- Email: [email protected]
P.2.a.022 Prevalence of pain in depression and health related quality of life outcomes: results from the FINDER study
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P.2.a Affective disorders and antidepressants – Affective disorders (clinical)
conduct assessment with mini international neuropsychiatric interview (MINI) version 5.0, depressive symptom checklist (DSC) of CERAD and 17-item Hamilton depression scale. In addition, geriatric depression scale (GDS) and CES-D were self-administered before clinical interview. To examine quality of life (QOL), SF36 was administered. Subthreshold depression is operationally defined as follows: first, subthreshold depression have two or more concurrent symptoms of depression in DSM-IV with at least one of core depressive symptoms such as depressed mood or loss of interest; second, it is checked positive if each depressive symptom is present ‘more than half a day’ or ‘more than seven days during two weeks’ instead of ‘most of day’ or ‘nearly every day during two weeks’; third, subthreshold depression is associated with evidence of social and occupational dysfunction; fourth, subthreshold depression do not meet criteria for the diagnosis of major depressive disorder (MDD) and minor depressive disorder (MnDD). For evaluation of global cognition, memory and frontal function, neuropsychological test of CERAD-K and frontal assessment battery (FAB) are applied. For assessing subjective QOL, SF-36 scale was used. Results: The numbers of subjects with MDD, MnDD and STD were 53 (5.3%), 52 (5.2%) and 73 (7.4%) respectively and 814 subjects were evaluated to be not depressed. Not only MDD and MnDD but also STD showed the lower performance in MMSE (21.75±5.29*), Word List Memory Test (13.58±5.14**), Word List Recall Test (4.15±2.33**), Categorical Fluency (11.82±3.85*), Trail Making A (136.48±98.39*) and B (246.64±66.73*) than normal controls (*p < 0.05, ** p < 0.001, ANCOVA computing gender, age, and education as covariates). The performance of Word List Recognition Test (8.22±2.16 in MDD, 8.16±2.29 in MnDD, and 8.08±1.81 in STD) was not influenced by the presence of depression regardless of the diagnostic criteria (p = 0.226, ANCOVA computing gender, age, and education as covariates). Depression patients showed the lower scores in all domains of SF-36 than normal controls regardless of the diagnostic criteria used (p < 0.001, ANCOVA computing gender, age, and education as covariates). Conclusion: Subthreshold depression was found to be a significant clinical entity in late life since it impaired cognition, mental health and physical health. More attention should be paid to STD in late life. The influence of depression on memory can be characterized by impairment of retrieval, rather than impairment of encoding and storage, which is different from memory decline in Alzheimer’ disease. References [1] Broadhead WE, Blazer DG, George LK, Tse CK, 1990, Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 264, 2524–2528. [2] Coulehan JL, Schulberg HC, Block MR, Janosky JE, Arena VC, 1990, Depressive symptomatology and medical comorbidity in a primary care clinic. Int J Psychiatry Med 20, 335–347. [3] Geiselmann B, Bauer M, 2000 March/April, Subthreshold depression in the elderly: qualitative or quantitative distinction. Comprehensive Psychiatry 41(2 Suppl 1), 32−38.
P.2.a.022 Prevalence of pain in depression and health related quality of life outcomes: results from the FINDER study K. Demyttenaere1 ° , N. Yurgin2 , C. Reed2 , D. Quail3 , N. Dantchev4 , A.L. Montejo5 , B. Monz6 , M. Bauer7 , A. Tylee8 , L. Grassi9 . 1 Universitair Aiekenhuis Gasthuisberg, Department
of Psychiatry, Leuven, Belgium; 2 Eli Lilly and Company Limited, European Health Outcomes Research, Windlesham, United Kingdom; 3 Eli Lilly and Company Limited, European Medical Information Sciences, Windlesham, United Kingdom; 4 HˆotelDieu, Unit´e de Psychiatrie, Paris, France; 5 Hospital Universitario de Salamanca, Department of Psychiatry, Salamanca, Spain; 6 Boehringer Ingelheim GmbH, Global Health Economics & Outcomes Research, Ingelheim, Germany; 7 University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany; 8 Institute of Psychiatry, Health Services and Population Research Department, London, United Kingdom; 9 University of Ferrara, Section of Psychiatry, Ferrara, Italy Purpose: Patients with depression often experience pain [1] but how this pain impacts on outcomes of depression treatment is largely unknown. The objectives of this analysis are to explore the baseline characteristics and outcomes of patients with depression who have moderate/severe pain compared to those with no/mild pain. Methods: FINDER (Factors INfluencing Depression Endpoints Research) is a 6-month prospective, observational study on the health related quality of life (HRQoL) of 3,468 outpatients with depression starting a new antidepressant (AD) treatment at time of enrolment. Diagnosis of depression was based on clinical judgment and all treatment decisions were at the discretion of the investigator. Patients completed ratings on the Hospital Anxiety and Depression Scale (HADS), the Somatic Symptom Inventory (SSI-28) and on pain severity using Visual Analogue Scales (VAS) at the beginning of treatment (“baseline”) and 3 and 6 months later. Patients also completed HRQoL instruments the 36-item Short-Form-Health-Survey (SF-36) and European-Quality-of-life5-Dimensions (EQ-5D) questionnaire. Pain groups were defined using the VAS for severity of overall pain, with ratings 30 mm defined as having ‘no/mild pain’ and ratings >30 mm defined as having ‘moderate/severe pain.’ Pain response was defined as having moved from >30 mm to 30 mm at 6 months. For the purpose of these analyses, patient’s HADS depression subscores 7, 8−10 and >11 at baseline were classified as ‘non-cases’, ‘doubtful cases’, and ‘probable cases’ for depression, respectively. Results: 3468 patients were eligible for analysis. 56% of patients with depression experienced moderate/severe pain and 70% of these patients had no physical explanation for this pain (i.e. had no selected medical condition known to cause pain). Patients with pain were slightly older (mean 48.3) than those without pain (mean 44.8) but the distribution of females and males within the two groups was similar (69.8% and 66.0% respectively). Depressed patients with pain had a longer duration of depressive illness (mean 8.9 years) compared to those without pain (mean 8.0 years) but duration of the current depressive episode were similar (13.7 and 13.6% weeks, respectively). 71.3% of those with moderate/severe pain were ‘probable cases’ for depression compared to 59.6% of those with no/mild pain. Depression scores remained higher at 6 months for those with pain (mean 7.4) compared to those without pain (mean 5.7). Those with pain reported poorer HRQoL scores on SF-36 Physical Component Score and EQ-5D Health State Index and VAS both at baseline and after 6 months of treatment. The SF-36 Mental Component Score was similar for both groups. Conclusions: Over half of the patients in this study experienced moderate/severe pain, highlighting the high comorbidity between pain and depression. HRQoL outcomes, excluding SF-36 Mental Component Score, were worse in those with depression and pain.
P.2.a Affective disorders and antidepressants – Affective disorders (clinical) Further investigation into the impact of treating pain on depression response is warranted. FINDER was supported by Eli Lilly and Company Limited & Boehringer Ingelheim GmbH References [1] Garcia-Cebrian A, Gandhi P, Demyttenaere K, Peveler R, 2006, The association of depression and painful physical symptoms – a review of the European literature. Eur Psychiatry 21, 379−88.
P.2.a.023 Association of affective temperaments with Cloninger’s biological model of personality H.G. Kiss1 , X. Gonda1 ° , A. Rihmer2 , K. Seregi1 , D. Kovacs1 , P. Pestality1 , I. Kecskes1 , K.K. Akiskal3 , Z. Rihmer1 . 1 National Institute for Psychiatry and Neurology, Psychiatry No. III., Budapest, Hungary; 2 Semmelweis Medical University, Department of Psychiatry and Psychotherapy, Budapest, Hungary; 3 University of California at San Diego, Department of Psychiatry, San Diego, USA Background: Temperaments are constant constellations of the personality, traits and ways of reacting which characterise a person and remain constant during time and throughout several diverse situations. Most theories of temperament contain three essential components: (1) that temperaments are related to emotionality, (2) that temperaments are genetically determined and inherited and that temperaments are manifested from early childhood and remain relatively constant over life. In his biological model of personality, Cloninger has identified four major temperamental traits: harm avoidance, novelty seeking, reward dependence and persistence, which the authors consider the modern interpretation of the four ancient temperaments: melancholic is related to harm avoidance, choleric to novelty seeking, sanguine to reward dependence while phlegmatic to persistence [1]. In Akiskal’s model, on the other hand, affective temperaments are subaffective trait expressions of the subclinical phenotypes of affective disorders. Akiskal has described five basic distinguishable types of affective temperaments: anxious, depressive, hyperthymic, cyclothymic and irritable [2]. The Cloninger model has been developed based on the healthy personality, while Akiskal has derived his model of temperament based on clinical observations of affective disorders developing on the basis of different predispositions. Both models, however, has been extended to encompass the whole spectrum of personality from health to illness. The aim of our study was to investigate the relationship of the two models and the associations between them in a healthy population. Methods: 138 healthy people were included in the study. All participants completed the TEMPS-A questionnaire (Temperament Evaluation of Memphis, Pisa, Paris and San Diego) measuring affective temperaments and the TCI (Temperament and Character Inventory) measuring temperamental and character traits in Cloninger’s model. To analyse the association of temperaments within the two models, Spearman’s correlation was computed. Results: Depressive temperament had a strong significant positive correlation (r = 0.66) with harm avoidance and a moderate negative correlation (r = −0.55) with self directedness. Cyclothymic temperament had a strong significant negative correlation with self-directedness (−0.68). Hyperthymic temperament had a moderate significant negative correlation with harm avoidance (r = −0.55). Irritable temperament had a moderate significant
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correlation with self directedness (r = −0.48). The anxious temperament had a strong significant correlation with harm avoidance (r = 0.63) and a moderately strong significant negative correlation with self directedness (r = −0.50). The TEMPS-A subscales also had moderate and strong significant correlations with several subscales of the temperamental and character traits of the TCI. Conclusions: Our results are in line with our earlier expectations about the overlaps between the two models of temperaments, especially regarding the significant positive correlations between harm avoidance and depressive and anxious temperaments. Further analysis of our data, however, sheds light on important differences between the two temperamental concepts, and how these two models grab personality in different ways. The investigation of the two models and their associations leads us to better understanding of temperaments composing the personality. References [1] Svrakic DM, Cloninger CR, 2005, Personality disorders. In: Sadock BJ, Sadock VA (eds), Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. Lippincott Williams & Wilkins, Philadelphia 2063–2104. [2] Akiskal HS, Akiskal KK, Haykal R, Manning JS, Connor P, 2005, TEMPS-A: progress towards validation of a self-rated clinical version of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire. J Affect Disord 85, 3−16.
P.2.a.024 Social support in anxious and depressive outpatients M. Vidal Millares ° , I. Espi˜no Diaz, J. Brenlla Gonz´alez, M.C. Garc´ıa Mah´ıa. University Clinical Hospital, Psychiatry, Santiago de Compostela, Spain Introduction: The social upset associated the anxious and depressive patients is well documented and supposes one of the limited aspects of its global functioning [1]. These disorders are frequently associated with an important deterioration in social functioning, often substantially worse than the one experimented by patients with other chronic medical pathologies [2]. The enormous personal, social and economic impact of the depression, as well as anxiety disorders, which have to a great extent the associated deterioration of social operation, often under-appreciated [2]. In addition one has seen that the effectiveness in the improvement of the target depression symptoms not necessarily guarantees effectiveness in the improvement of the deterioration of social functioning [2]. Of this form, a recent increase in the use of social operations like ambulatory measurement in the clinical test of antidepressants exists [3]. Thus the recovery of the depression also requires not only the resolution of the depressive symptoms but also an improvement in the interaction of the individual with the individuals environment. Aims: To research the social support in depressive and anxious outpatients. To analyse the differences between the existing social support between both groups of disorders. Methods: The sample included 216 outpatients treated in a outpatient clinic in Santiago. Mean Age 36.5, diagnosed of anxiety or depressive disorder by an experienced psychiatrist. Assessment include the Beck Depression Inventory (BDI) using 13−14 as cut-off point and the Social Adaptation Self-Evaluation Scale (SASS).SASS offered an interpretative scale for determining degree of social support: “Patent Social Mismatch” (<25), “Probable Mismatch” (25−34); “Normality” (35−52) and “Superadaptation” (>53). Variables analysed included age, gender, diagnosed group, psychiatric disorder and results in scales related above. Statistical analyses were made with SPSS v.12.0 for Windows.
P.2.a Affective disorders and antidepressants – Affective disorders (clinical)
conduct assessment with mini international neuropsychiatric interview (MINI) version 5.0, depressive symptom checklist (DSC) of CERAD and 17-item Hamilton depression scale. In addition, geriatric depression scale (GDS) and CES-D were self-administered before clinical interview. To examine quality of life (QOL), SF36 was administered. Subthreshold depression is operationally defined as follows: first, subthreshold depression have two or more concurrent symptoms of depression in DSM-IV with at least one of core depressive symptoms such as depressed mood or loss of interest; second, it is checked positive if each depressive symptom is present ‘more than half a day’ or ‘more than seven days during two weeks’ instead of ‘most of day’ or ‘nearly every day during two weeks’; third, subthreshold depression is associated with evidence of social and occupational dysfunction; fourth, subthreshold depression do not meet criteria for the diagnosis of major depressive disorder (MDD) and minor depressive disorder (MnDD). For evaluation of global cognition, memory and frontal function, neuropsychological test of CERAD-K and frontal assessment battery (FAB) are applied. For assessing subjective QOL, SF-36 scale was used. Results: The numbers of subjects with MDD, MnDD and STD were 53 (5.3%), 52 (5.2%) and 73 (7.4%) respectively and 814 subjects were evaluated to be not depressed. Not only MDD and MnDD but also STD showed the lower performance in MMSE (21.75±5.29*), Word List Memory Test (13.58±5.14**), Word List Recall Test (4.15±2.33**), Categorical Fluency (11.82±3.85*), Trail Making A (136.48±98.39*) and B (246.64±66.73*) than normal controls (*p < 0.05, ** p < 0.001, ANCOVA computing gender, age, and education as covariates). The performance of Word List Recognition Test (8.22±2.16 in MDD, 8.16±2.29 in MnDD, and 8.08±1.81 in STD) was not influenced by the presence of depression regardless of the diagnostic criteria (p = 0.226, ANCOVA computing gender, age, and education as covariates). Depression patients showed the lower scores in all domains of SF-36 than normal controls regardless of the diagnostic criteria used (p < 0.001, ANCOVA computing gender, age, and education as covariates). Conclusion: Subthreshold depression was found to be a significant clinical entity in late life since it impaired cognition, mental health and physical health. More attention should be paid to STD in late life. The influence of depression on memory can be characterized by impairment of retrieval, rather than impairment of encoding and storage, which is different from memory decline in Alzheimer’ disease. References [1] Broadhead WE, Blazer DG, George LK, Tse CK, 1990, Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 264, 2524–2528. [2] Coulehan JL, Schulberg HC, Block MR, Janosky JE, Arena VC, 1990, Depressive symptomatology and medical comorbidity in a primary care clinic. Int J Psychiatry Med 20, 335–347. [3] Geiselmann B, Bauer M, 2000 March/April, Subthreshold depression in the elderly: qualitative or quantitative distinction. Comprehensive Psychiatry 41(2 Suppl 1), 32−38.
P.2.a.022 Prevalence of pain in depression and health related quality of life outcomes: results from the FINDER study K. Demyttenaere1 ° , N. Yurgin2 , C. Reed2 , D. Quail3 , N. Dantchev4 , A.L. Montejo5 , B. Monz6 , M. Bauer7 , A. Tylee8 , L. Grassi9 . 1 Universitair Aiekenhuis Gasthuisberg, Department
of Psychiatry, Leuven, Belgium; 2 Eli Lilly and Company Limited, European Health Outcomes Research, Windlesham, United Kingdom; 3 Eli Lilly and Company Limited, European Medical Information Sciences, Windlesham, United Kingdom; 4 HˆotelDieu, Unit´e de Psychiatrie, Paris, France; 5 Hospital Universitario de Salamanca, Department of Psychiatry, Salamanca, Spain; 6 Boehringer Ingelheim GmbH, Global Health Economics & Outcomes Research, Ingelheim, Germany; 7 University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany; 8 Institute of Psychiatry, Health Services and Population Research Department, London, United Kingdom; 9 University of Ferrara, Section of Psychiatry, Ferrara, Italy Purpose: Patients with depression often experience pain [1] but how this pain impacts on outcomes of depression treatment is largely unknown. The objectives of this analysis are to explore the baseline characteristics and outcomes of patients with depression who have moderate/severe pain compared to those with no/mild pain. Methods: FINDER (Factors INfluencing Depression Endpoints Research) is a 6-month prospective, observational study on the health related quality of life (HRQoL) of 3,468 outpatients with depression starting a new antidepressant (AD) treatment at time of enrolment. Diagnosis of depression was based on clinical judgment and all treatment decisions were at the discretion of the investigator. Patients completed ratings on the Hospital Anxiety and Depression Scale (HADS), the Somatic Symptom Inventory (SSI-28) and on pain severity using Visual Analogue Scales (VAS) at the beginning of treatment (“baseline”) and 3 and 6 months later. Patients also completed HRQoL instruments the 36-item Short-Form-Health-Survey (SF-36) and European-Quality-of-life5-Dimensions (EQ-5D) questionnaire. Pain groups were defined using the VAS for severity of overall pain, with ratings 30 mm defined as having ‘no/mild pain’ and ratings >30 mm defined as having ‘moderate/severe pain.’ Pain response was defined as having moved from >30 mm to 30 mm at 6 months. For the purpose of these analyses, patient’s HADS depression subscores 7, 8−10 and >11 at baseline were classified as ‘non-cases’, ‘doubtful cases’, and ‘probable cases’ for depression, respectively. Results: 3468 patients were eligible for analysis. 56% of patients with depression experienced moderate/severe pain and 70% of these patients had no physical explanation for this pain (i.e. had no selected medical condition known to cause pain). Patients with pain were slightly older (mean 48.3) than those without pain (mean 44.8) but the distribution of females and males within the two groups was similar (69.8% and 66.0% respectively). Depressed patients with pain had a longer duration of depressive illness (mean 8.9 years) compared to those without pain (mean 8.0 years) but duration of the current depressive episode were similar (13.7 and 13.6% weeks, respectively). 71.3% of those with moderate/severe pain were ‘probable cases’ for depression compared to 59.6% of those with no/mild pain. Depression scores remained higher at 6 months for those with pain (mean 7.4) compared to those without pain (mean 5.7). Those with pain reported poorer HRQoL scores on SF-36 Physical Component Score and EQ-5D Health State Index and VAS both at baseline and after 6 months of treatment. The SF-36 Mental Component Score was similar for both groups. Conclusions: Over half of the patients in this study experienced moderate/severe pain, highlighting the high comorbidity between pain and depression. HRQoL outcomes, excluding SF-36 Mental Component Score, were worse in those with depression and pain.
P.2.a Affective disorders and antidepressants – Affective disorders (clinical) Further investigation into the impact of treating pain on depression response is warranted. FINDER was supported by Eli Lilly and Company Limited & Boehringer Ingelheim GmbH References [1] Garcia-Cebrian A, Gandhi P, Demyttenaere K, Peveler R, 2006, The association of depression and painful physical symptoms – a review of the European literature. Eur Psychiatry 21, 379−88.
P.2.a.023 Association of affective temperaments with Cloninger’s biological model of personality H.G. Kiss1 , X. Gonda1 ° , A. Rihmer2 , K. Seregi1 , D. Kovacs1 , P. Pestality1 , I. Kecskes1 , K.K. Akiskal3 , Z. Rihmer1 . 1 National Institute for Psychiatry and Neurology, Psychiatry No. III., Budapest, Hungary; 2 Semmelweis Medical University, Department of Psychiatry and Psychotherapy, Budapest, Hungary; 3 University of California at San Diego, Department of Psychiatry, San Diego, USA Background: Temperaments are constant constellations of the personality, traits and ways of reacting which characterise a person and remain constant during time and throughout several diverse situations. Most theories of temperament contain three essential components: (1) that temperaments are related to emotionality, (2) that temperaments are genetically determined and inherited and that temperaments are manifested from early childhood and remain relatively constant over life. In his biological model of personality, Cloninger has identified four major temperamental traits: harm avoidance, novelty seeking, reward dependence and persistence, which the authors consider the modern interpretation of the four ancient temperaments: melancholic is related to harm avoidance, choleric to novelty seeking, sanguine to reward dependence while phlegmatic to persistence [1]. In Akiskal’s model, on the other hand, affective temperaments are subaffective trait expressions of the subclinical phenotypes of affective disorders. Akiskal has described five basic distinguishable types of affective temperaments: anxious, depressive, hyperthymic, cyclothymic and irritable [2]. The Cloninger model has been developed based on the healthy personality, while Akiskal has derived his model of temperament based on clinical observations of affective disorders developing on the basis of different predispositions. Both models, however, has been extended to encompass the whole spectrum of personality from health to illness. The aim of our study was to investigate the relationship of the two models and the associations between them in a healthy population. Methods: 138 healthy people were included in the study. All participants completed the TEMPS-A questionnaire (Temperament Evaluation of Memphis, Pisa, Paris and San Diego) measuring affective temperaments and the TCI (Temperament and Character Inventory) measuring temperamental and character traits in Cloninger’s model. To analyse the association of temperaments within the two models, Spearman’s correlation was computed. Results: Depressive temperament had a strong significant positive correlation (r = 0.66) with harm avoidance and a moderate negative correlation (r = −0.55) with self directedness. Cyclothymic temperament had a strong significant negative correlation with self-directedness (−0.68). Hyperthymic temperament had a moderate significant negative correlation with harm avoidance (r = −0.55). Irritable temperament had a moderate significant
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correlation with self directedness (r = −0.48). The anxious temperament had a strong significant correlation with harm avoidance (r = 0.63) and a moderately strong significant negative correlation with self directedness (r = −0.50). The TEMPS-A subscales also had moderate and strong significant correlations with several subscales of the temperamental and character traits of the TCI. Conclusions: Our results are in line with our earlier expectations about the overlaps between the two models of temperaments, especially regarding the significant positive correlations between harm avoidance and depressive and anxious temperaments. Further analysis of our data, however, sheds light on important differences between the two temperamental concepts, and how these two models grab personality in different ways. The investigation of the two models and their associations leads us to better understanding of temperaments composing the personality. References [1] Svrakic DM, Cloninger CR, 2005, Personality disorders. In: Sadock BJ, Sadock VA (eds), Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. Lippincott Williams & Wilkins, Philadelphia 2063–2104. [2] Akiskal HS, Akiskal KK, Haykal R, Manning JS, Connor P, 2005, TEMPS-A: progress towards validation of a self-rated clinical version of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire. J Affect Disord 85, 3−16.
P.2.a.024 Social support in anxious and depressive outpatients M. Vidal Millares ° , I. Espi˜no Diaz, J. Brenlla Gonz´alez, M.C. Garc´ıa Mah´ıa. University Clinical Hospital, Psychiatry, Santiago de Compostela, Spain Introduction: The social upset associated the anxious and depressive patients is well documented and supposes one of the limited aspects of its global functioning [1]. These disorders are frequently associated with an important deterioration in social functioning, often substantially worse than the one experimented by patients with other chronic medical pathologies [2]. The enormous personal, social and economic impact of the depression, as well as anxiety disorders, which have to a great extent the associated deterioration of social operation, often under-appreciated [2]. In addition one has seen that the effectiveness in the improvement of the target depression symptoms not necessarily guarantees effectiveness in the improvement of the deterioration of social functioning [2]. Of this form, a recent increase in the use of social operations like ambulatory measurement in the clinical test of antidepressants exists [3]. Thus the recovery of the depression also requires not only the resolution of the depressive symptoms but also an improvement in the interaction of the individual with the individuals environment. Aims: To research the social support in depressive and anxious outpatients. To analyse the differences between the existing social support between both groups of disorders. Methods: The sample included 216 outpatients treated in a outpatient clinic in Santiago. Mean Age 36.5, diagnosed of anxiety or depressive disorder by an experienced psychiatrist. Assessment include the Beck Depression Inventory (BDI) using 13−14 as cut-off point and the Social Adaptation Self-Evaluation Scale (SASS).SASS offered an interpretative scale for determining degree of social support: “Patent Social Mismatch” (<25), “Probable Mismatch” (25−34); “Normality” (35−52) and “Superadaptation” (>53). Variables analysed included age, gender, diagnosed group, psychiatric disorder and results in scales related above. Statistical analyses were made with SPSS v.12.0 for Windows.