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array:23 [ "pii" => "S1579212921000458" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.01.012" "estado" => "S300" "fechaPublicacion" => "2021-03-01" "aid" => "2402" "copyright" => "SEPAR" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2021;57:179-85" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S1579212921000069" "issn" => "15792129" "doi" => "10.1016/j.arbr.2021.01.003" "estado" => "S300" "fechaPublicacion" => "2021-03-01" "aid" => "2429" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2021;57:186-94" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Implementation of a gene panel for genetic diagnosis of primary ciliary dyskinesia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "186" "paginaFinal" => "194" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Implementación de un panel de genes para el diagnóstico genético de la discinesia ciliar primaria" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1309 "Ancho" => 2273 "Tamanyo" => 232382 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional diagram of a respiratory cilium showing its structural components and genes in which variants have been found. The number of patients with variants in each gene is shown in parentheses. N-DRC: nexin-dynein regulator complex; Outer dynein arm-DC: outer dynein arm docking complex.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Noelia Baz-Redón, Sandra Rovira-Amigo, Ida Paramonov, Silvia Castillo-Corullón, Maria Cols-Roig, María Antolín, Elena García-Arumí, Alba Torrent-Vernetta, Inés de Mir Messa, Silvia Gartner, Ignacio Iglesias-Serrano, M. Araceli Caballero-Rabasco, Óscar Asensio de la Cruz, Gerardo Vizmanos-Lamotte, Carlos Martín de Vicente, María del Mar Martínez-Colls, Ana Reula, Amparo Escribano, Francisco Dasí, Miguel Armengot-Carceller, Eva Polverino, Esther Amengual Pieras, Rosanel Amaro-Rodríguez, Marta Garrido-Pontnou, Eduardo Tizzano, Núria Camats-Tarruella, Mónica Fernández-Cancio, Antonio Moreno-Galdó" "autores" => array:28 [ 0 => array:2 [ "nombre" => "Noelia" "apellidos" => "Baz-Redón" ] 1 => array:2 [ "nombre" => "Sandra" "apellidos" => "Rovira-Amigo" ] 2 => array:2 [ "nombre" => "Ida" "apellidos" => "Paramonov" ] 3 => array:2 [ "nombre" => "Silvia" "apellidos" => "Castillo-Corullón" ] 4 => array:2 [ "nombre" => "Maria" "apellidos" => "Cols-Roig" ] 5 => array:2 [ "nombre" => "María" "apellidos" => "Antolín" ] 6 => array:2 [ "nombre" => "Elena" "apellidos" => "García-Arumí" ] 7 => array:2 [ "nombre" => "Alba" "apellidos" => "Torrent-Vernetta" ] 8 => array:2 [ "nombre" => "Inés" "apellidos" => "de Mir Messa" ] 9 => array:2 [ "nombre" => "Silvia" "apellidos" => "Gartner" ] 10 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Iglesias-Serrano" ] 11 => array:2 [ "nombre" => "M. Araceli" "apellidos" => "Caballero-Rabasco" ] 12 => array:2 [ "nombre" => "Óscar" "apellidos" => "Asensio de la Cruz" ] 13 => array:2 [ "nombre" => "Gerardo" "apellidos" => "Vizmanos-Lamotte" ] 14 => array:2 [ "nombre" => "Carlos" "apellidos" => "Martín de Vicente" ] 15 => array:2 [ "nombre" => "María del Mar" "apellidos" => "Martínez-Colls" ] 16 => array:2 [ "nombre" => "Ana" "apellidos" => "Reula" ] 17 => array:2 [ "nombre" => "Amparo" "apellidos" => "Escribano" ] 18 => array:2 [ "nombre" => "Francisco" "apellidos" => "Dasí" ] 19 => array:2 [ "nombre" => "Miguel" "apellidos" => "Armengot-Carceller" ] 20 => array:2 [ "nombre" => "Eva" "apellidos" => "Polverino" ] 21 => array:2 [ "nombre" => "Esther" "apellidos" => "Amengual Pieras" ] 22 => array:2 [ "nombre" => "Rosanel" "apellidos" => "Amaro-Rodríguez" ] 23 => array:2 [ "nombre" => "Marta" "apellidos" => "Garrido-Pontnou" ] 24 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Tizzano" ] 25 => array:2 [ "nombre" => "Núria" "apellidos" => "Camats-Tarruella" ] 26 => array:2 [ "nombre" => "Mónica" "apellidos" => "Fernández-Cancio" ] 27 => array:2 [ "nombre" => "Antonio" "apellidos" => "Moreno-Galdó" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289620300739" "doi" => "10.1016/j.arbres.2020.02.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620300739?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921000069?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000003/v1_202103110801/S1579212921000069/v1_202103110801/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1579212921000446" "issn" => "15792129" "doi" => "10.1016/j.arbr.2019.12.026" "estado" => "S300" "fechaPublicacion" => "2021-03-01" "aid" => "2390" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2021;57:172-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Comparing Spirometric Reference Values From Childhood to Old Age Estimated by LMS and Linear Regression Models" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "172" "paginaFinal" => "178" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparación de los valores de referencia espirométrica de la infancia a la vejez estimada mediante el método LMS y modelos de regresión lineal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0020" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 972 "Ancho" => 1333 "Tamanyo" => 56273 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "David Martínez-Briseño, Laura Gochicoa-Rangel, Luis Torre-Bouscoulet, Silvia Cid-Juárez, Rosario Fernández-Plata, Luisa Martínez-Valdeavellano, Sofía Chapela-Lara, Rodrigo del Río-Hidalgo, Rogelio Pérez-Padilla" "autores" => array:9 [ 0 => array:2 [ "nombre" => "David" "apellidos" => "Martínez-Briseño" ] 1 => array:2 [ "nombre" => "Laura" "apellidos" => "Gochicoa-Rangel" ] 2 => array:2 [ "nombre" => "Luis" "apellidos" => "Torre-Bouscoulet" ] 3 => array:2 [ "nombre" => "Silvia" "apellidos" => "Cid-Juárez" ] 4 => array:2 [ "nombre" => "Rosario" "apellidos" => "Fernández-Plata" ] 5 => array:2 [ "nombre" => "Luisa" "apellidos" => "Martínez-Valdeavellano" ] 6 => array:2 [ "nombre" => "Sofía" "apellidos" => "Chapela-Lara" ] 7 => array:2 [ "nombre" => "Rodrigo" "apellidos" => "del Río-Hidalgo" ] 8 => array:2 [ "nombre" => "Rogelio" "apellidos" => "Pérez-Padilla" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0020"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921000446?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000003/v1_202103110801/S1579212921000446/v1_202103110801/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Validity of Self-rating Screening Scales for the Diagnosis of Depression and Anxiety in Adult Patients With Bronchiectasis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "179" "paginaFinal" => "185" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Natalia Colomo, Casilda Olveira, Javier Hernández-Pedrosa, Trinidad Bergero, Julia Fábrega-Ruz, Nuria Porras, María Victoria Girón, Luis Fernández de Rota, Gabriel Olveira" "autores" => array:9 [ 0 => array:3 [ "nombre" => "Natalia" "apellidos" => "Colomo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "Casilda" "apellidos" => "Olveira" "email" => array:1 [ 0 => "casi1547@separ.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Javier" "apellidos" => "Hernández-Pedrosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "Trinidad" "apellidos" => "Bergero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "Julia" "apellidos" => "Fábrega-Ruz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Nuria" "apellidos" => "Porras" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "María Victoria" "apellidos" => "Girón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 7 => array:3 [ "nombre" => "Luis Fernández" "apellidos" => "de Rota" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 8 => array:3 [ "nombre" => "Gabriel" "apellidos" => "Olveira" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Pneumology Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Mental Health Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Pneumology Department, Hospital Costa del Sol. Marbella, Málaga, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Validez de las escalas de autoevaluación para el diagnóstico de depresión y ansiedad en pacientes adultos con bronquiectasias" ] ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0010" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 724 "Ancho" => 1333 "Tamanyo" => 82566 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Depression and anxiety are prevalent in the general population and represent a significant public health problem.<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">1–3</span></a> These psychiatric disorders are often under-diagnosed, occur comorbidly with chronic illnesses and are associated with worse adherence to prescribed treatments and increased health care utilization and costs.<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">4–8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The gold standard for diagnosing psychiatric disorders is a structured clinical interview, such as the Structured Clinical Interview for DSM-IV.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">9</span></a> However, structured clinical interviews require administration by trained health professionals, are time-consuming and difficult to apply in routine clinical practice. Reliable, valid and easily applicable screening instruments are needed to identify patients with depression and anxiety.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The Hospital Anxiety and Depression Scale (HADS)<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">10</span></a> and the Beck Depression Inventory (BDI)<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">11</span></a> have proved to be reliable depression screening instruments in general practice and in medical patients,<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">12,13</span></a> and they have been well validated for use in the Spanish population.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">14,15</span></a> The Hamilton Anxiety Scale<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">16</span></a> is a scale developed to measure the severity of anxiety symptoms, and it has been validated for use in the Spanish population.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">17</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Bronchiectasis is the end result of several different diseases, managed in similar ways, but which lead to pulmonary infections, loss of lung function and worsening of health related quality of life.<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">18,19</span></a> Recent studies have shown that patients with bronchiectasis have a higher prevalence of symptoms of depression (between 20 and 30%) and anxiety (around 40%) than healthy subjects.<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">20–23</span></a> However, these studies used screening scales such as HADS and BDI, and not a psychological evaluation performed by a mental health professional, to evaluate the presence of symptoms of depression and anxiety.</p><p id="par0025" class="elsevierStylePara elsevierViewall">There are no previous studies aimed at assessing the validity of the screening scales for depression and anxiety in adult patients with bronchiectasis. Accordingly, the purpose of the present study was to analyze the psychometric properties of the self-rating screening scales for depression and anxiety; and to evaluate the concordance for the diagnosis of symptoms of depression and anxiety between these screening scales and the structured clinical interview for DSM-IV in patients with bronchiectasis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Method</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Patients</span><p id="par0030" class="elsevierStylePara elsevierViewall">This is a cross sectional study that included patients with a diagnosis of bronchiectasis who were monitored periodically (every 2–3 months) in the adult bronchiectasis/cystic fibrosis unit at the Hospital Regional Universitario de Málaga (Málaga, Spain) between May 2012 and May 2013.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Inclusion criteria: patients aged 16 and older with bronchiectasis of any etiology (including cystic fibrosis) who attended the adult bronchiectasis/cystic fibrosis unit for routine review. If at this time they had a respiratory exacerbation or a recent hospital admission, their inclusion was postponed at least 30 days until completion of treatment of the acute process. In all cases bronchiectasis was diagnosed by high-resolution computerized tomography of the chest with the use of a 1–1.5<span class="elsevierStyleHsp" style=""></span>mm window for every 10<span class="elsevierStyleHsp" style=""></span>mm with acquisition times of 1<span class="elsevierStyleHsp" style=""></span>s during full inspiration, following the criteria of Naidich et al.<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">24</span></a> All patients underwent a full etiological study following the diagnostic algorithm of bronchiectasis of the Sociedad Española de Neumología y Cirugía Torácica (SEPAR).<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">19</span></a> Exclusion criteria: transplant waiting list, problems understanding the questionnaires, absence of written informed consent.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The Research Ethics Committee of the Hospital Regional de Málaga approved the study. All participants gave written informed consent.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Measurements</span><p id="par0045" class="elsevierStylePara elsevierViewall">The day of the appointment at the bronchiectasis/cystic fibrosis unit, patients who met inclusion criteria and none of the exclusion criteria were invited to participate. Written informed consent was obtained from each participant before inclusion.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Sociodemographic data were collected, including age, sex, marital/partner status, employment status and educational level.</p><p id="par0055" class="elsevierStylePara elsevierViewall">A full clinical history, from diagnosis through to study participation, was recorded in a regional database. During each visit, clinical variables were collected prospectively, including body mass index (BMI), spirometry and sputum samples for microbiologic analysis. Pulmonary exacerbations were assessed prospectively using the SEPAR criteria.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">19</span></a> Forced vital capacity (FVC) and forced expiratory volume in 1<span class="elsevierStyleHsp" style=""></span>s (FEV1) were expressed in absolute terms (ml) and as a percentage using a reference population.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">25</span></a> The number of exacerbations and hospital admissions in the year prior to the evaluation were also utilized in the analyses. Anxiolytic and antidepressant intake was also recorded.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The day of the inclusion in the study, patients completed the self-reported HADS questionnaire, the BDI, the Hamilton Anxiety Scale and the QOL-B questionnaire (in case of non cystic fibrosis patients) and CFQ-R (in case of cystic fibrosis patients). Afterwards, each participant received a specific appointment with a mental health care professional to conduct a structured clinical interview.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The HADS questionnaire<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">10</span></a> comprises two sub-scales, each one ranges from 0 to 21 points; one assesses the symptoms of depression (HADS-D), and the other one the symptoms of anxiety (HADS-A). It was validated in Spanish, including patients with respiratory pathology (chronic obstructive pulmonary disease – COPD).<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">26</span></a> The following severity cut-off scores for anxiety and depression have been recommended by the authors of the measure: In each sub-scale, a score below 7 is considered normal range, between 8 and 10 means probable presence of depression or anxiety respectively, and more than 11 suggests the presence of depression or anxiety respectively. These cut-off points have been previously used in patients with Cystic Fibrosis and bronchiectasis.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">27</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The BDI<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">11</span></a> is a 21-item-self report-multiple choice inventory. BDI items are rated on a 4-point scale ranging from 0 to 3 based on severity of each item; the maximum total score is 63. The following severity cut-off scores have been recommended: below 9 is considered no depression, between 10 and 18 probable mild depression, between 19 and 29 probable moderate depression, and more than 30 probable severe depression. However, other cut-off points have also been proposed in patients with respiratory diseases such as COPD.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">28</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The Hamilton Anxiety Scale<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">16</span></a> consists of 14 items, each defined by a series of symptoms, and measures both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety). Each item is scored on a scale of 0 (not present) to 4 (severe), with a total score range of 0–56, where <17 indicates mild severity, 17–24 mild to moderate severity and 25–30 moderate to severe. These cut-off points have been used in patients with COPD.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">29</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The structured clinical interview: patients were individually interviewed by a mental health care professional (who was blinded to the scores obtained in the self-reported questionnaires) using the Spanish version 5.0.0 of the structured Mini International Neuropsychiatric Interview (MINI).<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">30,31</span></a> The MINI evaluates for depression and anxiety according to the DSM-IV criteria.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">9</span></a> The outcome in the MINI was considered the gold standard.</p><p id="par0085" class="elsevierStylePara elsevierViewall">QOL-B-Spain: is a disease-specific questionnaire for patients with bronchiectasis in Spanish. It is a self-report measure consisting of 37 questions divided into 8 domains, and takes about 10<span class="elsevierStyleHsp" style=""></span>min to complete. The scores are standardized across 8 scales, ranging from 0 to 100, with higher scores indicating better health-related quality of life.<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">32</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">CFQR 14+ (Spain): is a disease-specific questionnaire for patients with cystic fibrosis in Spanish. It is a self-report measure consisting of 50 questions and takes about 10–15<span class="elsevierStyleHsp" style=""></span>min to complete. The scores are standardized across 12 scales, ranging from 0 to 100, with higher scores indicating better health-related quality of life.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">14,33</span></a> QOLB and CFQ-R share 8 scales that are the ones analyzed in this work: Physical functioning, Role functioning Vitality, Emotional functioning, Social functioning, Treatment burden, Health perceptions, Respiratory symptoms.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0095" class="elsevierStylePara elsevierViewall">We present psychometric properties of the HADS-D, HADS-A, BDI and Hamilton Anxiety Scale at various optimal cut-off values and at traditionally accepted cut-off values. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Agreement between the screening scales and the diagnoses obtained by the MINI was measured using kappa coefficient and by calculating the area under the receiver operating (ROC) curve (AUC). Maximal discrimination between those with or without a DSM-IV diagnosis was reached at the highest sum of sensitivity and specificity that is termed the Youden index.<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">34</span></a> The normality of distributions was verified using the Kolmogorov–Smirnov test. Quantitative variables were compared using <span class="elsevierStyleItalic">t</span> tests or the Mann–Whitney test. Additionally, the Spearman correlation coefficient was employed in order to assess correlations between the screening scales of depression and anxiety, clinical variables and QOL-B and CFQ-R dimensions. To test the statistical significance of the difference between the areas under 2 dependent ROC curves we used the method of DeLong. Confidence levels of 95% were considered in two tail hypothesis tests.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">A total of 52 subjects were included (71.2% women, mean age of 44 years old). Thirty subjects (57.7%) had a diagnosis of non-cystic fibrosis bronchiectasis, and 22 (42.3%) had a diagnosis of cystic fibrosis. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the sociodemographic and clinical characteristics of the study participants.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The results of the MINI based on the DSM-IV criteria showed that 18 subjects (34.6%) had a diagnosis of depression, and 25 subjects (48.1%) had a diagnosis of anxiety.</p><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> summarizes the psychometric properties of the HADS-D subscale and the BDI compared with the MINI for the diagnosis of depression. Optimal cut-off values were ≥9 for the HADS-D (sensitivity 0.833, specificity 0.971), and 17 for BDI (sensitivity 0.889, specificity 0.912). <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a and b shows the ROC curves for the HADS-D and the BDI, respectively. The AUC was 0.962 (95% CI 0.918–1) for the HADS-D, and 0.978 (95% CI 0.945–1) for the BDI. Difference between areas was 0.0155 (95% CI −0.0378 to 0.0688); <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.5681.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> summarizes the psychometric properties of the HADS-A subscale and the Hamilton Anxiety Scale compared with the MINI for the diagnosis of anxiety. Optimal cut-off values were ≥4 for the HADS-A (sensitivity 0.960, specificity 0.593) and 17 for the Hamilton Anxiety Scale (sensitivity 0.800, specificity 0.852). <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>c and d shows the ROC curves for the HADS-A and the Hamilton Anxiety Scale, respectively. The AUC was 0.833 (95% CI 0.723–0.943) for the HADS-A, and 0.876 (95% CI 0.781–0.970) for the Hamilton Anxiety Scale. Difference between areas was 0.0422 (95% CI −0.0694 to 0.154); <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.4585.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">We found significant correlations between the score of the scales HADS-D, HADS-A, BDI and the Hamilton Anxiety Scale with each other and with all the dimensions of the QOL-B and CFQ-R, except for treatment burden. We do not observe significant correlations of the scores of the scales with clinical variables such as BMI, age, FEV1%, or exacerbations rate (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>). Patients with <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> or any chronic bronchial infection did not have significantly different scores from any of the self-rated screening scale for depression and anxiety studied relative to those not colonized (data not shown).</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">Anxiety and depression are commonly reported in patients with bronchiectasis, therefore in this group of patients it is especially important to screen for the presence of symptoms of these psychiatric disorders in the Bronchiectasis Units, and refer the right patients to a mental health team for treatment. The prevalence varies among different studies, which depends on the method of diagnosis. In previous studies performed in this group of patients using screening scales to diagnose depression and anxiety, the prevalence of depression symptoms ranges between 20 and 34%, and the prevalence of anxiety between 38 and 55%.<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">20–23</span></a> In the present study, the MINI revealed a prevalence of depression of 34.6% and anxiety of 48.1%. To our knowledge this is the first study in patients with bronchiectasis in which a structured clinical interview was performed.</p><p id="par0130" class="elsevierStylePara elsevierViewall">The optimal cut-off values of the screening scales in patients with bronchiectasis might differ from the ones traditionally accepted, as have been reported previously in other diseases. Optimal cut-off values for the diagnosis of depression using HADS-D ranges between 7 in patients on hemodialysis<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a> and in patients with obstructive pulmonary disease,<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">28</span></a> and 8 in patients with coronary artery disease<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">13</span></a> and in patients with systemic lupus erythematosus.<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">36</span></a> For the BDI, an optimal cut-off point of 14 was reported in a study with patients on hemodialysis,<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a> and an optimal cut-off point of 13 was found in patients with obstructive pulmonary disease.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">28</span></a> For the anxiety screening scales, the optimal cut-off point for HADS-A was 6 in patients with systemic lupus erythematosus<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">36</span></a> and in patients on hemodialysis,<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a> 8 in patients with coronary artery disease,<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">13</span></a> 9 in patients with obstructive pulmonary disease.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">28</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">However, we did not find any studies that assess the psychometric properties of the screening scales to detect depression and anxiety in patients with bronchiectasis. We believe it to be of interest because of the high prevalence of these psychiatric disorders in this specific group of patients, and the negative consequences of the under-diagnosis and under-treatment of these psychiatric symptoms on the quality of life and disease severity.<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">20–22</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Therefore, in the present study we assessed the optimal cut-off points of the screening scales (HADS-D, BDI, HADS-A and Hamilton Anxiety Scale) to determine the most sensitive and specific value to detect depression and anxiety of each scale in this specific group of patients. To detect depression, we found that the optimal cut-off value for the HADS-D was 9, and for the BDI it was 14. These cut-off points for both scales are close to, but are not the standard recommendation.<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">10,11</span></a> Additionally, both HADS-D and BDI have a high and similar AUC to detect depression and may be used indistinctly as a tool for screening depression in patients with bronchiectasis. To detect anxiety, our results showed that the optimal cut-off value for HADS-A was 4, and for the Hamilton Anxiety Scale was 17. In this case, we found that the standard cut-off point recommendation for HADS-A has a low sensitivity in patients with bronchiectasis, thus we propose using 4 as the cut-off point in order to improve the performance of the HADS-A in this group of patients. For the Hamilton Anxiety Scale, we suggest using 17 as a cut-off point to detect anxiety. HADS-A and the Hamilton Anxiety Scale have a good and similar AUC to detect anxiety.</p><p id="par0145" class="elsevierStylePara elsevierViewall">The scores of the three scales evaluated (HADS, BDI and Hamilton) have presented significant negative correlations (higher scores, worse quality of life) with the 8 dimensions of the patients reported outcome QOL-B and CFQ-R evaluated, except for treatment burden, being especially high in the emotional functioning dimension. On the contrary, we do not observe significant associations of HADS, BDI or Hamilton scores, with individual important components such as BMI, age, <span class="elsevierStyleItalic">P. aeruginosa</span> or any chronic bronchial infection, FEV1%, or exacerbations rate. These results are similar to those previously found by our group where symptoms of depression and anxiety were significant predictors of health-related quality of life in patients with bronchiectasis, independently of respiratory involvement, age or other variables. These results reinforce the importance of assessing symptoms of depression/anxiety in bronchiectasis because it adds new information on the impact of the disease on the patient. So the current multidimensional scoring systems like such as the Bronchiectasis Severity Index (BSI), FACED, and e-FACED<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">37–39</span></a> developed in bronchiectasis are useful to assess the clinical severity and prognosis of the disease, but they do not include other important dimensions such us the impact of bronchiectasis upon the patient.<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">40,41</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The strength of the study is that is the first paper on this topic in patients with bronchiectasis and includes the evaluation of associations of screening test with clinical and quality of life variables. The limitation is that we have included patients with and without CF (and probably the characteristics of these two groups could be different). In any case, a specific test for CF such as CFQ-R and non-bronchiectasis for QOL-B has been used for the evaluation of quality of life, since both questionnaires share the same 8 dimensions analyzed in this study.</p><p id="par0155" class="elsevierStylePara elsevierViewall">In conclusion, the self-rating screening scales HADS, BDI and Hamilton Anxiety Scale are reliable tools to screen for depression and anxiety in adult patients with bronchiectasis. However, our results suggest that the use of specific cut-off values may improve the diagnostic accuracy of the previous scales in patients with bronchiectasis.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Authors’ contributions</span><p id="par0160" class="elsevierStylePara elsevierViewall">G.O. and C.O. substantially contributed to the conception and design of the study, acquisition, analysis, and interpretation of the data; statistical analysis; and drafting of the manuscript. N.C. contributed to the acquisition, analysis, and interpretation of the data; statistical analysis; revised the article for important intellectual content and drafting of the manuscript; J.H.-P., T.B., J.F.-R., N.P. M.V.G., and L.F.D.R. contributed to the data acquisition and critical review of the manuscript.</p><p id="par0165" class="elsevierStylePara elsevierViewall">G.O. is the guarantor of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflict of interests</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1479299" "titulo" => "Graphical abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:3 [ "identificador" => "xres1479300" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Aims" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusion" ] ] ] 2 => array:2 [ "identificador" => "xpalclavsec1347348" "titulo" => "Keywords" ] 3 => array:3 [ "identificador" => "xres1479301" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0035" "titulo" => "Contexto global" ] 1 => array:2 [ "identificador" => "abst0040" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0045" "titulo" => "Método" ] 3 => array:2 [ "identificador" => "abst0050" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0055" "titulo" => "Conclusión" ] ] ] 4 => array:2 [ "identificador" => "xpalclavsec1347347" "titulo" => "Palabras clave" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 6 => array:3 [ "identificador" => "sec0010" "titulo" => "Method" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Measurements" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0040" "titulo" => "Authors’ contributions" ] 10 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interests" ] 11 => array:2 [ "identificador" => "xack518845" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-11-24" "fechaAceptado" => "2020-01-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1347348" "palabras" => array:7 [ 0 => "Depression" 1 => "Anxiety" 2 => "Bronchiectasis" 3 => "Infection" 4 => "HADS" 5 => "BDI" 6 => "MINI" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1347347" "palabras" => array:7 [ 0 => "Depresión" 1 => "Ansiedad" 2 => "Bronquiectasia" 3 => "Infección" 4 => "HADS" 5 => "BDI" 6 => "MINI" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Background</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">There are no previous studies aimed at assessing the validity of the screening scales for depression and anxiety in adult patients with bronchiectasis.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Aims</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">To analyze the psychometric properties of Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and Hamilton Anxiety Scale and to evaluate the concordance for the diagnosis of depression and anxiety between these screening scales and the structured clinical interview in adult patients with bronchiectasis.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Method</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cross sectional study. 52 patients with bronchiectasis completed HADS, BDI and Hamilton Anxiety Scale; afterwards, were individually interviewed by a mental health care professional using the structured Mini International Neuropsychiatric Interview (MINI), which evaluates for depression and anxiety according to DSM-IV criteria.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Based on MINI, 18 subjects (34.6%) had a diagnosis of depression and 25 (48.1%) had anxiety. Optimal cut-off values to detect depression were ≥9 for the HADS-D (sensitivity 0.833, specificity 0.971, AUC 0.962 [95% CI 0.918–1]), and 17 for BDI (sensitivity 0.889, specificity 0.912, AUC 0.978 [95% CI 0.945–1]). Optimal cut-off values to detect anxiety were ≥4 for the HADS-A (sensitivity 0.960, specificity 0.593, AUC 0.833 [95% CI 0.723–0.943]), and 17 for Hamilton Anxiety Scale (sensitivity 0.800, specificity 0.852, AUC 0.876 [95% CI 0.781–0.970]).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The self-rating screening scales HADS, BDI and Hamilton Anxiety Scale are reliable tools to screen for depression and anxiety in adult patients with bronchiectasis. However, the use of specific cut-off values may improve the diagnostic accuracy of the previous scales in this specific group of patients.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Aims" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Contexto global</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">No existen estudios previos dirigidos a la evaluación de las escalas de detección de la depresión y de la ansiedad en pacientes adultos con bronquiectasias.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objetivos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Analizar las propiedades psicométricas de la escala de ansiedad y depresión hospitalaria (HADS, por sus siglas en inglés), el inventario de depresión de Beck (BDI, por sus siglas en inglés) y la escala de ansiedad de Hamilton, y evaluar la concordancia para el diagnóstico de la depresión y la ansiedad entre estas escalas de detección y la entrevista clínica estructurada en pacientes adultos con bronquiectasias.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Método</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal. Cincuenta y dos pacientes con bronquiectasias completaron la HADS, el BDI y la escala de ansiedad de Hamilton; posteriormente, un psiquiatra profesional de la salud mental les entrevistó individualmente utilizando la entrevista estructurada denominada Minientrevista neuropsiquiátrica internacional (MINI), que evalúa la depresión y la ansiedad siguiendo los criterios del DSM-IV.</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Basándonos en la MINI, 18 sujetos (el 34,6%) fueron diagnosticados de depresión y 25 de ellos (el 48,1%) presentaba ansiedad. Los valores de corte óptimos para detectar depresión fueron ≥<span class="elsevierStyleHsp" style=""></span>9 para la HADS-D (sensibilidad: 0,833; especificidad: 0,971; ABC: 0,962 [IC 95%: 0,918-1]) y 17 para el BDI (sensibilidad: 0,889; especificidad: 0,912; ABC: 0,978 [IC 95%: 0,945-1]). Los valores de corte óptimos para detectar ansiedad fueron ≥<span class="elsevierStyleHsp" style=""></span>4 para la HADS-A (sensibilidad: 0,960; especificidad: 0,593; ABC: 0,833 [IC 95%: 0,723-0,943]) y 17 para la escala de ansiedad de Hamilton (sensibilidad: 0,800; especificidad: 0,852; ABC: 0,876 [IC 95%: 0,781-0,970]).</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusión</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Las escalas de autoevaluación HADS, BDI y la escala de ansiedad de Hamilton son herramientas fiables para detectar la depresión y la ansiedad en pacientes adultos con bronquiectasias. Sin embargo, el uso de valores de corte específicos puede mejorar la precisión diagnóstica de las escalas anteriores en este grupo concreto de pacientes.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0035" "titulo" => "Contexto global" ] 1 => array:2 [ "identificador" => "abst0040" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0045" "titulo" => "Método" ] 3 => array:2 [ "identificador" => "abst0050" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0055" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2709 "Ancho" => 2506 "Tamanyo" => 241863 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">ROC curves of the self-rating screening scales compared with MIN. (a) and (b) show the ROC curves for the HADS-D and the BDI, respectively, compared with the MINI for the diagnosis of depression. (c) and (d) show the ROC curves for the HADS-A and the Hamilton Anxiety Scale, respectively, compared with the MINI for the diagnosis of anxiety.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">FEV1: forced expiratory volume in the first second; HADS: Hospital Anxiety and Depression Scale.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> (%) or mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (28.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (71.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Marital status</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Single \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (28.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Married or cohabitant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (63.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Divorced or separated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Widowed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Employment status</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Able to work \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (57.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unemployed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (19.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Retired \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (23.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Educational level</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No education \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (9.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Primary school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (36.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Secondary school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (34.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>College \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (19.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Drug use</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anxiolytics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (23.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antidepressants \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (9.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Respiratory disease</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bronchiectasis non-cystic fibrosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (57.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cystic fibrosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (42.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">FEV1</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1971<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>932 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>27.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Respiratory exacerbations in the last 12 months (n)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.02<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.56 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.78<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.44 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Colonization of the respiratory tract (n, %)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Any bacteria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (79.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Haemophilus influenzae</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (49.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (70.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Staphylococcus aureus</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (43.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Body mass index (kg/m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Screening scales</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HADS-depression score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HADS-anxiety score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>BDI score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hamilton scale score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">MINI</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Depression \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (34.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (48.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Quality of life dimensions</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Physical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>34.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Role \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>27.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vitality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>27.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Emotion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>28.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Social \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>25.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Health \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>27.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2545535.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Categorical variables are <span class="elsevierStyleItalic">n</span> (%) and continuous variables are mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Sociodemographic and clinical characteristics of the study participants.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">AUC: area under the curve; BDI: Beck Depression Inventory; HADS-D: Hospital Anxiety and Depression Scale – Depression subscale; NPV: negative predictive value; PPV: positive predictive value. Bold: optimal cut-off values.</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">HADS-D: AUC 0.962. CI 95% (0.918–1); <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001.</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">BDI: AUC 0.978. CI 95% (0.945–1); <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cut-off score \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sensitivity \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="