No abstract

The Daily Record of Severity of Problems (DRSP) form was developed to aid in the diagnosis and evaluation of DSM-IV Premenstrual Dysphoric Disorder (PMDD). The reliability and validity of the procedure was tested in two studies. Study A included 27 subjects who ranged from having few or no premenstrual problems to those who met criteria for PMDD. Study B included 243 subjects, all of whom met criteria for PMDD. Individual items and Summary Scores had high test-retest reliability in both studies. Internal consistency of Summary Scores was also high in both studies. Summary Scores had moderate to high correlations with other measures of severity of illness. In addition, items and Summary Scores have been shown to be sensitive to change and to treatment differences in Study B. The DRSP provides sensitive, reliable, and valid measures of the symptoms and impairment criteria for PMDD.

Published formulas for the large sample variance of the kappa statistic that are appropriate for the case of different sets of raters for different subjects, when each set of raters is selected at random from a larger pool of available raters, are determined to be incorrect. New formulas are derived and checked by Monte Carlo simulation. Kappa is shown to be identical, except for terms that go to zero as the number of subjects increases, to the intraclass correlation coefficient resulting from applying a one-way analysis of variance to the data. Many human endeavors have been cursedwith repeated failures before final success is achieved. The scaling of Mount Everest is one example. The discovery of the Northwest Passage is a second. The derivation of a correct standard error for kappa is a third.Cohen (1960, 1968) presented kappa and weighted kappa as chance-corrected measures of agreement between two raters, each of whom independently classifies each of a sample of subjects into one of k mutually exclusive and exhaustive categories. The standard error formulas that he presented as well as formulas published by Everitt (1968) were shown by Fleiss, Cohen, and Everitt (1969) to be incorrect. The formulas presented in the latter article have been confirmed analytically by Landis and Koch (1977a) and have been confirmed by means of Monte Carlo simulation by Cicchetti and Fleiss (1977) and Fleiss and Cicchetti (1978).Fleiss (1971) extended kappa to the case in which each of a sample of subjects is rated on a nominal scale by the same number of raters but in which the raters rating one subject are Requests for reprints should be sent to

The low-to-moderate resolution of linkage analysis in complex traits has underscored the need to identify disease phenotypes with presumed genetic homogeneity. Bipolar disorder (BP) accompanied by psychosis (psychotic BP) may be one such phenotype. We previously reported a genome-wide screen in a large bipolar pedigree sample. In this follow-up study, we reclassified the disease phenotype based on the presence or absence of psychotic features and subgrouped pedigrees according to familial load of psychosis. Evidence for significant linkage to psychotic BP (genome-wide Po0.05) was obtained on chromosomes 9q31 (lod ¼ 3.55) and 8p21 (lod ¼ 3.46). Several other sites were supportive of linkage, including 5q33 (lod, and 20q13 (lod ¼ 1.98). For most loci, the highest lod scores, including those with genome-wide significance (at 9q31 and 8p21), occurred in the subgroup of families with the largest concentration of psychotic individuals (Z3 in a family). Interestingly, all regions but six-5q33, 6q21, 8p21, 8q24, 13q32 and 18q21-appear to be novel; namely, they did not show notable linkage to BP in other genome scans, which did not employ psychosis for disease classification. Also of interest is possible overlap with schizophrenia, another major psychotic disorder: seven of the regions presumed linked in this study-5q, 6q, 8p, 13q, 15q, 17p, and 18q-are also implicated in schizophrenia, as are 2p13 and 10q26, which showed more modest support for linkage. Our results suggest that BP in conjunction with psychosis is a potentially useful phenotype that may: (1) expedite the detection of susceptibility loci for BP and (2) cast light on the genetic relationship between BP and schizophrenia.

The Premenstrual Assessment Form (PAF) is a new self report procedure designed to measure changes in mood, behavior, and physical condition during the premenstrual period. It reflects the great variability of premenstrual syndromes as opposed to the common practice of viewing these changes as a single entity. In comparison to commonly used procedures, the PAF 1) contains a broader variety and more specific descriptions of positive as well as negative changes; 2) provides Unipolar Summary Scales and Bipolar Continua which are sensitive measures for indexing levels of severity on various types of change; and 3) provides specific criteria for Typological Categories descriptive of different syndromes of change, especially those of mood and behavior. The paper describes the development of the PAF and the three scoring systems and illustrates the sensitivity of the individual items and scoring systems in reflecting the great diversity of change manifested during the premenstrual period.