Faculty Bibliography

People suffering from schizophrenia-spectrum disorders often endorse a reduced quality of life (QoL) as compared to the general population. There appears to be a lack of studies for rural catchment areas for this patient population. We conducted a cross-sectional study with 94 people with schizophrenia-spectrum disorders in a mainly rural alpine area. We used multilevel models controlled for covariates to analyze the data. Total service satisfaction was associated with psychological aspects of subjective QoL and physical well-being in our model. Variables characterizing autonomy and empowerment of the person seem crucial concerning the QoL in this population.

Objective The current study presents the translation and adaptation of the 20-item Taiwan version of the Borderline Personality Inventory (BPI) into Brazilian Portuguese (BPI-P). Methods After translation and back-translation, the Brazilian Portuguese version was administered to three samples: patients with borderline personality disorder, psychiatric patients with comorbid substance use disorder and volunteers with no reported mental disorders. Results Significant differences between groups for borderline scores (analysis of variance [ANOVA], F = 52.923, p = 0.01) were found but there were no significant correlations between scores for borderline personality disorder and alcohol or nicotine dependence. The BPI-P had satisfactory validity for borderline personality disorder, even when anxiety and depression were present, with an area under the receiver operating characteristic curve of 0.931 at a cutoff point of 14. Conclusion This study provides support for the potential utility of the BPI-P as a screening instrument for clinical practice in Portuguese speaking countries, including outpatients with alcohol and nicotine use disorders in early or sustained remission.

STUDY OBJECTIVES/OBJECTIVE:Sleep apnea is associated with hypertension, and treatment may improve outcomes. We examine national burden of sleep apnea, rates of sleep apnea treatment, and whether racial/ethnic disparities exist among patients with hypertension. METHODS:Data from the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS), 2005-2012, were analyzed (N = 417,950). We identified hypertension patient visits where sleep apnea diagnosis or complaint was recorded. Primary outcome measures were sleep study, medication, or behavioral therapy (diet, weight loss, or exercise counseling). We used multivariate logistic regression to examine treatment by demographic/clinical factors. RESULTS:Among patients with hypertension, sleep apnea was identified in 11.2-per-1,000 visits. Overall, patients with hypertension and a sleep disorder were referred for sleep study in 14.4% of visits, prescribed sleep medication in 11.2% of visits, and offered behavioral therapy in 34.8% of visits. Adjusted analyses show behavioral therapy more likely to be provided to obese patients than normal/overweight (OR = 4.96, 95%CI[2.93-8.38]), but less likely to be provided to smokers than nonsmokers (OR = 0.54, 95%CI[0.32-0.93]). Non-Hispanic blacks were less likely to receive medications than non-Hispanic whites (OR = 0.19, 95% CI[0.06-0.65]). CONCLUSIONS:In the U.S., sleep apnea were observed in a small proportion of hypertension visits, a population at high-risk for the disorder. One explanation for the low prevalence of sleep apnea observed in this patient population at high risk for the disorder is under-diagnosis of sleep related breathing disorders. Behavioral therapy was underutilized, and non-Hispanic Blacks were less likely to receive medications than non-Hispanic Whites.