抑郁自评量表和贝克抑郁量表区分抑郁症严重程度的准确度

目的 对抑郁自评量表和贝克抑郁量表诊断抑郁症和区分抑郁症严重程度的准确性进行 评价。方法 选取 2018 年 8 月至 2020 年 8 月在重庆市精神卫生中心就诊的门诊和自愿住院 200 例以情 绪和睡眠问题为主诉的患者,以 ICD-10 的条目标准进行抑郁症的诊断和抑郁症严重程度的评估,同时 完成抑郁自评量表和贝克抑郁量表的评定,采用受试者工作特征（ROC）曲线下面积评价两个抑郁量表 的准确性。结果 抑郁自评量表和贝克抑郁量表具有明显的相关性（r=0.848,P＜ 0.001）,两个量表诊断 抑郁症和区分抑郁症严重程度的 ROC 曲线下面积差异无统计学意义（P＞ 0.1）。随着抑郁程度的加重, ROC 曲线下面积逐渐增大（0.754/0.761～0.904/0.911）,Youden 指数逐渐增加（0.498/0.403～0.768/0.751）, 阳性似然比逐渐增加（2.71/2.14～9.63/10.1）,阳性预测值逐渐增加但不理想（17.2%/17.8%）。结论 抑郁 自评量表和贝克抑郁量表诊断抑郁症和区分抑郁症严重程度的准确性相当,且抑郁程度越重,两种量 表的评定就会越准确,两种量表有特定的使用目的和特定的人群,不能随意推荐使用。     

慢性心力衰竭患者自评抑郁量表评测的临床分析

目的 了解慢性心力衰竭(CHF)患者抑郁的发生率、临床特点,并分析其影响因素.方法 运用自评抑郁量表(SDS)对128例CHF患者进行测评,并进行统计学分析.结果 CHF患者抑郁的发生率为43.8%,女性高于男性,年龄、病程、心功能分级对CHF患者抑郁的发生有不同程度的影响.结论 部分CHF患者存在抑郁等心理问题,应用SDS能早期发现抑郁患者,在治疗心力衰竭的基础上,应加强对抑郁的心理和药物治疗.     

六个常用的焦虑抑郁量表的相关因子分析

相当多的在神经内科就诊的患者中存在焦虑及抑郁症状,为了能在这些就诊者中早期识别出情感障碍的患者,量表是很好的辅助工具。常用的焦虑抑郁量表有6个:医院焦虑抑郁量表抑郁分表(hosp ital anxiety and depression scale fordepression,HAD-D)、医院焦虑抑郁量表焦虑分表(hosp     

流调用抑郁自评量表在社区应用的效度研究

目的 检测我国社区用修订版流调用抑郁自评量表（ＣＥＳ－Ｄ，２０项）的效度，以及与临床诊断的一致性。 方法 ４８３名受检者源自痴呆调查中≥５５岁非痴呆老人，经自评后，用ＤＩＳ评定并作临床诊断。 结果 （１）按临床工作用标准，重症抑郁发生率达５．６％（２７／４８３）。（２）当取界限分≥１６时，抑郁障碍检出的敏感性为９２．６％，特异性８６．８％。（３）协同效应一致性良好，按性别、年龄及文化程度分组结果也     

病人健康问卷抑郁自评量表（PHQ-9）的临床应用

病人健康问卷（Patient Health Questionnaire-9,PHQ-9）是一个简便、有效的抑郁障碍自评量表,在抑郁症诊断的辅助和症状严重程度评估方面,均具有良好的信度和效度.在基于评估的治疗策略中,PHQ-9可以作为制订治疗方案的参考,以及治疗过程中对疗效的评估工具.PHQ-9的衍生版本PHQ-8,PHQ-2和他评量表PHQ-9-OV,针对不同研究对象,有着相应的临床应用效果.现就PHQ-9在临床的应用及优势进行论述.     

脑卒中患者伴发抑郁的综合干预效果评价

目的 观察对本社区脑卒中患者伴发抑郁的患病率、发病程度、综合干预治疗的情况.方法 以109例社区脑卒中患者为对象,应用ZUNG抑郁自评量表(SDS)进行抑郁评估,对抑郁患者进行有效的心理及药物治疗,进行自身前后比较.结果 本组脑卒中患者抑郁患病率48.6%,其患病率与年龄有关,与性别、卒中类型无关,经干预治疗后下降至33.9%.结论 应对脑卒中患者进行抑郁调查和及时治疗.     

我国常用的抑郁自评量表介绍及应用

由于生活节奏的加快、生活压力的繁重,导致抑郁症发病率越来越高,但抑郁症识别率低,能够有效治疗的病例不足40%[1].有研究发现,10%~25%的轻度抑郁症患者如未能得到及时识别及治疗将在1~3年内发展为重度抑郁症[2],因此早期的识别及治疗,可以延缓患者重度抑郁症的发生.心理评定量表[3]作为一种定量及标准化工具,不但能够辅助医生对这些患者进行辨识并给予相应客观的评价,而且可以让患者意识到自身疾病的状态及程度,配合医生的治疗.因此,应重视心理量表并大力发展心理量表在临床中的应用.本文简要地概述了目前国内常用的抑郁症状评估自评量表及应用情况,旨在以后可以编制出适合我国抑郁症人群的抑郁筛查评定量表,及时发现抑郁人群,减少抑郁症的误诊、漏诊等问题.为了文章的简洁明了,在此只选择性的引用各量表的文献进行应用情况分析.     

ZUNG氏抑郁自评量表（SDS）作为外科住院患者抑郁障碍常规筛查工具的可行性研究

目的探讨ZUNG氏抑郁自评量表（SDS）作为外科住院患者抑郁障碍筛查工具的可行性。方法首先对符合入组条件的293例外科住院患者进行SDS的初步筛查,然后采用美国《精神障碍诊断与统计手册第四版》DSM—Ⅳ轴Ⅰ障碍定式临床检查（Structured Clinical Interview for DSM—Ⅳ Axis Ⅰ Disorders,SCID）作为金标准进行诊断,将SDS筛查抑郁障碍的效能与SCⅡ）对抑郁障碍诊断的金标准进行比较。结果资料完整的266例患者用SDS筛查外科住院患者抑郁障碍发生率为30．8％,用SCID诊断抑郁障碍的发生率为37．18％。外科医师对抑郡障碍的识别率仅为2．53％。SDS筛选抑郁障碍与SCID诊断抑郁障碍的一致性好。结论综合医院外科住院患者抑郁发生率高,外科医师对抑郁障碍的识别率极低,SDS可作为外科住院患者抑郁障碍的常规筛查工具。     

自杀意念自评量表的初步制定

目的：编制适合我国国情的自杀意念自评量表（SIOSS）以利于早期发现和干预。方法：参考相关文献并结合经验选编条目池形成初稿，再以216名受试者的测试结果，对初稿进一步检验与筛选，形成最终量表，同时进行信度和效度检验。结果：SIOSS共26条，绝望、乐观、睡眠、掩饰4个因子。除掩饰因子外，余各因子及条目与精神症状自评量表（SCL-90）总分及抑郁因子聚合度良好。抑郁症组（患者组）量表总分和各因子分均高于对照组，且患者组自杀意念的发生率（42.3%）明显高于对照组（5.4%）。量表参考划界点为12分。结论：自杀意念自评量表的信度与效度均达到统计要求，可作为筛查自杀意念的有效测量工具。     

慢性乙肝患者的SDS、SAS调查研究

目的 调查慢性乙肝患者存在的焦虑抑郁等精神卫生问题。方法 应用SDS、SAS及自编简易问卷,对慢性乙肝患者进行调查。结果 SDS总标准分均值为48.57±16.79;SAS总标准分均值43.77±6.79,经统计学分析,均显著高于国内常模。结论 提示慢性乙肝患者的抑郁、焦虑情绪明显高于一般人群,但与性别无关,建议进一步普及、开展心理咨询与治疗,促进患者心身全面康复。     

Standardization of the Korean Version of the Geriatric Depression Scale: Reliability, Validity, and Factor Structure

Objective

We developed a Revised Korean version of the Geriatric Depression Scale (GDS-KR) and examined its reliability, validity, and factor structures. We also estimated its optimal cutoff scores for major depressive disorder (MDD) and minor depressive disorder (MnDD) stratified by age and education.

Methods

The GDS-KR was administered to 888 subjects (61 MDD patients, 45 MnDD patients, and 782 normal elders). Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) and Hamilton Depression Rating Scale (HAM-D). The mean GDS-KR scores of the MDD patients, MnDD patients and normal elders were compared to evaluate its discriminant validity. To evaluate its construct validity, a principal component analysis with varimax rotation was performed. Receiver operator characteristic (ROC) curve analyses were performed to evaluate its diagnostic ability.

Results

Chronbach''s coefficient alpha for the GDS-KR was 0.90 and the test-retest reliability was 0.91 (p<0.01). The Pearson correlation coefficients of the GDS-KR scores with the CES-D-K and HAM-D scores were 0.63 (p<0.01) and 0.56 (p<0.01), respectively. The GDS-KR consisted of 5 factors. The optimal cut-off scores of the GDS-KR were 16/17 for MDD only and 15/16 for both MDD and MnDD. The optimal cutoff scores of the GDS-KR were higher in the less educated and younger subjects. The diagnostic accuracy for MDD of the GDS-KR was higher than that of the CES-D.

Conclusion

The GDS-KR was found to be a reliable and valid questionnaire for screening MDD and MnDD in late life.     

医院焦虑抑郁量表在综合性医院中的应用

目的 评价医院焦虑和抑郁量表在综合性医院住院病人中应用的信度和效度。方法 应用医院焦虑抑郁量表(HADS)对846名住院病人进行调查,并与焦虑自评量表(SAS)和抑郁自评量表(SDS)做相关分析。结果 (1)通过因素分析得到3个相互关联的因素,抑郁、精神性焦虑、精神运动性激越。(2)不同病种分析,HADS具有较高的内部一致性。(3)相关分析得到该量表与SAS、SDS存在较高的相关。(4)通过与SAS、SDS的比较得到以9分作为HADS的筛选临界值是较可靠的。结论 医院焦虑抑郁量表作为综合性医院焦虑抑郁情绪的筛查工具还是较为可靠的。     

Factor structures of a Japanese version of the Geriatric Depression Scale and its correlation with the quality of life and functional ability

We investigated the 15-item Geriatric Depression Scale (GDS-15) with regard to its factors and, reproducibility, as well as its relationship to activities of daily living, social factors, medical conditions, and quality of life for community-dwelling elderly people in Japan. The study population consisted of 736 community-dwelling elderly participants aged 65 or older. Exploratory factor analysis of the data and correlation coefficients between factors and activities of daily living, quality of life, social factors, and medical conditions were calculated for two consecutive years. The reproducibility of the results was also evaluated. As the result, GDS-15 had three reproducible factors specified as follows: factor I, “energy loss and pessimistic outlook”; factor II, “positive mental status (reversed)”; and factor III, “empty feeling.” Comparing our findings with a review of research in this area, positive items (excluding “feel full of energy”) seem to compose an universal factor. Factor I correlated best with quality of life, factor II with activities of daily living, and factor III with subjective cognitive function. These results suggest the GDS-15 can be used to assess the functional ability and quality of life, as well as depressive mood in older adults.     

A short matrix-version of the Edinburgh Depression Scale

OBJECTIVE: Given the importance of depression as a world health problem, depression assessment should be standard practice in large-scale health surveys. The aim of the study was to construct a short matrix-version of the Edinburgh Depression Scale (EDS) that can be used in questionnaire studies. METHOD: On the basis of the complete EDS scale of ten items, answered by 2730 women, stepwise multiple regression analysis was used to find the combination of items that explains the maximum proportion of the variance of the full scale sum score. The selected EDS items were thereafter correlated with the Hopkins Symptom Check List (SCL-25) for external validation. RESULTS: The sum of five selected items from the EDS correlated at r = 0.96 with the full version. The EDS-5 scores correlated strongly with the SCL-25 (r = 0.75). CONCLUSION: The EDS-5 version shows good psychometric properties and may, for some scientific purposes, substitute the full EDS scale.     

An examination of the psychometric properties of the Hospital Anxiety and Depression Scale in Chinese patients with acute coronary syndrome

The psychometric properties of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for patients with acute coronary syndrome (ACS) were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis (CFA) was conducted on the HADS to establish its psychometric properties in 138 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test–retest reliability values for the HADS total and HADS anxiety sub-scales were found to be acceptable. The HADS depression sub-scale lacked acceptable internal reliability. The underlying factor structure of the HADS comprised three distinct factors, though inconsistency between the best three-factor model fit was observed between observation points. The HADS was confirmed to be a useful screening instrument to assess symptoms of psychological distress in ACS patients. Further research is required to determine the most appropriate use of HADS sub-scale structures in clinical populations.     

Factor structure of the Cornell Scale for Depression in Dementia among Japanese poststroke patients

BACKGROUND: the present study reports on the first translation and use of the Cornell Scale for Depression in Dementia (CSDD) (Alexopoulos, Abrams, Young, & Shamoian, 1988) among poststroke patients (n = 101) in Japan. OBJECTIVES: the study had three main purposes: 1. To examine the factor structure of the CSDD among Japanese poststroke patients; 2. To compare this with the factor structure identified for Anglo-American Alzheimer's (AD) patients; and 3. To examine the prevalence and covariates of depressive symptoms among the Japanese stroke survivors. METHODS: poststroke patients and their caregivers (n = 202), at a random sample of neurological hospitals in western Japan, were interviewed using the study instruments. Data was also collected from patient charts. All subjects at each site who met the study criteria participated in the study. RESULTS: the four-factor solution for poststroke subjects was analogous to that found among AD patients with 2 main exceptions. In contrast to AD patients: 1. Physical complaints were unrelated to depressed mood in stroke patients; and 2. Agitation and psychosis loaded with depressed mood in stroke patients rather than as a separate unique factor as in AD patients. However, in the exploratory 5-factor model, agitation and suicidal ideation comprised a unique factor. Using standard cutoff scores for the CSDD, 58.2% of poststroke patients had scores suggesting possible depression. CSDD scores were not related to functional ability, or stroke characteristics such as aphasia or right or left-sided paralysis. However, scores were significantly higher among subjects < or = 2 years poststroke. Feelings of irritability, anxiety, sadness, and sleep problems were most prevalent. DISCUSSION: despite the prevalence of depressive symptoms, none of the subjects were currently receiving any mental health treatment. Findings suggest that symptoms differ by poststroke duration, which may necessitate different treatment approaches.     

汉密顿抑郁量表6项版本(HAMD-6)的信度及效度研究

目的检验汉密顿抑郁量表6项版本(HAMD-6)的信度与效度。方法选用汉密顿抑郁量表6项版本(HAMD-6)与24项版本(HAMD-24)对264例住院及门诊抑郁症患者和32名正常对照进行了评定;并对随机抽取的34例住院患者在第1次评定后3天进行第2次评定;由经培训的2名评定员对其中的10名抑郁症患者同时施行量表评定,进行评分者信度研究;将HAMD-6与另3个版本(17项、21项、24项)进行相关分析,进行效度研究。结果HAMD-6的内部一致性系数Cronbachs的α为0.474,条目间的平均相关系数为0.131,34例患者重测HAMD-6的相关系数为0.951(P<0.01),评定员HAMD-6相关系数为0.989(P<0.01);HAMD-6各条目与总分的相关系数r在0.294~0.645之间(P<0.01);患者组同正常对照组HAMD-6总分经t检验,差异具有显著性(P<0.01);264例抑郁症患者HAMD-6总分与另3个版本总分显著相关,r为0.638~0.683(P<0.01)。结论HAMD-6同广泛使用的其他版本一样具有较高的信度与效度,并由于条目简洁,操作方便,易于掌握和节省时间,值得在临床推广使用。     

The Bech-Rafaelsen Mania Scale and the Hamilton Depression Scale.

In a study of 18 patients with manic symptomatology and 31 patients with melancholic symptomatology the Bech-Rafaelsen Mania Scale (BRMS) and the Hamilton Depression Scale (HDS) have been compared. The results showed that the inter-observer reliability of the BRMS was adequate compared with the HDS. Both scales are constructed for assessing the severity of manic or melancholic states, and no difference was found in the total BRMS or HDS score between the various diagnostic groups, when the patients were classified by an index of the course and symptomatology otive disorder, using the Multi-axial Classificetion System for Affective Disorders (MULTI-CLAD). The homogeneity of the BRMS seemed more adequate than that of the HDS, when each item was correlated to the corresponding total score. Although the homogeneity of the BRMS needs to be evaluated by other statistical models than correlation analysis, our results seem to indicate that the improvement in assessing manic-melancholic states quantitatively is a matter of redefining items or incorporating new items in the melancholic rather than the manic part of these rating scales.     

Hamilton Depression Scale in dementia

INTRODUCTION : Wide variations in frequency of depression in primary degenerative dementia (PDD) and in vascular dementia (VD) have been reported. This may perhaps be due to inadequacy of common diagnostic tools in detecting depression in the face of cognitive decline. We evaluated here the Hamilton Depression Rating Scale (HDRS) in demented patients with PDD and VD. METHODS : We examined 50 consecutive patients with PDD and 50 consecutive patients with VD. All patients underwent neurological examination and their depression was evaluated using DSM-III-R criteria and the HDRS. The data obtained were analysed for distribution of depression and pattern of responses obtained in the HDRS. Sensitivity, specificity and Youden's J-indices for different cut-off scores of the HDRS in its ability to detect depression in this population were calculated. RESULTS : Dementia was associated with depression in 38% of the patients (DSM-III-R criteria). HDRS scores were higher in depressed patients (z= -5.7, P < 0.0001) with an HDRS cut-off score of 10 being indicative of depression in demented patients. Symptoms related to 'affective' components of the HDRS (such as depressive mood and anxiety) were strongly associated with the diagnosis of depression (Mann-Whitney tests, P < 0.0001). CONCLUSION : Depression is frequent in demented patients. The HDRS has good criterion validity in the evaluation of depression in demented patients. (Int J Psych Clin Pract 2002; 6: 91-94)