The Development of a Self-rating Questionnaire for Screening Dementia

Few self-rating questionnaires have been developed for use in screening for dementia due to technical difficulties. We were required to develop a self-rating questionnaire for dementia for the first-stage screening of a 1995 dementia prevalence study in the Nagasaki Prefecture. In our pilot study, we drafted a questionnaire of 43 items and applied it to 399 subjects in attendance at educational programs for senior citizens, and residing in institutions for senior citizens and in nursing homes for the aged. 185 subjects (71 males, 114 females ; average age, 77.3 years) successfully completed the questionnaire, including 39 subjects with medically diagnosed dementia. We conducted a discriminant analysis on these subjects\u27 responses to the original 43 items, and extracted 13 items which most contributed to discrimination of dementia. The sensitivity of discrimination by the final questionnaire was 0.82, and the specificity was 0.89. In the prevalence study of dementia in Nagasaki Prefecture, we could re-examine the validity of the questionnaire. The high sensitivity and moderate level of specificity of the questionnaire was considered reasonable for use in screening dementia

Nagasaki Schizophrenia Study : Outcome of a 15-year Follow-up of an Incident Cohort

The Nagasaki World Health Organization (WHO) Collaborating Center for Research and Training in Mental Health conducted the WHO Coordinated Multi-Center Study of the Long-term Course and Outcome of Schizophrenia as a part of the International Study on Schizophrenia (ISoS). The study used 107 patients who were initially diagnosed as having ICD-9 schizophrenia for the WHO Collaborative Study on the Determinants of Outcome of Severe Mental Disorders (DOSMeD). Subjects were first collected in 1979-1980 for an incidence study of schizophrenia in Nagasaki. In this 15-yearfollow- up study, 7 subjects died, 43 subjects were lost to follow-up and 57 were successfully traced. Among the 7 death cases, 4 suicides were confirmed and 1 was suspected. During the 15-year period, 25 (44%) of the 57 living subjects displayed continuous psychotic course type schizophrenia. During the last 2 years, 14 (25%) were not psychotic ; 31 (54%) were continuously psychotic. Global Assessment of Functioning Scale for Symptomatology (GAF-S) indicated symptomatological outcomes : 16 (28%) had severe symptoms (GAF-S70). Social outcome was evaluated using the Global Assessment of Functioning Scale for Disability (GAF-D): 28 (49%) showed poor adjustment (GAF-D70). The overall time trend was almost evenly divided in thirds : 20 (35%) were getting better, 18 (32%) were the same and 19 (33%) were worse. The present study showed that the outcome of schizophrenia is not always poor, although some patients display a continuous course and poor outcome