Psychometric properties of the short form of the Children's Depression Inventory (CDI-S) in young people with physical disabilities

ObjectiveDepression is a significant issue for young people with physical disabilities. Efficient and reliable questionnaires are needed to evaluate and monitor the efficacy of depression treatments in this population. The aim of this study was to evaluate the reliability and validity of the 10-item version of the Children's Depression Inventory (CDI-S) in a sample of young people with physical disabilities.MethodsA convenience sample of young people with physical disabilities (N = 97) was recruited and interviewed. Reliability was evaluated using the Cronbach's α and examining the item-total correlations. Validity was evaluated by computing Pearson correlations between scores on the CDI-S and measures of pain and psychological functioning (anxiety and depression).ResultsThe CDS-I items loaded on a single factor. The internal consistency of the scale was good (Cronbach's α = 0.84) and the CDI-S showed moderate significant correlations with pain intensity (r = 0.29), pain interference (r = 0.46) and psychological functioning (r = − 0.57). Two of the items, however, did not perform well (i.e., item-total correlations < 0.3, and Cronbach's α improved when they were deleted).ConclusionThe findings support the reliability and validity of the CDI-S scores for use in young people with physical disabilities. The measure's psychometric properties should be studied in larger samples. In addition, there is a new brief version of the CDI (CDI-S 2) that needs to be evaluated in order to determine which of the two scales is better for assessing depression in young people with physical disabilities.     

Depression and anxiety in pediatric inflammatory bowel disease and cystic fibrosis

The lifetime and current prevalence of depression and anxiety disorders was determined in 41 children with Crohn's disease, 12 children with ulcerative colitis, and 52 children with cystic fibrosis, using the Kiddie-Schedule for Affective Disorders and Schizophrenia interview. The lifetime prevalence of depression was 29% in Crohn's disease, 21% in ulcerative colitis, and 11.5% in cystic fibrosis. The difference in the prevalence of depression between Crohn's disease and cystic fibrosis was significant (p less than 0.05). The lifetime and current prevalence of dysthymia was significantly greater in ulcerative colitis than Crohn's disease (p less than 0.01) or cystic fibrosis (p less than 0.01). The lifetime prevalence of atypical depression was significantly greater in Crohn's disease than cystic fibrosis (22% versus 5.8%, p less than 0.05) and was also greater in ulcerative colitis than cystic fibrosis (21% versus 5.8%, p = 0.1). There was no difference between the groups in the current prevalence of major depression or atypical depression, or in the lifetime or current prevalence of anxiety disorders.     

Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease

Structured psychiatric interviews and psychological self-report measures were administered to 28 patients with irritable bowel syndrome and 19 patients with inflammatory bowel disease. Significantly more of the patients with irritable bowel syndrome had lifetime diagnoses of major depression, somatization disorder, generalized anxiety disorder, panic disorder, and phobic disorder. They had significantly more medically unexplained somatic symptoms, and most had suffered from psychiatric disorders, particularly anxiety disorders, before the onset of their irritable bowel symptoms.     

Cognitive-behavioral therapy for depression in adolescents with inflammatory bowel disease: a pilot study

OBJECTIVE: To evaluate the safety and feasibility of cognitive-behavioral therapy (CBT) for depression in physically ill adolescents. METHOD: In an open trial, 11 adolescents (12-17 years) with inflammatory bowel disease and either major or minor depression underwent 12 sessions of a manual-based CBT enhanced by social skills, physical illness narrative, and family psychoeducation components. Standardized instruments assessed pre- to posttreatment changes in depression, physical health, global psychological functioning, and social functioning. Perceived helpfulness and satisfaction with CBT were assessed. RESULTS: There were significant reductions in DSM-IV depression diagnoses and depressive symptoms and improvements in global psychological and social functioning. Adolescents' perceptions of their general health and physical functioning improved, although illness severity measures were unchanged. High subject satisfaction and helpfulness ratings for CBT were found along with no adverse events and high subject adherence. CONCLUSIONS: A manual-based CBT approach adapted to treat depression in physically ill adolescents appears to be a safe, feasible, and promising intervention.     

Medical management of inflammatory bowel disease: Incorporating goals for drug therapy and psychosocial support

Inflammatory bowel disease consists of two disorders: 1) ulcerative colitis, and 2) Crohn's disease. While they share many similar characteristics, the two disorders should be considered separately from a medical management standpoint, based on different responses to drug therapy. Drug therapy should also be assessed on the basis of treating active disease (inducing remission), or preventing or reducing recurrence (maintenance drug therapy). In addition, a patient's emotional and psychosocial needs should be addressed. Incorporating strategies to improve a patient's coping skills and increase involvement in management of chronic diseases such as ulcerative colitis and Crohn's disease can enhance treatment results.     

Cut-Off Scores of the Children's Depression Inventory for Screening and Rating Severity in Korean Adolescents

Objective

The aim was to establish an optimal cut-off score of the Children''s Depression Inventory (CDI) for detecting depression and rating severity in Korean adolescents.

Methods

A total of 468 students aged 12-16 years from 8 middle schools in Busan, Korea participated in this study. The Korean version of the CDI and Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version were used to evaluate depressive symptoms. Receiver-operating characteristics (ROC) analyses were conducted to evaluate case-finding performance and set the cut-off scores.

Results

ROC analyses demonstrated that the overall discrimination power of the CDI is good enough to evaluate adolescent depression. The CDI sum score of 20 was identified as the optimal screening cut-off score, where sensitivity was 0.83 and specificity was 0.89. This cut-off score could apply regardless of subjects'' gender. The cut-off scores were examined in order of the depression severity: 15 for mild, 20 for moderate, and 25 for severe depression with high sensitivity and specificity.

Conclusion

The CDI cut-off scores of our study can be recommended for screening depressed youth and rating the severity of depressive symptoms. The high negative predictive value suggested that the cut-off score of 20 would result in a small number of missed cases. Further studies are needed to ascertain these CDI cut-off scores for different age groups.     

Depression as a risk factor for Alzheimer disease: the MIRAGE Study

BACKGROUND: Depression symptoms may be associated with the development of Alzheimer disease (AD). OBJECTIVES: To evaluate the association between depression symptoms and risk of AD, and to explore the temporal aspects of this association. SETTING: Academic institutions with specialized memory clinics. DESIGN: Cross-sectional, family-based, case-control study with standardized self- and proxy questionnaires to collect information on depression symptoms and other risk factors. PARTICIPANTS: A total of 1953 subjects with AD and 2093 of their unaffected relatives enrolled in the Multi-institutional Research in Alzheimer's Genetic Epidemiology Study. MAIN OUTCOME MEASURES: Odds ratios (ORs) of AD were estimated with and without depression symptoms, adjusted for age, sex, education, history of head trauma, and apolipoprotein E status. RESULTS: There was a significant association between depression symptoms and AD (adjusted OR, 2.13; 95% confidence interval [CI], 1.71-2.67). In families where depression symptoms first occurred within 1 year before the onset of AD, the association was higher (OR, 4.57; 95% CI, 2.87-7.31), while in the families where the depression symptoms first occurred more than 1 year before the onset of AD, the association was lower (OR, 1.38; 95% CI, 1.03-1.85). In families where depression symptoms first occurred more than 25 years before the onset of AD, there was still a modest association (OR, 1.71; 95% CI, 1.03-2.82). CONCLUSIONS: Depression symptoms before the onset of AD are associated with the development of AD, even in families where first depression symptoms occurred more than 25 years before the onset of AD. These data suggest that depression symptoms are a risk factor for later development of AD.     

The dexamethasone suppression test and the Children's Depression Inventory in psychiatric disorders in children

This open study attempts to evaluate the usefulness of objective diagnostic tests in the child and adolescent age group. Fifty-eight children admitted to a Child and Adolescent Psychiatric service were administered the Dexamethasone Suppression Test (DST), the Children's Depression Inventory (CDI) or both. Rates of DST non-suppression were significantly elevated in children with major affective disorders (10/12) and in children suffering from adjustment disorders (3/18). Children with major depressions and conduct disorders both showed elevated scores on the CDI (p less than 0.025), and these two groups did not significantly differ from each other on this measure. The implications of these findings for future research are discussed.     

Supportive-expressive group psychotherapy for persons with inflammatory bowel disease.

OBJECTIVE: Supportive-expressive (SE) group psychotherapy is designed to be applicable to medically ill populations. In this open trial, SE therapy was adapted for use in treating inflammatory bowel disease (IBD). METHOD: Thirty subjects with Crohn's disease (CD) or ulcerative colitis (UC) were enrolled in 4 psychotherapy groups. Each group met weekly for 20 weeks to discuss emotional and interpersonal issues associated with illness. Physical and psychological variables were measured at the onset and at the finish of the group sessions. RESULTS: There was no mean group change in quality of life (QL), anxiety, or depression over the course of treatment, although there was a mean group reduction in maladaptive coping. CONCLUSION: Although the trial was uncontrolled and the sample size small, which limits interpretation, the results are consistent with an ineffective intervention. Because a null result would be consistent with previously reported psychotherapeutic trials in cases of IBD, and because SE therapy has been effective in treating other medically ill populations, we discuss characteristics of IBD that may account for a relative resistance to psychotherapeutic support.     

Depression in Parkinson disease: a disabling but neglected factor

20 depressed and 20 non depressed patients with Parkinson disease were rated for disability on the Northwestern University Disability Scale and for severity of the typical motor symptoms on the Columbia University Rating Scale and were assessed for mental deterioration. The severity of the typical symptoms was practically equivalent in the two groups but the depressed patients not only presented mild mental deterioration but were significantly more disabled (less independent) than the patients without depression. A significant correlation was found between severity of depression and degree of disability but not between severity of depression and severity of typical motor symptoms. Depression was diagnosed much later than the typical symptoms. Only 25% of the depressed parkinsonians had received tricyclic antidepressants, about 20% had been treated with dopamine-antagonist psychotropic drugs and some 50% had received no treatment at all against depression. Timely diagnosis and appropriate treatment of depression in parkinsonian patients limits the effects of a major disabling factor.Party supported by Regione Piemonte, grant n. 17     

Sleep quality and disease activity in patients with inflammatory bowel disease: a systematic review and meta-analysis

Short sleep or insufficient sleep are significant health concerns among patients with inflammatory bowel disease (IBD). Although an association between sleep quality and disease activity has been reported, findings have been inconsistent. The aim of this systematic review and meta-analysis was to assess the association between sleep quality and disease activity in IBD patients by reviewing findings from cross-sectional and prospective cohort studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted in five electronic databases from inception to May 2020. Studies that examined the relationship between sleep quality and disease activity in IBD patients were screened for eligibility. Six studies were included for the analysis. Sleep quality was measured using subjective questionnaires in six studies and objective methods in three studies. Disease activity was diagnosed following standard guidelines. A significant association between subjective sleep quality and disease activity was observed (pooled OR = 3.52, 95%CI:1.82,6.83, P < 0.001). A significant association between sleep efficiency and disease activity was observed as well (pooled OR = 4.55, 95%CI:1.92,10.75, P = 0.001). Findings from this study indicate that both subjective and objective poor sleep quality were associated with an increased risk for disease activity. Larger studies with an experimental design are warranted to confirm the effects of sleep quality on intestinal pathological changes in IBD patients.     

Impaired fibrinolytic capacity in patients with inflammatory bowel disease

The venous occlusion test was applied to 17 patients with inflammatory bowel disease (IBD; 7 cases of Crohn's disease, 10 cases of ulcerative colitis). Results were compared to those obtained in 20 healthy matched control subjects. Patients with IBD had significantly decreased t-PA Ag release (p less than 0.001) and had no significant vWF Ag release. Residual PAI activity was evidenced after venous stasis in the IBD group but not in the control group. Hypofibrinolysis was more important in patients with an evolutive IBD than in patients with IBD in remission. Impaired systemic fibrinolytic capacity might contribute to an increased risk for thromboembolic complications and to the pathogenesis of inflammatory bowel disease.     

Plasminogen activators in the intestine of patients with inflammatory bowel disease

Plasminogen activators were determined in intestinal tissue, obtained after surgery from patients with Crohn's disease and ulcerative colitis, and compared with normal intestinal tissue from colorectal cancer patients. The activity and quantity of tissue-plasminogen activator (t-PA) was found to decrease with the severity of inflammation in the patients with inflammatory bowel disease. Urokinase (u-PA) activity, however, was not changed compared with controls or in relation with severity of inflammation. In contrast, the level of u-PA antigen was found to be increased significantly in the inflammatory bowel disease tissues and was also related with severity of inflammation. The difference between u-PA activity and antigen in inflammatory bowel disease tissue could be attributed to an increase in inactive pro-u-PA and u-PA-inhibitor complexes. This increase in u-PA and the concomitant decrease in t-PA, are similar to those found in premalignant colonic adenomas, and might be related to the known increased cancer risk in inflammatory bowel disease.     

Discriminant analysis of Beck Depression Inventory and Hamilton Rating Scale for Depression in Huntington's disease

Depression is common in Huntington's disease, but standard rating scales have doubtful validity in this population. Using data from the European Huntington's Disease REGISTRY study, the authors examined the discriminant value of items on the Beck Depression Inventory (N=843) and the Hamilton Rating Scale for Depression (N=768). Good discriminators of depression, apart from "depressed mood," were "guilt," "loss of interest," and "suicidality." Items that discriminated poorly were "weight loss," "sleep disturbance," "loss of appetite," "psychomotor retardation," "agitation," and "irritability." These findings highlight the limited usefulness of these scales within the area of Huntington's disease.     

Cognitive-behavioral therapy for adolescents with inflammatory bowel disease and subsyndromal depression

OBJECTIVE: To examine the feasibility and efficacy of a manual-based cognitive-behavioral therapy (CBT) in reducing depressive symptomatology in adolescents with inflammatory bowel disease (IBD). Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) modified for youths with IBD was compared to treatment as usual (TAU), plus an information sheet about depression, without therapist contact using assessable patient analysis. METHOD: Following assessment, participants 11 to 17 years old with IBD and mild to moderate subsyndromal depression were randomly assigned to PASCET-PI (n = 22) or comparison treatment (n = 19). Primary outcome measures at baseline (T1) and 12 to 14 weeks posttreatment (T2) were Children's Depression Inventory (child/parent report), Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), Children's Global Assessment Scale, and Perceived Control Scale for Children. RESULTS: The PASCET-PI group showed significantly greater improvement in Children's Depression Inventory (child/parent report), Children's Global Assessment Scale, and Perceived Control Scale for Children posttreatment than the comparison group. CONCLUSIONS: Screening and treatment of depressive symptoms in pediatric settings is feasible. PASCET-PI may be an efficacious intervention for subsyndromal depression in adolescents with IBD, although comparison with a more active treatment is necessary to attribute the improvement to PASCET-PI. Clinical trial registration information: URL: http://clinicaltrials.gov. Unique identifier: NCT00446238.