Matilde Álvarez Gómez

Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia

OBJECTIVE To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. DESCRIPTION Observational validation study questionnaire. SETTING Performed in a Medellin city community care level of mixed (public and private) psychiatric consultation. SUBJECTS Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. MAIN OUTCOMES MEASURES The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbachs alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity 100%, and specificity 85.6%). CONCLUSIONS This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women.

OriginalValidez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, ColombiaDiagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian female population☆

OBJECTIVE To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. DESCRIPTION Observational validation study questionnaire. SETTING Performed in a Medellin city community care level of mixed (public and private) psychiatric consultation. SUBJECTS Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. MAIN OUTCOMES MEASURES The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbachs alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity 100%, and specificity 85.6%). CONCLUSIONS This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women.

Delirium during the first evaluation of children aged five to 14 years admitted to a paediatric critical care unit

OBJECTIVES To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5-14 years. METHOD/DESIGN This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24-72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type. We report the characteristics of PCAM-ICU delirium (at least three of the required items scored positive) and of subthreshold score cases (two positive items). RESULTS Of 77 admissions, 15 (19.5%) had delirium, and 11 (14.2%) were subthreshold. A total of 53.3% of delirium and 45.5% of subthreshold cases were hypoactive. The prevalence of delirium and subthreshold PCAM-ICU was 83.3% and 16.7% in mechanically ventilated children. The most frequent combination of PCAM-ICU alterations in subthreshold cases was acute onset-fluctuation with altered alertness. The main nursing diagnoses were related to reduced cellular respiration. CONCLUSIONS Delirium is common in critically ill children. It is necessary to assess whether certain nursing diagnoses imply an increase in delirium. Longitudinal studies of subthreshold PCAM-ICU cases are needed to understand their importance better.