Validation of a Turkish Version of the ICD-10 Symptom Rating (ISR)

Numerous psychiatric and psychosomatic clinics in Turkey and Germany use the Symptom Checklist 90 Revised (SCL-90-R) developed by Derogatis (1977) or the validated Turkish version by Dag (1991) for assessing psychological symptoms. Many patients informed us during numerous studies and visits to these clinics that this test with its 90 questions took too long and that they were unable to sufficiently concentrate on it. In the meantime, the much more economical ICD-10 Symptom Rating (ISR) (Tritt et al., 2008) self-rating questionnaire, comprising 29 questions, has been developed in Germany in 2008. In 2008 and 2009 we therefore decided to translate the ISR into Turkish, to analyse it for its reliability and validity and compare it with the SCL-90-R and the BDI. In an analysis of 277 Turkish subjects – 127 of whom were inpatients, 36 outpatients and 104 clinically unremarkable healthy participants – very good psychometric characteristics were achieved in terms of high internal consistency of individual, additional and overall scales. The results of the factor analysis conducted showed that the ISR Measure has satisfactory construct validity. In a random sample of inpatients, the Cronbach’s alpha values ranged from 0.66 (scale: Compulsive syndrome) to 0.93 (overall scale). The advantage of this instrument over BDI and SCL-90-R lies in its shorter processing time. The German version of the ISR promises lesser use of time and good empirical quality, which we double-checked with a translated Turkish version tested on persons of Turkish origin in Germany

The association of childhood trauma and personality disorder with adult chronic depression. A cross-sectional study in depressed outpatients

Objective: Chronic depression has often been associated with childhood trauma. There may, however, be an interaction between personality pathology, childhood trauma, and chronic depression. This interaction has not yet been studied. Method: This retrospective analysis is based on 279 patients contacted for a randomized trial in an outpatient psychotherapy center over a period of 18 months from 2010 to 2012. Current diagnoses of a personality disorder and presence of chronic depression were systematically assessed using the Structured Clinical Interview for DSM-IV. Retrospective reports of childhood trauma were collected using the short form of the Childhood Trauma Questionnaire (CTQ-SF). DSM-IV–defined chronic depression was the primary outcome. The association between chronic depression, childhood trauma, and personality disorders was analyzed using correlations. Variables that had at least a small effect on correlation analysis were entered into a series of logistic regression analyses to determine the predictors of chronic depression and the moderating effect of childhood trauma. Results: The presence of avoidant personality disorder, but no CTQ-SF scale, was associated with the chronicity of depression (odds ratio [OR] = 2.20, P = .015). The emotional abuse subscale of the CTQ-SF did, however, correlate with avoidant personality disorder (OR = 1.15, P = .000). The level of emotional abuse had a moderating effect on the effect of avoidant personality disorder on the presence of chronic depression (OR = 1.08, P = .004). Patients who did not suffer from avoidant personality disorder had a decreased rate of chronic depression if they retrospectively reported more severe levels of emotional abuse (18.9% vs 39.7%, respectively). Conclusions: The presence of avoidant personality pathology may interact with the effect of childhood trauma in the development of chronic depression. This has to be confirmed in a prospective study