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KGVM Symptom Scale.pdf ((TOP))

Background: Scales to measure the severity of different dimensions of auditory hallucinations and delusions are few. Biochemical and psychological treatments target dimensions of symptoms and valid and reliable measures are necessary to measure these.

KGVM Symptom Scale.pdf

The main psychiatric assessments of psychosis tend to measure the severity and/or frequency of the main clinical features. They are invariably interview-based rather than self-report, since lack of insight is traditionally seen to be central to the disorder (David, 1990). Most include both items rated from the information elicited from the respondent, and others rated on the basis of observation during the interview. Their administration can range from 20 minutes to several hours, depending on how symptomatic the individual is. The most widely used measures include the Present State Examination (PSE; Wing et al., 1974), now incorporated in the Schedules for Clinical Assessment in Neuropsychiatry (SCAN; WHO, 1992); the Brief Psychiatric Rating Scale (BPRS; Overall & Gorham, 1962); the Scales for the Assessment of Positive Symptoms (SAPS; Andreasen, 1984a) and for the Assessment of Negative Symptoms (SANS; Andreasen, 1984b); the Positive and Negative Symptom Scale (PANSS; Kay et al., 1987, 1988, 1989), the Krawiecka Scale (also known as the Manchester Scale and the KGV; Hyde 1989; Krawiecka et al., 1977), and the Comprehensive Psychiatric Rating Scale (CPRS; Asberg et al., 1978; Jacobsson et al., 1978).

Each of these scales has advantages and disadvantages, and the appropriateness of their use will depend on the purpose of the assessment (see Barnes & Nelson, 1994). For instance, the PSE will enable a reliable classification of syndromes, but is not useful to look at change over time. The BPRS, which contains 16 subscales each rated on a seven-point scale, is better for the detection of change, but reliability and validity are poorer. The PANSS, which contains seven items on positive symptoms, seven items on negative symptoms, and 16 items on general psychopathology, is used extensively in research, but the interview is time-consuming and not user-friendly for clinical purposes. The SAPS and SANS are the most thorough in terms of positive and negative symptoms, but do not include other areas of psychopathology which may be relevant clinically, such as disorganisation or emotional problems. The KGV combines brevity with a wide range of symptomatology (eight symptoms are recorded, falling into three main categories: affective (depression and anxiety), positive (delusions, hallucinations, and incoherence and irrelevance of speech), and negative (poverty of speech, flattened incongruous affect, and psychomotor retardation)), but there is only one item each for rating delusions and hallucinations.

Similarly, apart from the general psychiatric measures mentioned above such as the SANS and the PANSS, there are few specific negative symptoms scales. One notable exception includes the Subjective Experience of Negative Symptoms Scale (SENS; Selten et al., 1993), which is a self-rating scale based on the SANS items, and measures the severity and related distress of negative symptoms as perceived by the person. It requires respondents to compare themselves with others of their own age on a number of indices of motivation, enthusiasm and social function, and to rate their distress with their perceived level of function. Otherwise, clinical researchers have used assessment tools measuring social functioning and quality of life, both related to negative symptoms.

Single scores can be obtained from the Global Assessment of Functioning Scale (GAF; DSM-III-R, APA, 1987), and an adapted version of the GAF, the Social and Occupational Functioning Assessment Scale (SOFAS; Goldman et al., 1992). The Social Behaviour Scale (Wykes & Sturt, 1986) covers 21 items that measure the behavioural consequences of symptoms, chosen because they were identified as providing a barrier to successful resettlement in the community. The items are rated from information provided by a key informant, on a five-point scale. The scale can be used to provide an overall score by adding up all items that are rated 2 or more, or it can be used to monitor change using the individual five-point scale ratings. The Social Functioning Scale (Birchwood et al., 1990) measures social performance in a number of areas. It can be completed by the client, a carer, or a key worker (different forms are available), and norms are given for comparable samples (e.g. the unemployed).

In addition, a couple of measures have been developed for use in epidemiological studies looking at the incidence of psychosis in the general population. The Psychosis Screening Questionnaire (PSQ; Bebbington & Nayani, 1995) is a very brief screening interview to ascertain the presence of hypomania, thought insertion, paranoia, strange experiences, and hallucinations. The Community Assessment of Psychic Experiences (CAPE; Stefanis et al., 2002) is a 40-item self-report instrument based on the PDI (Peters et al., 1999b; 2004), but with added questions on hallucinations, negative symptoms and depression. Each item assesses both frequency of the experience and associated distress.

Bentall, R. P. (1990). The syndromes and symptoms of psychosis: Or why you can't play twenty questions with the concept of schizophrenia and hope to win. In R. P. Bentall (Ed.), Reconstructing schizophrenia. London: Routledge.

Schizophrenia is a chronic broad-spectrum mental health condition that can manifest in various ways. In the past schizophrenia used to be divided into 5 subtypes including paranoid, catatonic, disorganized, residual, and undifferentiated. Presently experts understand that individuals with schizophrenia often experience overlapping symptoms throughout their lives and such subtypes are not always useful. The classification of schizophrenia changed in 2013 with an update to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The DSM update also changed the criteria needed to warrant a diagnosis of schizophrenia. Prior to 2013 individuals needed to have one of the symptoms of schizophrenia to be diagnosed. Now, a person must have at least two symptoms for a minimum of six months, one of which must be hallucinations, delusions, or disorganized speech. While it is no longer considered useful to divide schizophrenia into separate subtypes, it is still important to understand the various ways schizophrenia can affect people.

Catatonia is characterized by either excessive movement, referred to as catatonic excitement, or decreased movement, known as a catatonic stupor. People experiencing catatonia may not react to stimuli, will often remain in strange body positions, make odd movements, and may experience extreme rigidity of the limbs. Additional symptoms associated with catatonic schizophrenia include the inability to speak (mutism), mimicking words (echolalia), and mimicking actions (echopraxia).

Also known as hebephrenic schizophrenia, disorganized schizophrenia is characterized by disorganized behaviors and nonsensical speech in the absence of delusions and hallucinations. Other symptoms include flat affect, inappropriate emotional and facial reactions, disorganized thinking, and difficulty with daily activities. Most of these symptoms are widely experienced by the majority of people living with a diagnosis of schizophrenia.

Residual schizophrenia can be somewhat confusing. The diagnosis was used when a person had previously been diagnosed with schizophrenia and no longer experienced prominent symptoms such as delusions and hallucinations, yet still exhibited symptoms including a flattened affect, psychomotor difficulties, and disturbed speech. Experts now understand that many people with schizophrenia experience periods when their symptoms wax and wane in frequency and intensity. Such residual symptoms are common in most cases.

Undifferentiated schizophrenia was the diagnosis used to describe those whose symptoms fit into more than one subtype of schizophrenia. For example, someone who experienced both delusions and hallucinations along with catatonic behavior and cognitive difficulties may have been diagnosed with undifferentiated schizophrenia.

Background. Scales to measure the severity of different dimensions of auditory hallucinations anddelusions are few. Biochemical and psychological treatments target dimensions of symptoms andvalid and reliable measures are necessary to measure these.

Neck or shoulder pain symptoms appear to intensify since office workers with UCS generally sit with curved postures, take prolonged constant muscle activity, and perform repetitive job tasks [18, 19]. Pain is considered as the strongest stimulus to central motor programming, which can alter electromyography (EMG) patterns in functional tasks since it has an inhibitory effect on muscle activation [20]. Some clinical studies confirmed that the tenderness of muscles is considered the most common type of neck or shoulder pain in office workers [19, 21, 22].

Among office workers, postural changes and movement patterns in the scapula refer to the UCS including postural malalignments and altered muscle activity associated with workability and sickness absence [30]. Such conditions may play an important role in the development of neck and shoulder pain, which can be measured with electromyography as far as physiological measurement is concerned [31]. Meanwhile, balancing and restoring muscle activity by maintaining the alignment (upright body position) can reduce chronic neck pain and induce a more relaxed muscle activity pattern during work [32]. Due to the study population and WRMSDs impacts containing workability and sickness absence, it is evident the importance of managing UCS symptoms along with monitoring muscle activity to decrease the incidence of subsequent impairments [33].

The SDQ is a brief 25-item screening questionnaire for children and adolescents and young people aged between 4-18 years. The SDQ covers five areas: emotional symptoms, hyperactivity, conduct problems, peer problems and prosocial behaviour. The SDQ can be completed by parents, teachers and young people over age 11 years.


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