RESUMEN
OBJECTIVE: Clinical assessment of depression in men with testosterone deficiency to improve differential diagnosis of this type of depression. MATERIAL AND METHODS: Thirty-seven men (mean age 50.1±9.08 years) with depressive episode and testosterone level ≤12.1 nmol/l were included in the main group. Depressive episode was diagnosed based on ICD-10 criteria (F-32). Additional assessment of physical and psychometrics parameters was evaluated. Forty men (mean age 42.3±10.53 years) with depression based on ICD-10 criteria (F32, F33) and testosterone level >12.1 nmol/l were included in the comparison group. RESULTS: Symptoms of depression in men with testosterone deficiency were less severe and led to less functional disturbance. There were some clinical differences in symptoms and syndromes. Single-episode course with manifestation at a later age was more typical for the main group while the comparison group was mostly characterized by recurrent episodes manifesting at an earlier age. CONCLUSION: Depression in men with testosterone deficiency has a number of differences that must be taken into account when diagnosing and choosing treatment tactics.
Asunto(s)
Depresión , Hipogonadismo , Adulto , Depresión/diagnóstico , Depresión/epidemiología , Depresión/etiología , Humanos , Hipogonadismo/diagnóstico , Hipogonadismo/epidemiología , Masculino , Persona de Mediana Edad , Psicometría , TestosteronaRESUMEN
OBJECTIVES: The Diagnostic Interview for Psychoses (DIP) was developed to enhance the quality of diagnostic assessment of psychotic disorders. The aim of the study was the adaptation of the Russian language version and evaluation of its validity and reliability. MATERIAL AND METHODS: Ninety-eight patients with psychotic disorders (89 video recordings) were assessed by 12 interviewers using the Russian version of DIP at 7 clinical sites (in 6 cities of the Russian Federation). DIP ratings on 32 cases of a randomized case sample were made by 9 interviewers and the inter-rater reliability was compared with the researchers' DIP ratings. Overall pairwise agreement and Cohen's kappa were calculated. Diagnostic validity was evaluated on the basis of comparing the researchers' ratings using the Russian version of DIP with the 'gold standard' ratings of the same 62 clinical cases from the Western Australia Family Study Schizophrenia (WAFSS). RESULTS: The mean duration of the interview was 47±21 minutes. The Kappa statistic demonstrated a significant or almost perfect level of agreement on the majority of DIP items (84.54%) and a significant agreement for the ICD-10 diagnoses generated by the DIP computer diagnostic algorithm (κ=0.68; 95% CI 0.53,0.93). The level of agreement on the researchers' diagnoses was considerably lower (κ=0.31; 95% CI 0.06,0.56). The agreement on affective and positive psychotic symptoms was significantly higher than agreement on negative symptoms (F(2,44)=20.72, p<0.001, η2=0.485). The diagnostic validity of the Russian language version of DIP was confirmed by 73% (45/62) of the Russian DIP diagnoses matching the original WAFSS diagnoses. Among the mismatched diagnoses were 80 cases with a diagnosis of F20 Schizophrenia in the medical documentation compared to the researchers' F20 diagnoses in only 68 patients and in 62 of the DIP computerized diagnostic outputs. The reported level of subjective difficulties experienced when using the DIP was low to moderate. CONCLUSION: The results of the study confirm the validity and reliability of the Russian version of the DIP for evaluating psychotic disorders. DIP can be recommended for use in education and training, clinical practice and research as an important diagnostic resource.