS patients before and after a one-year period of treatment with IFN-beta1a (Avonex). PATIENTS AND METHODS: QoL was assessed using the SF-36 in 121 relapsing-remitting MS patients. We compared QoL before and after treatment and with data from a normal population. We also studied the possible influence of disease progression on the SF-36 scores. RESULTS: One hundred six patients completed the study (87%). Compared to a normal population, patients were, at baseline, worse off for all QoL scales, varying from a minimum decrease of 0.73 SD in mental health, to a maximum decrease of 1.55 SD in general health. After treatment, we found no significant changes in any of the QoL scores, except for physical function, where we noted a slight but significant decrease (p = 0.03). Furthermore, there was no significant change either in the physical component summary (PCS) or mental component summary (MCS). The 'reported health transition' item was significantly improved compared to baseline (p = 0.001). At indusion, significant correlations were found between EDSS scores and scores of physical function (p < 0.001), role - physical (p < 0.01), general health and social function (both p < 0.01), and with the PCS (p < 0.01). Patients with dinical relapses and/or disability progression had a more significant decease in physical function (p < 0.05) and also in social function (p < 0.05). CONCLUSION: The QoL, assessed by the SF-36 scale, is correlated with disability in MS. IFN-beta1a treatment (Avonex) has no negative effect on MS patient's QoL.     

Salivary cortisol,personality, and aggressive behavior in adolescent boys: a 5-year longitudinal study

OBJECTIVE: The present investigation tested the hypothesis that low resting salivary cortisol concentration in preadolescent boys would be associated with aggressive behavior later in adolescence. Second, it tested whether personality traits would mediate this relation. METHOD: Resting salivary cortisol concentrations from 314 boys (10-12 years of age) were assayed. When the boys reached 15 to 17 years of age these concentrations were analyzed in the context of personality traits, measured with the Multidimensional Personality Questionnaire, and aggressive behavior, measured with the Youth Self-Report inventory. RESULTS: Low cortisol in preadolescence was associated with low harm avoidance, low self-control, and more aggressive behavior 5 years later, during middle adolescence. Cortisol was not related to negative emotionality or any of its factors (including trait aggression). Low self-control was identified as the primary personality mediator of the relation between low cortisol and later aggressive behavior. CONCLUSIONS: In adolescent boys, low resting cortisol concentrations appear predictive of clinically important personality factors. Increased aggressive behavior in adolescents with low resting cortisol may be more strongly associated with lack of self-control than with a specifically "aggressive personality."     

Disability and quality of life in Guillain-Barré syndrome – Longitudinal study

Longitudinal health-related quality of life (QoL) data in Guillain-Barré (GBS) patients are still scarce. We, therefore, investigated health- related QoL in GBS patients from Serbia and surrounding countries during a six-month follow-up period, and analyzed its association with patients' disability. Our study comprised 74 adult patients diagnosed with GBS from May 2017 until May 2018 in seven tertiary healthcare centers. Health-related QoL was investigated using the SF-36 questionnaire, and compared with functional disability assessed by the GBS disability scale (GDS). Tests were performed at day 14, day 28, month 3 and month 6 from disease onset. GDS and SF-36 scores improved over time (p < 0.01). GDS scores were different at all four time points, while SF-36 did not differ between day 14 and day 28. Pooled SF-36 scores (especially physical ones) correlated with pooled GDS scores, except for Bodily Pain and Role Emotional scores. We found that GDS score at day 14 was an independent predictor of GDS score at month 6 (β = +0.52, p < 0.01), while SF-36 score at day 14 was an independent predictor of SF-36 score at month 6 (β = +0.51, p < 0.01). Neurologists should look not only on disability but also on QoL in GBS patients, since these two measures provide us with important complementary items of information.     

Quality of life in patients with orthostatic tremor

We assessed health-related quality of life (QoL) and depression, using the SF-36 and the Beck Depression Inventory (BDI), in 20 orthostatic tremor (OT) patients. All dimensions of the SF-36 were markedly reduced in OT and depression was found in 11 patients. The BDI score correlated significantly with several SF-36 subscores. We conclude that OT strongly impacts on QoL. The results highlight the importance of recognizing and treating depression in patients with OT.     

Salivary cortisol and dehydroepiandrosterone in relation to puberty and gender

This study investigates basal levels of cortisol and dehydroepiandrosterone (DHEA), and their relation to gender and pubertal development, in healthy children and adolescents. Salivary cortisol and DHEA levels were examined in 129 normally developing subjects aged eight to 16 years. Subjects provided morning (08:00 h) and evening (20:00 h) saliva samples over four consecutive days. Pubertal stage was assessed using Tanner stage sketches, and subjects were grouped according to their general status of pubertal development (pre-early puberty: Tanner stageII). Results showed that morning salivary cortisol in mid-postpubertal girls was greater than in mid-postpubertal boys, but not pre-early pubertal girls and boys. Mean levels of salivary DHEA were greater in mid-postpubertal boys and girls than in pre-early pubertal boys and girls. Changes in hypothalamic-pituitary-adrenal (HPA) axis function that occur during puberty may have implications for immediate and long-term adolescent health.     

Alcohol dependence: the impact of cognitive behaviour therapy with or without naltrexone on subjective health status

OBJECTIVES: To examine the health-related quality of life of alcohol-dependent patients across a 12-week cognitive behaviour treatment (CBT) program and identify whether the patient selection of the anticraving medication naltrexone further enhanced these outcomes. METHOD: One hundred and thirty-six consecutive alcohol-dependent subjects voluntarily participated and were offered naltrexone, of which 73 (54%) participants declined medication. A matched design was used. Of the 136 subjects, 86 (43 naltrexone and CBT; 43 CBT only) could be individually matched (blind to outcome measures) for gender, age, prior alcohol detoxification and dependence severity. Measures of health status and mental health wellbeing included the Rand Corporation Medical Outcomes Short Form 36 Health Survey (SF-36) and the General Health Questionnaire (GHQ-28). RESULTS: Pre-treatment, all had SF-36 and GHQ-28 scores markedly below national norms. Post-treatment, significant improvement in seven of the eight SF-36 subscales and all of the GHQ-28 subscales occurred, approximating national normative levels. Patients in the CBT + naltrexone group were significantly more likely to have increased days abstinent (p=0.002) and to complete the program abstinent (p=0.051). The adjunctive use of naltrexone did not provide additional benefit as reflected in SF-36 and GHQ-28 scores, beyond CBT alone. CONCLUSIONS: Patients who completed the CBT-based treatment program reported significant improvements in self-reported health status (SF-36) and wellbeing (GHQ-28). The adjunctive use of naltrexone demonstrated no additional improvement in these measures.     

Panic disorder in patients with chronic heart failure

OBJECTIVE: Our objective was to assess the prevalence of panic disorder, its influence on quality of life (QoL), and the presence of further anxiety and depressive comorbid disorders in outpatients with chronic heart failure (CHF). METHODS: In a cross-sectional study, anxiety and depressive disorders were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria in patients with CHF who were aged > or =18 years and had New York Heart Association (NYHA) Functional Classes I-IV, using the Patient Health Questionnaire. Health-related QoL was evaluated using the Short-Form 36 Health Survey (SF-36). RESULTS: Of the 258 participating patients, 24 (9.3%) fulfilled diagnostic criteria for panic disorder. Seven of these (29.2%) were diagnosed with comorbid anxiety disorders, 11 (47.3%) were diagnosed with comorbid depressive disorder, and 5 (20.8%) were diagnosed with other anxiety disorders and any depressive disorder. Female gender [odds ratio (OR)=3.1; 95% confidence interval (95% CI)=1.2-7.8; P=.02] and a lower level of education (OR=0.3; 95% CI=0.1-0.9; P=.04) were associated with the presence of panic disorder. In patients with panic disorder, QoL was significantly more restricted on all subscales of the SF-36 as compared to those without panic disorder, even when age, gender, and NYHA functional class were controlled for (P=.05 to <.01). CONCLUSION: Approximately 1 of 10 patients with CHF suffers from panic disorder, many of whom also have additional anxiety or depressive comorbid disorders. Female gender and a low level of education are positively associated with the presence of panic disorder. QoL is severely limited by the presence of panic disorder. Diagnosis of mental disorders and treatment offers for affected patients should be available in patient care.     

Subjective sleep disturbance in patients with partial epilepsy: a questionnaire-based study on prevalence and impact on quality of life

PURPOSE: This study was designed to assess whether sleep disturbance is more frequent among patients with partial seizures and what impact on quality of life (QoL) sleep disturbance may have on patients with partial seizures. METHODS: Questionnaire booklets were mailed to 1,183 patients from four Dutch clinics. Each patient was asked to find two age- and gender-matched controls to complete the same set of questionnaires [Sleep Diagnosis List (SDL), Medical Outcomes Study (MOS)-Sleep Scale, Groningen Sleep Questionnaire, Epworth Sleepiness Scale, and the SF-36 Health Survey]. The prevalence of sleep disturbance, based on the SDL, was compared between those with partial epilepsy and controls. Mean scores on sleep and the SF-36 Physical (PCS) and Mental (MCS) Component Summary scales were compared. RESULTS: Responses from 486 patients and 492 controls were analyzed. Respondents with partial epilepsy had a highly significant, twofold higher prevalence of sleep disturbance compared with controls (38.6 vs. 18.0%; p < 0.0001). Most sleep-disorder subscales showed significant abnormalities in respondents with epilepsy, compared with controls. Mean SF-36 MCS and PCS scores were significantly lower in respondents with epilepsy compared with controls in both the strata with sleep disturbance and without (all p values <0.05). The presence of a sleep disturbance in respondents with epilepsy was associated with the greatest impairment in QoL. CONCLUSIONS: Sleep disturbance is more than twice as prevalent in persons with partial epilepsy compared with controls, and most domains of sleep are significantly disturbed. Persons with partial epilepsy have significant QoL impairment, and sleep disturbance further compounds this.     

The association between bullying behaviour, arousal levels and behaviour problems

Research into bullying behaviour has identified two main categories of bullying behaviour, direct bullying and relational bullying, within which different profiles are evident, namely 'pure' bullies, 'pure' victims, bully/victims and neutral children. The current study examined the relationship between direct and relational bullying profiles, arousal levels, and behaviour problems. 242 (males: 121, females: 121) Secondary school pupils (mean age 13.5 years) completed three questionnaires; the Arousal Predisposition Scale (APS) (Behav. Res. Therapy 26 (1988) 415); the School Relationships Questionnaire (SRQ) (detailed in J. Child Psychol. Psychiatry 41(8) (2000) 989; Br. J. Psychol. 92 (2001) 673); the Strengths and Difficulties Questionnaire (SDQ) (J. Child Psychol. Psychiatry 38(5) (1997) 581). Results revealed that the bully/victim profile for direct and relational bullying had the highest levels of arousal compared to other bullying profiles. Conversely, direct 'pure' bullies had low levels of arousal. Clinical behaviour problems as measured by the SDQ were associated with high levels of arousal. Clinically low arousal was not related to either bullying profiles, or behaviour problems. These findings were largely consistent with the arousal theory of behaviour (Crime and personality, 1964), which indicates that arousal levels are differentially associated with distinct behaviour patterns. The results provide implications for bullying intervention strategies, and methods to manage the school environment in relation to arousal levels.     

Mood,eating attitudes,and anger in obese women with and without Binge Eating Disorder

Objective: The aim of this study was to evaluate the anger levels and their management in obese patients. Methods: A total of 103 obese women [51 with Binge Eating Disorder (BED) and 52 without BED] were included in the study and compared to 93 healthy controls. They were assessed with the State–Trait Anger Expression Inventory (STAXI), Beck Depression Inventory (BDI), and Eating Disorder Inventory-2 (EDI-2). Results: The BDI score is higher in obese subjects than in controls and obese binge eaters have higher levels of depression than obese patients without BED. Differences among the three groups can be found in almost all subscales of the EDI-2, even after controlling for the variable depression (BDI). For STAXI, the only difference among the three groups, which remains significant after controlling for depression, is the tendency to express anger outside (AX-OUT), which is higher in obese binge eaters. The correlation study highlights the importance of impulsivity in the group of obese binge eaters, whereas in obese patients without BED, the tendency toward anger suppression (AX-IN) is seen. Discussion: Obese patients with BED might be considered a subgroup deserving greater psychiatric interest, both for the greater severity of the eating disorder and for the comorbidity with subthreshold depressive symptoms and with borderline personality traits. In obese patients without BED, eating behavior seems more correlated to the psychological functioning typical of psychosomatic disorders. Implications for treatment are discussed.     

Involvement in bullying and depression in a 2-year follow-up in middle adolescence

The main objective was to analyse whether involvement in bullying at school predicts depression, and whether depression predicts involvement in bullying in middle adolescence. A total of 2,070 15-year-old girls and boys in two Finnish cities were surveyed at ninth grade (age 15) at schools, and followed up 2 years later in the Adolescent Mental Health Cohort Study (AMHC). Depression was measured by a Finnish modification of the 13-item short Beck Depression Inventory. Involvement in bullying was elicited by three questions focusing on being a bully, being a victim to bullying, and being left alone by peers against one’s wishes. Similar questions were posed at both time points. Statistical analyses were carried out using cross-tabulations with chi-square/Fisher’s Exact Test statistics, and logistic regression. The results summarized that, both being a victim to bullying and being a bully predicted later depression among boys. Among girls, depression at T1 predicted victimisation at T2. Depression at T1 predicted experience of being left alone at T2 among both sexes. It was concluded that victimisation to bullying may be a traumatising event that results in depression. However, depression also predicts experience of victimisation and of being left alone against one’s wishes. Depression may impair an adolescent’s social skills and self-esteem so that the adolescent becomes victimised by peers. However, depression may also distort and adolescent’s experiences of social interactions.     

Health-related quality of life among first-degree relatives of patients with obsessive-compulsive disorder in Italy

OBJECTIVE: The aim of this study was, first, to examine health-related quality of life among relatives of Italian patients with obsessive-compulsive disorder and, second, to search for potential predictors of quality of life among these relatives. METHODS: Health-related quality of life was assessed among 64 non-psychiatrically ill family members of 48 patients with obsessive-compulsive disorder by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Structured Clinical Interview for DSM-IV Axis II Disorders were used to assess obsessive-compulsive disorder among the patients. Mean SF-36 scores of participants were compared with expected scores for 2,031 persons from the Italian general population (Italian norms) by using the one-sample t test. Correlates of health-related quality of life were examined by means of independent-sample t tests and Pearson correlations; variables significantly associated with SF-36 subscales were entered into a stepwise multiple linear regression analysis with the physical and mental components as dependent variables. RESULTS: Relatives of patients with obsessive-compulsive disorder showed a greater impairment in health-related quality of life in the SF-36 subscales of role limitations due to physical health, vitality, social functioning, role limitations due to emotional problems, and mental health. When a stepwise multiple linear regression analysis was performed with the physical component and the mental component of the SF-36 as dependent variables, female gender, older age, and the total score on the Family Accommodation Scale predicted a poorer score on the physical component, whereas the only predictor of a poorer score on the mental component was the patient's Y-BOCS total score. CONCLUSIONS: The study provides evidence that obsessive-compulsive disorder impairs health-related quality of life among family members of patients with obsessive-compulsive disorder, even among healthy family members. Involving family members in the treatment of obsessive-compulsive disorder could improve their perceived quality of life.     

Cannabis use and mental health-related quality of life among individuals with anxiety disorders

Cannabis is the most widely used illicit substance in individuals with anxiety disorders. The aim of this study was to assess mental health-related quality of life (QoL) among individuals with anxiety disorders with and without concurrent cannabis use based on a large representative US sample. Mental health-related QoL of regular cannabis users (N = 144), occasional cannabis users (N = 181) and non-users (N = 4427) was assessed using the Short-Form 12-Item Health Survey (SF-12). Among individuals with anxiety disorders, mean SF-12 mental summary scores were significantly lower (indicating a lower QoL) among regular, but not occasional, cannabis users (by 0.8 standard deviations (SDs) and 0.6SD for females and males, respectively) compared to non-users. Adjusting for sociodemographic variables and co-morbid mood disorders, regular, but not occasional, cannabis use was associated with lower mental health summary and subscales scores. Out results highlight the importance of taking into account direct functional and emotional outcomes, as well as frequency of cannabis used, when assessing the impact of cannabis use among individuals with anxiety disorders.     

Quality of life in patients with craniocervical dystonia: Italian validation of the “Cervical Dystonia Impact Profile (CDIP-58)” and the “Craniocervical Dystonia Questionnaire (CDQ-24)”

Dystonia is a disabling and disfiguring disorder that can often affect many aspects of patients’ daily lives, and lower their self-esteem. To date, quality of life (QoL) has been assessed in dystonic patients using generic measures that do not address the specific problems of this diagnostic group. Recently, two disease-specific scales “The Cervical Dystonia Impact Profile (CDIP-58)” and the “Craniocervical Dystonia Questionnaire (CDQ-24)” were validated for measuring QoL in craniocervical dystonia patients. No disease-specific scales for QoL for dystonic patients are currently available in Italian. The aim of our study was to produce and validate the Italian version of the CDIP-58 and CDQ-24. We obtained the Italian version of CDQ-24 and CDIP-58 with a back-translation design. Both scales were applied to a population of 94 craniocervical dystonia patients along with the Short Form 36 health-survey questionnaire (SF-36), both before and 4 weeks after botulinum toxin therapy. A group of 65 controls matched for sex, age and comorbidity underwent the SF-36. Internal consistency was satisfactory for all subscales. Both the CDIP-58 and CDQ-24 showed moderate to high correlations with similar items of the SF-36. Sensitivity to change was confirmed by highly significant improvements in all CDQ-24 subscales and by moderate improvements in three out of eight CDIP-58 subscales and total score. This is the first Italian study on QoL in dystonia patients. We validated the Italian version of two disease-specific questionnaires to evaluate QoL in craniocervical dystonia patients. These scales could be useful for both clinical practice and clinical trials.