The Latin-America version of the Internalized Stigma of Mental Illness scale (LA- ISMI): A multicentric validation study from three Latin-America countries

International audienceBackgroundTo date, no data have been available concerning the psychometric characteristics of the Internalized Stigma of Mental Illness scale (ISMI-29) in Latin American countries. The aim of this study was to validate a Latin American version of the ISMI in people with schizophrenia.MethodsThe study included 253 stabilized outpatients with schizophrenia from 3 Mental Health Services in three Latin American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). We analyzed the psychometric properties using item response and classical test theories. An item reduction was then performed to improve the psychometric properties of the ISMI-29. The final version of the ISMI was tested for construct validity, reliability, external validity and differential item functioning (DIF).ResultsThe five-factor structure of the ISMI-29 was not confirmed using confirmatory factor analysis (RMSEA = 0.12, CFI = 0.77, and WRMR = 2.20). Seventeen items were discarded to obtain a satisfactory psychometric version. The ISMI-12 evaluates 3 dimensions: social stigma (4 items), stigma experience (4), and self-stigma (3). The factor structure accounted for 68% of the total variance. Internal consistency was satisfactory. The scalability was satisfactory, with INFIT statistics within an acceptable range. In addition, the results confirmed the absence of DIF and supported the invariance of the item calibrations between countries.ConclusionThe ISMI-29 is not valid in our sample and should not be used in Latin American countries. The ISMI-12 is the first internalized stigma questionnaire with satisfactory psychometric properties available in Latin American countries. Its brevity could facilitate its dissemination and use in clinical settings

Relationships between social stigma, stigma experience and self-stigma and impaired quality of life in schizophrenia accross three Latin-America countries

International audienceThe relationships between stigma and quality of life in schizophrenia (QoL) have been extensively explored but have mostly focused on self-stigma and self-esteem and have never been explored in Latin-America. The objective of this study was to determine which stigma dimensions were associated with QoL in a sample of community-dwelling SZ subjects of three Latin-American countries. Stabilized outpatients with SZ were recruited in three Mental Health Services in three Latin-American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Stigma and Qol-SZ were evaluated by self-administered questionnaires, the Internalized Stigma of Mental Illness scale (ISMI-12) and the SQoL-18. 253 participants were included. In multivariate analyses, QoL has been associated with each stigma dimension (social stigma, stigma experience and self-stigma), independently of age, gender, education level, ethnicity, age at illness onset, illness symptomatology and mental health treatment. More specifically, social stigma was significantly associated with impaired psychological and physical well-being, self-esteem and friendship. Self-stigma was significantly associated with impaired psychological well-being, self-esteem and autonomy. The present results confirm the importance of stigma in QoL of SZ subjects and identify new targets to develop stigma-orientated programs. Most of the previous programs have focused on self-stigma while social stigma has shown to be associated with a wide range of impaired QoL areas. Stigma and QoL may have a bidirectional relationship and targeting some specific QoL areas (like autonomy through self-empowerment approaches) may also improve the effectiveness of these programs to reduce stigma impact on the quality of life of subjects with schizophrenia. Future studies should also explore differences across countries as subjects from Bolivia were more frequently Aymara and reported higher stigma and lower QoL than SZ subjects from other countries

Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life

International audienc

Negative Survival Impact of High Radiation Doses to Neural Stem Cells Niches in an IDH-Wild-Type Glioblastoma Population

Aims: Assess the impact of radiation doses to neural stem cell (NSC) niches in patients with IDH-wild-type glioblastoma.Materials and Methods: Fifty patients were included in the study. NSC niches [SubVentricular Zone (SVZ) and Sub Granular Zone (SGZ)] were contoured by fusing CT scans and pre-therapy MRI, Tumor location defined ipsilateral and contralateral SVZ and SGZ. Prognostic significance of clinical, biological and dosimetric parameters were examined. We generated a Recursive Partitioning Analysis (RPA) model with independent prognostic classes.Results: Median follow-up: 23.8 months. Event free and overall survival (OS): 10 and 19.1 months. Incomplete surgery, PTV (planning target volume), ipsilateral SVZ or NSC niche mean dose > 57.4 Gy, contralateral NSC niche mean dose > 35 Gy and bilateral NSC niche mean dose > 44 Gy were significantly correlated with reduced OS. Only EGFR amplification was an independent prognostic factor (p = 0.019) for OS. RPA generated independent risk groups: 1 (low risk): [ipsilateral NSC mean dose (INMD) < 58.01 Gy and methylated MGMT promoter], 2: (INMD < 58.01 Gy and unmethylated MGMT promoter and contralateral SVZ mean dose < 18.6 Gy; p = 0.43), 3: (INMD < 58.01 Gy and unmethylated MGMT promoter and contralateral SVZ mean dose > 18.6 Gy; p = 0.002) and 4: (very high risk) (INMD > 58.01 Gy; p < 0.001).Conclusion: High radiation doses to ipsilateral NSC and contralateral SVZ could have a negative impact on overall survival in IDH-wild-type glioblastoma population

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Caracterisation of response shift effect using the Random Forest method

Evaluer la qualité de vie (QV) a pris une importance croissante dans le domaine de la santé, tout particulièrement pour les maladies graves tels que les cancers. Cependant l’analyse des données de QV demeure complexe et reste peu utilisée pour changer les standards de prise en charge des patients. Une des raisons est que les patients pourraient exprimer un effet « response shift » (changement de réponse) au cours de la maladie et par conséquent biaiser les résultats en sur- ou sous estimant l’effet traitement mesurer par le différentiel de QV. En effet lorsque l’évolution de la QV est étudiée, on fait souvent l’hypothèse que la perception qu’ont les patients du concept étudié ne va pas se modifier au cours du temps. Or les patients font face à une maladie et à des traitements. L’impact que peuvent avoir la maladie et les traitements sur la vie du patient va généralement l’amener à s’adapter et modifier sa perception du concept étudié. Ainsi l’occurrence potentielle d’un effet « Response Shift » est une des problématiques à appréhender pour distinguer ce qui relève d’un « vrai » changement de QV et de ce qui est de l’adaptation.To asses Quality Of Life, patients are often asked to evaluate their well-being using a self-report instrument to document patient-reported outcome (PROs) measures. The data are often collected on multiple domains, such as physical function, social health and emotional health. However, longitudinal PROs, which are collected at multiple occasions from the same individual, may be affected by adaptation or "response shift" effects and may lead to under- or overestimation of the treatment effects. Response shift is the phenomenon by which an individual's self-evaluation of a construct changes due to change in internal standards of measurement (recalibration), a change in value or priorities (reprioritization), or a personal redefinition of the target construct (reconceptualisation). If the response shift is present in the data, the interpretation of change is altered and conventional difference between post-test and pre-test may not be able to detect true change in PROs measures. The aim of the work is to propose an innovative method, based on random forest method, to highlight response shift effect

Caracterisation of response shift effect using the Random Forest method

Evaluer la qualité de vie (QV) a pris une importance croissante dans le domaine de la santé, tout particulièrement pour les maladies graves tels que les cancers. Cependant l’analyse des données de QV demeure complexe et reste peu utilisée pour changer les standards de prise en charge des patients. Une des raisons est que les patients pourraient exprimer un effet « response shift » (changement de réponse) au cours de la maladie et par conséquent biaiser les résultats en sur- ou sous estimant l’effet traitement mesurer par le différentiel de QV. En effet lorsque l’évolution de la QV est étudiée, on fait souvent l’hypothèse que la perception qu’ont les patients du concept étudié ne va pas se modifier au cours du temps. Or les patients font face à une maladie et à des traitements. L’impact que peuvent avoir la maladie et les traitements sur la vie du patient va généralement l’amener à s’adapter et modifier sa perception du concept étudié. Ainsi l’occurrence potentielle d’un effet « Response Shift » est une des problématiques à appréhender pour distinguer ce qui relève d’un « vrai » changement de QV et de ce qui est de l’adaptation.To asses Quality Of Life, patients are often asked to evaluate their well-being using a self-report instrument to document patient-reported outcome (PROs) measures. The data are often collected on multiple domains, such as physical function, social health and emotional health. However, longitudinal PROs, which are collected at multiple occasions from the same individual, may be affected by adaptation or "response shift" effects and may lead to under- or overestimation of the treatment effects. Response shift is the phenomenon by which an individual's self-evaluation of a construct changes due to change in internal standards of measurement (recalibration), a change in value or priorities (reprioritization), or a personal redefinition of the target construct (reconceptualisation). If the response shift is present in the data, the interpretation of change is altered and conventional difference between post-test and pre-test may not be able to detect true change in PROs measures. The aim of the work is to propose an innovative method, based on random forest method, to highlight response shift effect

L’incarcération des personnes sans logement et en grande difficulté psychique dans les procédures de comparution immédiate

Cet article présente les résultats d’une étude menée dans un tribunal de grande instance, en 2016 et concerne les justiciables des comparutions immédiates. Il s’intéresse particulièrement à ceux qui cumulent deux critères représentant un facteur important d’incarcération : être sans domicile et vivre avec une grande difficulté psychique. On observe, en effet, que pour les prévenus les plus précaires, les questions de santé mentale interviennent clairement dans la décision du magistrat d’incarcérer ou non. Nous discuterons de l’enjeu que représente l’attention portée par les professionnels de justice au cercle rue-hôpital-prison.This article presents the results of a study carried out in a "tribunal de grande instance" in 2016 and focuses on defendants who are the subjects of immediate trial appearance. This article’s emphasis is particularly placed on individuals who respond to two criteriae representing an important factor of incarceration: being homeless and display from a mental health issues. The observation is made that, for the most vulnerable defendants, mental health issues are clearly involved in the judge’s decision to sentence to jail or not. Finally, this article also discusses the issue of the attention paid by justice professionals to the revolving door