Mood Disturbances Across the Continuum of Care Based on Self-Report and Clinician Rated Measures in the interRAI Suite of Assessment Instruments

Abstract

BackgroundMood disturbance is a pervasive problem affecting persons of all ages in the general population and the subset of those receiving services from different health care providers. interRAI assessment instruments comprise an integrated health information system providing a common approach to comprehensive assessment of the strengths, preferences and needs of persons with complex needs across the continuum of care.ObjectiveOur objective was to create new mood scales for use with the full suite of interRAI assessments including a composite version with both clinician-rated and self-reported items as well as a self-report only version.MethodsWe completed a cross-sectional analysis of 511,641 interRAI assessments of Canadian adults aged 18+ in community mental health, home care, community support services, nursing homes, palliative care, acute hospital, and general population surveys to develop, test, and refine new measures of mood disturbance that combined clinician and self-rated items. We examined validity and internal consistency across diverse care settings and populations.ResultsThe composite scale combining both clinician and self-report ratings and the self-report only variant showed different distributions across populations and settings with most severe signs of disturbed mood in community mental health settings and lowest severity in the general population prior to the COVID-19 pandemic. The self-report and composite measures were strongly correlated with each other but differed most in populations with high rates of missing values for self-report due to cognitive impairment (e.g., nursing homes). Evidence of reliability was strong across care settings, as was convergent validity with respect to depression/mood disorder diagnoses, sleep disturbance, and self-harm indicators. In a general population survey, the correlation of the self-reported mood scale with Kessler-10 was 0.73.ConclusionsThe new interRAI mood scales provide reliable and valid mental health measures that can be applied across diverse populations and care settings. Incorporating a person-centered approach to assessment, the composite scale considers the person's perspective and clinician views to provide a sensitive and robust measure that considers mood disturbances related to dysphoria, anxiety, and anhedonia.

The interRAI CHESS scale is comparable to the palliative performance scale in predicting 90-day mortality in a palliative home care population

“…Once completed, data elements within the assessment automatically generate a series of health index scales (e.g., CHESS Scale, mood disturbance) that can be used to develop and evaluate care plans. Evidence of the validity and reliability of the interRAI PC instrument has been reported previously [43][44][45][46].…”

“…a Note that different reference groups are used for models 1-4 due to sample size limitations in the highest PPS scores. *p < 0.05; **p < 0.001; All other variables had a p < 0.0001, except age[45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64], which was not significant.Abbreviations: interRAI PC = interRAI Palliative Care instrument; OR = Odds ratio; CI = Confidence interval; X 2 : Chi Square.…”

Self-medication with anxiolytics and antidepressants: main risk factors and repercussions

“…8,9 Disorders of mood or affective disorders are a group of psychiatric conditions characterized by a feeling of loss of control over mood, resulting in generalized discomfort, negatively impacting the sufferer, increasing morbidity and mortality. 8,10,11 The prevalence of mood disorders, including symptoms of depression and anxiety, has been increasing, which is of concern due to the blockages, social isolation, and economic and healthrelated concerns stemming from the COVID-19 pandemic, coupled with the risk of suicide increasing by 0.5% to 4% over a lifetime in the general population. 10,12 Anxiety is a mood disorder and a common health problem.…”

“…8,10,11 The prevalence of mood disorders, including symptoms of depression and anxiety, has been increasing, which is of concern due to the blockages, social isolation, and economic and healthrelated concerns stemming from the COVID-19 pandemic, coupled with the risk of suicide increasing by 0.5% to 4% over a lifetime in the general population. 10,12 Anxiety is a mood disorder and a common health problem. In this disorder, the individual is in an unpleasant affective state of anticipation, presenting as a reaction of heightened apprehension, arousal and vigilance because of a stressful event or in the absence of clear and immediate danger.…”