Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q): reliability and validity.
ABSTRACT The pediatric version of the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q) was developed to aid in the assessment of an important aspect of life experience in children and adolescents.
The reliability and validity of the PQ-LES-Q was tested using data from a sample of 376 outpatient children (6-11 years old) and adolescents (12-17 years old) with major depressive disorder.
The internal consistency coefficients at screening, baseline, and endpoint were high (0.87, 0.90, 0.89, respectively) as was the 1-week test-retest intraclass correlation coefficient of reliability (0.78). The correlations of the PQ-LES-Q total score with concurrent measures of severity of illness were in the moderate range (e.g., Global Clinical Impression of Severity, -0.40; Children's Global Assessment Scale, 0.36; Children's Depression Rating Scale total score, -0.45), as were the correlations with measures of change between baseline and endpoint (e.g., Clinical Global Impression of Severity, -0.34; Children's Global Assessment Scale, 0.33; Children's Depression Rating Scale total score, -0.45).
These findings support the use of the PQ-LES-Q as an additional measure of current clinical status and outcome because it taps dimensions that are not covered by the commonly used global severity of illness or symptomatic measures.
[show abstract] [hide abstract]
ABSTRACT: Background: Aripiprazole is an atypical antipsychotic that was approved, relatively recently, for use in adolescents with schizophrenia. Objective: The aim was to discuss efficacy and tolerability issues of aripiprazole in adolescents suffering from schizophrenia. Method: A Medline search identified only three studies and one post hoc analysis for one of them, concerning the use of aripiprazole in adolescents with schizophrenia. Finally, one of the studies was excluded because of the small number of cases treated with aripiprazole. Results: Based on the clinical evidence, including data from two short-terms clinical trials and one post-hoc analysis of one of the abovementioned studies, aripiprazole seemed generally safe and well tolerated in children and adolescents. Aripiprazole at doses of 10 to 30 mg/day was more efficacious in ameliorating the symptoms (including hostility) of schizophrenia than was placebo. It was associated with low number and mild-to-moderate intensity of adverse events, and with no clinically relevant findings in ECGs, vital signs, and clinical laboratory tests. The most common adverse events were extrapyramidal disorder, somnolence, and tremor. Also aripiprazole is unlikely to be associated with hyperprolactinemia and clinically significant weight gain. Conclusion: Scant information exists to evaluate the use of aripiprazole in early-onset schizophrenia, due to the lack of published studies. The initial encouraging results provide further support and point out the necessity for systematic research on the efficacy and tolerability of aripiprazole in pediatric patients suffering from schizophrenia.Current developments in psychopharmacology 01/2012; 1(2):117-121.
Article: Relative cost-effectiveness of treatments for adolescent depression: 36-week results from the TADS randomized trial.[show abstract] [hide abstract]
ABSTRACT: The cost-effectiveness of three active interventions for major depression in adolescents was compared after 36 weeks of treatment in the Treatment of Adolescents with Depression Study. Outpatients aged 12 to 18 years with a primary diagnosis of major depression participated in a randomized controlled trial conducted at 13 U.S. academic and community clinics from 2000 to 2004. Three hundred twenty-seven participants randomized to 1 of 3 active treatment arms, fluoxetine alone (n = 109), cognitive-behavioral therapy (n = 111) alone, or their combination (n = 107), were evaluated for a 3-month acute treatment and a 6-month continuation/maintenance treatment period. Costs of services received for the 36 weeks were estimated and examined in relation to the number of depression-free days and quality-adjusted life-years. Cost-effectiveness acceptability curves were also generated. Sensitivity analyses were conducted to assess treatment differences on the quality-adjusted life-years and cost-effectiveness measures. Cognitive-behavioral therapy was the most costly treatment component (mean $1,787 [in monotherapy] and $1,833 [in combination therapy], median $1,923 [for both]). Reflecting higher direct and indirect costs associated with psychiatric hospital use, the costs of services received outside Treatment of Adolescents with Depression Study in fluoxetine-treated patients (mean $5,382, median $2,341) were significantly higher than those in participants treated with cognitive-behavioral therapy (mean $3,102, median $1,373) or combination (mean $2,705, median $927). Accordingly, cost-effectiveness acceptability curves indicate that combination treatment is highly likely (>90%) to be more cost-effective than fluoxetine alone at 36 weeks. Cognitive-behavioral therapy is not likely to be more cost-effective than fluoxetine. These findings support the use of combination treatment in adolescents with depression over monotherapy.Journal of the American Academy of Child and Adolescent Psychiatry 07/2009; 48(7):711-20. · 4.98 Impact Factor