METHODOLOGY FOR ITS USE
This is an instrument in the form of a questionnaire. It can be filled out during the family interview with or without the patient, depending on the predisposition of the patient and the family. It collects data from pregnancy to adolescence and is a form of exploration or systematized anamnesis. In addition to the specific information, the interview offers the possibility of exploring the family’s experiences with the facts and circumstances they have lived. For example, often the data relating to gestation, birth and early childhood are not easily remembered, so in a LISMEN interview the child or adolescent may know the facts that he or she did not know or knew but did not remember. In addition, some parents are surprised to be asked about issues that are not relevant to them or that have not been related to a possible problem in the emotional development of their children. Also, the interview can become a pedagogical and sensitizing instrument of the emotional health of the family.
In the questionnaire, the risk factors follow a biographical temporality according to four stages: from 0 to 2 years, from 3 to 5 years, from 6 to 11 and from 12 to 17 years, following the cycles of the educational system currently in force in our country. The items are ordered chronologically, one for each risk factor. Thus, there are items or factors that can only be answered with reference to the first year of life, for example, differences in breastfeeding among siblings. However, others remain throughout the four stages described: such as frequent vomiting and/or feed refusal. For each item or factor it should be noted whether what is described is present, whether it is absent or whether it cannot be answered due to lack of information.
A glossary is available to facilitate the use of the LISMEN, and can be consulted on the same website. Normally description of the item or risk factor is usually sufficiently understandable and it is not essential to consult the glossary to fill in the questionnaire.
RELIABILITY AND VALIDITY
The statistical studies concerning the reliability and validity qualities of the instrument can be consulted in the doctoral thesis. For space reasons it is not reproduced directly on this website. You can download it in the Documentation section.
The population, from which the samples were extracted to observe the influence of the risk factors, belong to certain neighbourhoods of the city of Barcelona corresponding to the geodemographic area that at that time was served by the Mental Health Unit of Sant Martí Nord, managed by the Catalan Institute of health. A mental health unit that integrates the care of the adult, juvenile and child population (CSMA and CSMIJ) without discontinuity in treatment due to age.
In these samples we found people diagnosed with mental disorder from childhood and adolescence who had evolved into a severe mental disorder in adult life, a group of children who were treated in the consultation and from the beginning diagnosed as being at risk and detected by the service that, at that time, was called the Functional Unit of Childhood Care and also a group of infants were studied in their first year of life who were born in a neighbourhood with detected social difficulties. These groups were compared with a control group of people who were being treated at the family medicine and paediatric health services in the area, and had no identified mental health diagnosis.
Statistical comparisons between the group of people without mental health diagnosis and the group of people with a diagnosis, showed that there are significant differences, in particular, when they accumulate at least 10 risk factors in their lives. That is to say, if the LISMEN questionnaire is administered to a person and they obtain a score of 10 or more risk factors in their life, it can be concluded that they belong to the risk group, thus having a higher probability of developing mental disorders, whether serious or transitory, throughout their lives. Being included in this risk group does not mean that a mental disorder will develop, it will depend on protective factors and/or individual’s resilience. However, at a minimum, preventive consultation and follow-up should be offered. In some cases it is convenient to access the need for some form of psychotherapeutic treatment. In the statistical studies, it was possible to obtain this cut-off point among the person who may or may not be at risk, but no statistically significant differences could be obtained in the field of factorial analysis; like, for example, in the items related to bonding, family antecedents or items in the educational field. Nevertheless, the researchers who have used the LISMEN questionnaire have subsequently made specific groupings or have isolated groups of items to statistically analyse their presence in relation to other study variables.
The project was granted, at different times, by the Seny Foundation and by the Research Unit of the Catalan Institute of Health (ICS) in the area of Barcelona city.