A new inventory (EMBU) to assess the own memories of parental rearing behaviour was constructed. EMBU is comprised of 81 questions grouped in 15 subscales and two additional questions referring to consistency and strictness of parental rearing behaviour to be answered in a four-step scale for the father and for the mother separately. The subscales cover rearing practices as for eexample overinvolment, affection, overprotectiveness, guilt engendering, rejection. 152 healthy subjects of both sexes (108 males and 44 females) completed the inventory. The item analysis showed that both parents attained similar scores in about half of the questions. Fathers scored higher in items referring to strictness, punishment and a low degree of involvement whereas mothers scored higher in items referring to involvement and affection. A principal component factor analysis permitted the hypothesized subscales to be identified. An analysis of the internal consistency of the subscales revealed a high frequency of significant internal correlations. A principal component factor analysis of the total scores of the 15 subscales allowed three main dimensions of rearing behaviour to be identified quite close to those reported in similar studies in the literature where other scales had been used.
The original KSP scales were revised, shortened, modernized and psychometrically evaluated. The psychometric properties and the usefulness of the test battery were found to be substantially improved.
In 1983-1984 the Swedish Committee for the Prevention and Treatment of Depression offered an educational program on diagnosis and treatment of depressive disorders to all general practitioners on the island of Gotland. The program has been carefully evaluated; 1982 was used as the baseline and the main evaluation was carried out in 1985. After the educational programs, the frequency of sick leave for depressive disorders decreased, the frequency of inpatient care for depressive disorders decreased to 30% of that at the baseline; the prescription of antidepressants increased, but prescription of major tranquilizers, sedatives and hypnotics decreased. The frequency of suicide on the island decreased significantly. This study describes the long-term effects. In 1988, 3 years after the project ended, the inpatient care for depressive disorders increased, the suicidal rate returned almost to baseline values and the prescription of antidepressants stabilized. Thus, the effects were strictly related in time to the educational programs, indicating that the effects were real and not only a coincidence with local trends on Gotland. Furthermore, the results indicate that educational programs that can have pronounced effects on the health care system have to be repeated approximately every 2 years if long-term effects are to be expected.
In 1983-1984 the Swedish Committee for Prevention and Treatment of Depression (PTD Committee) introduced an educational program for all general practitioners (GPs) on the Swedish island of Gotland. The primary goal was to increase knowledge about diagnosis and treatment of patients with affective disorders. The effects of the educational programs were evaluated in detail; GPs identified more patients with depressive disorders and treated them more accurately. The suicide rate on Gotland was followed, primarily to ensure that the new treatment strategies did not include a risk for the individual patients. However, it was also hoped that increased awareness of patients with affective disorders and better treatment routines could reduce the suicide rate. The suicide rate dropped the year after the educational programs were introduced. This was a statistically significant deviation both from the long-term trend on Gotland and from the trends in Sweden as a whole. Programs aiming at giving GPs increased capacity and responsibility to treat patients with affective disorders do not increase the frequency of suicide. Better primary treatment of patients with depressive disorders may reduce the suicide rate in a given area.
A modified version of the SCID Screen questionnaire covering 103 criteria by means of 124 questions was compared with SCID II interviews in 69 psychiatric patients. The correlation between the number of criteria fulfilled in the SCID II interviews or the questionnaires was 0.84. In the SCID interviews, 54% of the patients had a personality disorder. When the SCID Screen questionnaire was used, 73% had a personality disorder. When the cut-off level for diagnosis was adjusted, the frequency found by means of the SCID screen questionnaire or the interviews was roughly the same, 58% and 54%, respectively. The overall kappa for agreement between the SCID II interviews and questionnaire with adjusted cut-off was 0.78.
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