Trends in Psychiatry and Psychotherapy Original ArticleResumo Introdução: A tomada de decisão (TD) é uma das habilidades mais relevantes para a funcionalidade. No entanto, esta habilidade é geralmente avaliada por meio de tarefas comportamentais, cuja validade ecológica tem sido questionada. De acordo com a literatura, a avaliação da TD deve ser complementada por questionários ou escalas, instrumentos estes que não estão disponíveis no português brasileiro. Desta forma, o objetivo deste estudo foi a tradução e validação de uma versão do Melbourne Decision Making Questionnaire (MDMQ), o instrumento mais amplamente utilizado na avaliação da TD, para uso em português. Métodos: A adaptação da MDMQ foi realizada através da tradução, retrotradução, avaliação por painel de juízes e estudo piloto. A versão da escala produzida neste processo foi submetida a análise fatorial e avaliação de consistência interna, levando a exclusão de 4 itens da escala original. A versão resultante da MDMQ, contando com 18 itens no total, foi então utilizada em estudo de validação, em que a TD foi comparada entre adultos saudáveis e portadores de depressão e transtorno bipolar. Resultados:O instrumento demonstrou consistência interna satisfatória, apesar da obtenção de alfas de Cronbach relativamente baixos para a subescala de hipervigilância. A estrutura fatorial do questionário traduzido foi semelhante a observada no instrumento original. Todas as medidas derivadas da MDMQ, mostraram-se discriminativas na comparação entre adultos saudáveis e portadores de transtornos mentais. Conclusão: A versão da MDMQ produzida neste estudo poderá realizar uma importante contribuição para a prática clínica e pesquisa neuropsicológica acerca da TD. Descritores: Tomada de decisões; inquéritos e questionários; psicometria; neuropsicologia. AbstractIntroduction: Decision making (DM) is among the most important abilities for everyday functioning. However, the most widely used measures of DM come from behavioral paradigms, whose ecological validity and standalone use has been criticized in the literature. Though these issues could be addressed by the use of DM questionnaires as a complementary assessment method, no such instruments have been validated for use in Brazilian Portuguese. Therefore, the aim of this study was to conduct the translation and validation of the Melbourne Decision Making Questionnaire (MDMQ) for use in a Brazilian population. Methods: The adaptation of the MDMQ involved the following steps: translation, back-translation, expert review and pilot study. These steps were followed by factor analysis and internal consistency measurements, which led to the exclusion of 4 items from the scale. The 18-item version of the MDMQ was then administered to a validation sample consisting of healthy adults, as well as patients with bipolar disorder (BD) and major depressive disorder (MDD). Results: The instrument displayed good internal consistency, with the hypervigilance subscale showing the lowest, though still acceptable, Cronbach's alpha value. It...
Executive functions and memory in bipolar disorders I and II: new insights from meta-analytic results.Objective: To perform a systematic review and meta-analysis of executive functions (EF) and episodic memory in bipolar disorder (BD). Methods: A literature search was conducted on three electronic databases. Results were combined using random-effects meta-analysis. Results: A total of 126 studies (6424 patients with BDI, 702 with BDII, and 8276 controls) were included. BDI was associated with moderate to large impairments across all cognitive functions and BDII with small-tomedium impairments. Small significant differences were identified between BDI and BDII on all cognitive functions except inhibition. The Trail Making Test (TMT) (g = 0.74, 95% CI: 0.67-0.80), Hayling Test (g = 0.58, 95% CI: 0.34-0.81), Digit Span Total (g = 0.79, 95% CI: 0.57-1.01), and Category Fluency (g = 0.59, 95% CI: 0.45-0.72) tasks were most sensitive to cognitive impairment in BDI. The TMT (g = 0.65, 95% CI: 0.50-0.80) and Category Fluency (g = 0.56, 95% CI: 0.37-0.75) were also sensitive to cognitive alterations in patients with BDII. Conclusion: BD type I was associated with more severe and widespread impairments than BDII, which showed smaller impairments on all functions except inhibition, where impairments were larger. Education and (hypo)manic symptoms should be further investigated in future studies due to their possible influence on the neuropsychological profile of BD. The instruments identified in this review should be considered for inclusion in cognitive assessment batteries in BD. Summations• Patients with BD type I performed worse than control subjects with moderate to large effect sizes, while patients with BD type II showed impairments with small-to-medium effect sizes. Small significant differences were identified between BD types I and II on all cognitive functions except inhibition.• Education, (hypo)mania symptom scores, and lithium use moderated cognitive impairments in BD.• The TMT B, Hayling Test B, Digit Span Total, and Category Fluency were most sensitive to cognitive impairments and to differences between cognitive performance in individuals with BD types I and II. Limitations• Small number of studies involving BD type II. • Large heterogeneity in effect sizes. • Inconsistent reporting of potential moderator variables (mood symptoms, medication use, comorbidities).
Objectives: Cognitive dysfunction is a key feature of major depressive (MDD) and bipolar (BD) disorders. However, rather than a single cognitive profile corresponding to each diagnostic categories, recent studies have identified significant intra-and cross-diagnostic variability in patterns of cognitive impairment. The goal of this study was to contribute to the literature on cognitive heterogeneity in mood disorders by identifying cognitive subprofiles in a population of patients with MDD, BD type I, BD type II, and healthy adults. Methods: Participants completed a neuropsychological battery; scores were converted into Z-scores using normative data and submitted to hierarchical cluster analysis. Results: Three distinct neuropsychological clusters were identified: (1) a large cluster containing mostly control participants, as well as some patients with BD and MDD, who performed at above-average levels on all neuropsychological domains; (2) a cluster containing some patients from all diagnostic groups, as well as healthy controls, who performed worse than cluster 1 on most tasks, and showed impairments in motor inhibition and verbal fluency; (3) a cluster containing mostly patients with mood disorders with severe impairments in verbal inhibition and cognitive flexibility. Conclusions: These findings revealed multiple cognitive profiles within diagnostic categories, as well as significant cross-diagnostic overlap, highlighting the importance of developing more specific treatment approaches which consider patients' demographic and cognitive profiles in addition to their diagnosis. (JINS, 2017, 23, 584-593)
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.