双相抑郁指数量表的研制及考评

目的 研制双相抑郁指数量表(BDIS),并考评其信度、效度.方法 通过复习文献,将双相抑郁患者的临床特征汇总,初步编制成双相抑郁指数量表(BDIS),并对连续入组46例双相抑郁(BD)、44例单相抑郁(UD)患者(诊断标准根据DSM-Ⅳ)评定,其中有42例患者进行评定者一致性信度评定.结果 实证后有11项条目被纳入BDIS.各条目与BDIS分的评定者一致性信度为0.61～0.87.BDIS各条目分与总分的相关系数为0.53～0.73.BDIS的Cronbach's alpha系数为0.68.BD患者的BDIS分均值[(7.26±3.12)分]显著高于UD患者[(4.80±3.08)分,(P＜0.01)].BDIS分与自评性轻躁狂量表(MDQ、HCL-32)分相关系数为0.56、0.45(均P＜0.01).经ROC曲线分析,BDIS分对判别BD有显著意义(P＜0.01),最佳划界分为5分(敏感性0.80、特异性0.64).结论 BDIS的信度、效度符合心理测量学要求,临床上可以作为判别双相抑郁、单相抑郁的辅助工具试用.

Development,validity and reliability of bipolar depression index scale (BDIS)

Objective To develop the bipolar depression index scale (BDIS) and test the validity and reliability of BDIS.Methods The original bipolar depression index scale (BDIS) was developed by the clinical features of bipolar depression reported by the studies focused on comparing the bipolar depression (BP) and unipolar depressive disorder (UP).46 patients with bipolar depression and 44 patients with unipolar depression were rated the original BDIS and enrolled consecutively by DSM-IV.Results There were eleven items in the BDIS.The interrater reliability between eleven items and BDIS score ranged from 0.61 to 0.87.The correlation coefficients between eleven items and BDIS score ranged from 0.53 to 0.73.The Cronbach's alpha of BDIS was 0.68.The mean BDIS score of BP(7.26 ± 3.12 ) was significantly higher than that of UP( (4.80 ± 3.08 ), (P ＜ 0.01 ).The BDIS scores were significantly correlated with the scores of Mood Disorder Questionnaire ( coefficient 0.56) and 32-item hypomania checklist ( coefficient 0.45).The BDIS score could discriminate between BP patients and UP patients by the ROG curve analysis and 5 was the best cutoff score ( sensitivity 0.80, specificity 0.64).Conclusions The validity and reliability of BDIS are fit for the requirements of psychometrics.BDIS may use to differentiate between bipolar depression and unipolar depression in the practice.