Simple screening questionnaires for major psychiatric disorders are needed for epidemiological research and clinical work. We describe the characteristics of the Hopkins Symptom Checklist-25 (HSCL-25) as a screening instrument in a two-phase epidemiological survey using the Structured Clinical Interview for DSM-III-R (SCID) as a diagnostic tool. The material consisted of 1609 subjects aged 31 years who were asked to participate in a health survey. The invitation included the HSCL-25 questionnaire. All "screen-positive" (HSCL-25 mean>/=1.55) subjects and every tenth "screen-negative" subject were invited to participate in the SCID interview. The sensitivity of the HSCL-25 for any present DSM-III-R axis-I psychiatric disorder was 48%. The specificity was 87%. The sensitivity of cases with comorbid psychiatric disorders was 100%. The HSCL-25 is a moderate instrument for screening with present axis-I DSM-III-R psychiatric disorders in a young adult population. It can be recommended for screening of psychiatric disorders.
Clinicians do not make the diagnosis of schizophrenia as often as the application of operational criteria would suggest they should. The discordance between clinical diagnosis and the research, operational diagnosis is especially likely in cases having late onset and few contacts to psychiatric hospital.
The aim of this study was to examine the factor structure and the validity of the Finnish version of the 20-item Toronto Alexithymia Scale (TAS-20). As part of the Northern Finland 1966 Birth Cohort Project, the TAS-20 was presented to a sample of 5034 31-year old persons. A confirmatory factor analysis showed that the three-factor model, earlier established with the original TAS-20, was in agreement with the Finnish version of the scale. Three criteria of goodness-of-fit met the standards for adequacy of fit. For the total scale, internal reliability (Cronbach's alpha) was 0.83 and for the three subscales (factors 1, 2, and 3) it was 0.81, 0.77, and 0.66, respectively. Two- and one-factor models for TAS-20 were also examined, but the other models did not perform as well as the three-factor model. The factor model also worked well with a sample of 516 students with a mean age of 24.8 years. In conclusion, the TAS-20 scale is useful in the Finnish version, too.
The distribution of personality disorders (PDs) was explored in hospital-treated subjects and in a population subsample. This study forms a part of the Northern Finland 1966 Birth Cohort study. Hospital case records of psychiatric treatment periods of all cohort members (n=11,017) were reviewed and re-checked against DSM-III-R criteria. A subsample of the cohort members living in Oulu (n=1609) were invited to a two-stage psychiatric field survey with Structured Clinical Interview for DSM-III-R (SCID) as a diagnostic method. The most common PDs in hospital-treated sample were cluster B PDs (erratic). In the population subsample, cluster C PDs (anxious) formed the majority.
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