Utilidad clínica de la versión española de la clinicall y useful depression outcome scale (cudos) para determinar los síntomas de respuesta precoz en pacientes diagnosticados de cualquiera de los trastornos del ánimo según DSM-IV.

Abstract

The social impact of depression is determined by its high prevalence and serious consequences both family and at work. According to the WHO, depression, in the last decade has been one of the main causes of disability and mortality. These data show the negative influence of depression on the evolution of some physical diseases and the need for early detection and appropriate treatment first attempt. Defusion or decentering is defined as "ability to observe one's thoughts and feelings separately, as temporary events not necessarily true or self-reflexes", taking them more detached in association with the reduction of anxiety, of depressive symptomatology and the increase of positive affect. Recently, Trujols et al published the adaptation and validation of the Clinically Useful Depression Outcome Scale (CUDOS) to Spanish, aiming to be both a diagnostic evaluation instrument as a measure of the severity of the depressive symptoms that assesses depression, effect or psychosocial impairment and quality of life. It is a self-administered scale, validated, brief, quick and easy to score for professionals with very good psychometric properties and closely linked to the DSM-IV criteria. The hypothesis of this study is that CUDOS is useful for detecting symptoms of early response in patients diagnosed with any of the mood disorders according to DSM-IV in clinical practice. The secondary objectives are to identify early response items and decide the role of decentering in predicting early response. To do so, after approval of the study protocol by the ethics committee of the Hospital de la Santa Creu i Sant Pau and Hospital Clínico Universitario San Carlos de Madrid, an observational, longitudinal, analytical, prospective, multicenter study was helded with a sample of 175 patients who met the inclusion criteria in acute inpatient units of psychiatry of both hospitals from January 2016 to December 2018. The instruments used were the CUDOS questionnaire and the questionnaire EQ-Decentering, both in its Spanish version. Statistical analysis was performed using SPSS (version 23.0). The study was conducted in strict accordance with international ethical guidelines for medical research in humans according to the standards listed in the Declaration of Helsinki. The items of the CUDOS that showed significant changes were 11 ("I thought I was a failure"), 14 ("I wanted to be dead") and 16 ("I thought of a hopeless future") and in the case of the EQ the 1 ("I am able to accept myself as I am") and 4 ("I can separate my thoughts and feelings from myself”). A logistic regression analysis was performed. We identified item 16 of the CUDOS and 4 of the EQ as significantly predictors of remission already on the fourth day of admission, deducing that when certain items of both scales change on the fourth day of admission, the patient tended to recover. We can say there is a risk factor in the CUDOS: think of a hopeless future and, a protector factor in the EQ: separate thoughts and feelings from oneself. As for the study's limitations, the type of self-administered questionnaire can encourage over-reporting or minimize the severity of symptoms. To this end, it was envisaged that clinical researchers conducted clinical assessments were blinded to the results of the questionnaires, which were collected by the principal investigator of the study.

Date of Award	12 Dec 2019
Original language	Spanish
Supervisor	Enric Alvarez Martinez (Director), Enric Alvarez Martinez (Tutor) & Joaquin Soler Ribaudi (Director)