Feasibility, reliability and validity of the Spanish version of Psychiatric Assessment Schedule for Adults with Developmental Disability: a structured psychiatric interview for intellectual disability.

Background: Over 30% of people with intellectual disability (ID) have a comorbid psychiatric disorder. However, there are few assessment instruments available for international use and cross-cultural validation studies of these instruments are rare. The aim of the present study was to standardize the Spanish version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD-10), a semi-structured interview for people with ID.

Assessment instruments: standardization of the European Service Mapping Schedule (ESMS) in Spain.

Objective: To adapt the European Service Mapping Schedule (ESMS) for use in Spain and assess the quality of this schedule.

Method: Following linguistic and conceptual translation, 77 services in five Spanish catchment areas were described by independent local raters, including two experts in health services research. Feasibility (applicability.

Hidden psychiatric morbidity in a vocational programme for people with intellectual disability.

The aim of the present study was to assess the point-prevalence of psychiatric disorders according to DSM-III-R criteria and the hidden morbidity in individuals with intellectual disability working in a vocational setting. The present study was carried out in a vocational centre in Southern Spain which is considered to be a model for social integration. One hundred and thirty workers with intellectual disability were interviewed by two experienced clinicians using the Assessment and Information Rating Profile, DSM-III-R criteria, and the General Assessment of Functioning and Clinical Global Impression scales.

Depersonalization in panic disorder: a clinical study.

Panic disorder (PD) has been hypothesized to be a heterogeneous entity, with distinct clinical subgroups. The presence of depersonalization during panic attacks may distinguish a specific subgroup of PD. We sought to analyze the differential features of a subgroup of PD patients with depersonalization.

Differential clinical features of late-onset panic disorder.

Objectives: The aim was to analyse the sociodemographic and clinical characteristics of panic disorder (PD) in patients with a PD onset after 60 years of age, at two outpatient psychiatric clinics in Barcelona (northeastern Spain).

Material And Methods: All patients presenting with PD at two outpatient clinics over a 4-year period were assessed by the same team. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with an earlier onset.

Service utilization and costs of first-onset schizophrenia in two widely differing health service areas in North-East Spain. PSICOST Group.

Objective: The aim of the study was to analyse the cost-incidence of schizophrenia in two areas with widely differing health service systems.

Method: The costs of patients with schizophrenia in the 3 years after the first service contact were evaluated (i) in an area (A) with fully developed mental health community programmes and (ii) in another area (B) without such programmes. The assessment included a standard description of services, as well as clinical, social and disability aspects.

Differential clinical features of early-onset panic disorder.

Background: Although panic disorder (PD) begins typically in adulthood, an earlier onset is not uncommon. Recent studies on early-onset PD indicate that this subgroup of patients may display distinct clinical characteristics.

Objective: To compare a subgroup of early-onset PD patients with the rest of the sample.

Utilisation of mental health services and costs of patients with schizophrenia in three areas of Spain.

Background: The analysis of the costs of schizophrenia and its treatment under different mental health care structures will facilitate the improved allocation of the limited resources available for the treatment of schizophrenia. The research we present compares health service use and total health care costs of three cohorts of subjects with schizophrenia which are representative of three areas of Spain (Burlada in Navarra, Cantabria and the Eixample of Barcelona).

Method: We selected first-time contacts with any psychiatric service who received a diagnosis of schizophrenia.

[Subtyping panic disorders according to their symptoms].

Background: Panic disorder (PD) is a common illness associated with high levels of disability and with a high utilisation of non-psychiatric health services which is inefficient in most cases. A better understanding of the clinical subtyping of PD may improve diagnosis both in psychiatric and medical settings. The present study is aimed at assessing the frequency, factorial grouping and comorbidity of PD symptoms in a naturalistic sample of patients.

Semiology and subtyping of panic disorders.

To date, the quantitative psychopathology of panic disorder (PD) has been less well studied than that of other psychiatric conditions such as schizophrenia or major depression. The aim of the present study was to assess the frequency and factorial grouping of symptoms in a naturalistic sample of PD patients. A total of 274 consecutive cases of PD who contacted an out-patient clinic in Barcelona, Spain were assessed by two experienced interviewers.

A reliability study of the Spanish version of the social behaviour schedule (SBS) in a population of adults with learning disabilities.

The reliability of the Spanish version of the Social Behaviour Schedule (SBS) was tested in a vocational setting on a sample of 64 subjects with learning disabilities. Test-retest assessment showed a good percentage of agreement (80%) and adequate kappa values for most SBS items. The overall percentage of agreement of inter-rater reliability was 85% and kappa values were moderate to nearly perfect for 52% of items.

Description and classification of mental health services: a European perspective.

Whilst steady progress has been made in the development and dissemination of valid and reliable instruments for evaluation of patient outcomes, progress in establishing standard methodologies for description and classification of mental health services has been limited. Valid and reliable methods of describing and classifying services are needed in mental health services research for purposes including; i) comparison of levels of provision between catchment areas and countries; ii) reaching an understanding of the relationship between socio-demographic indicators and service use; iii) investigation of the degree to which one service may be substituted for another; iv) evaluating programme implementation; and v) understanding why different outcomes are observed from apparently similar treatment programmes. Where programmes of research encompass different countries, the need for methods of comparing the local service contexts is particularly acute.

[Cost effectiveness analysis of olanzapine versus haloperidol in the treatment of schizophrenia++ in Spain].

Background: Cost-effectiveness of olanzapine in comparison with haloperidol, in Spanish schizophrenic patients, was analysed using a clinical decision model.

Methods: The model represents a simulation of the different clinical and therapeutic possibilities that an hypothetical cohort of patients could experienced in a 5-years period of treatment. Efficacy was measured as months with partial-complete remission.

Costs and offset effect in panic disorders.

Background: The study is aimed at assessing the costs before and after the diagnosis and the provision of effective treatment for panic disorder (PD), and the offset effect related to the psychiatric encounter.

Method: A 24-month prepost design was used to collect data on clinical status and health care services utilisation in a natural environment. The 61 PD patients' assessment included the SCID-UP, ratings on general functioning, improvement, severity of symptoms and level of disability.

[The use of services, the effect of compensation and the costs of a panic disorder].

Background: The use of general health care services by psychiatric patients has decreased drastically following correct diagnosis. This phenomenon, called offset effect, allows the use of inefficient health care services to be evaluated and contributes to the estimation of the relative impact of the disorder in addition to the estimation of the benefits of the training campaigns and/or the implementation of services. The aim of this study was to evaluate the offset effect and the costs of the panic disorder (PD) in a natural environment.

[Sexuality and schizophrenia].

The sex behaviour of patients suffering from schizophrenia has been largely overlooked. This study is aimed at describing the pattern of sexual responses and conducts in 113 inpatients with schizophrenia (DSM-III-R). A high rate of sexual dysfunction was found in both males (62.