护士使用简易老年焦虑问卷筛查老年广泛性焦虑障碍的信效度

目的评价护士使用中文版简易老年焦虑问卷（Geriatric Anxiety Inventory—Short Form,GAI--SF）用于筛查老年焦虑时的信度和效度。方法某综合医院门诊就诊的老年人97名为研究对象,由护士进行GAI—SF问卷及汉密尔顿焦虑量表（Hamilton Anxiety Scale,HAMA）评定,并且由两名精神科主治医师根据ICD-10广泛性焦虑障碍诊断标准进行诊断性面谈。计算组内相关系数考察评定者抑制性,计算克朗巴赫-α系数评价问卷内部一致性;计算两次测量得分相关系数考评问卷的重测信度,采用主成分分析方法考评问卷结构效度;通过GAI—SF与HAMA的相关分析来考评问卷的效标效度;以临床标准为参考标准,根据ROC曲线下面积（Area Under Curve,AUC）来判断GAI—SF的区分效度以及划定问卷的划界分。结果（1）信度：GAI—SF问卷总分评定者组内相关系数为0．73,表明评定者一致性较好,总克朗巴赫-α系数为0．87,表明问卷内部一致性好。间隔15d两次测量问卷评分相关系数为0．78,说明问巷具有较好的重测信度。（2）效度：主成分分析结果显示,问卷的每个条目都在主因子上有较高的负荷值（0．501～0．670）,说明问卷结构效度良好;GAI—SF与HAMA之间的相关系数为r=0．60,P〈0．05,说明问卷具有较好的校标效度。以临床评估标准为参考在区分焦虑问题时界值分为≥3时灵敏度为70．4％,特异度为75．0％,AUC为0．73。结论GAI—SF中文译本具有较好的信度和效度,能够区分老年广泛性焦虑问题;可使用该问卷筛查社区老年广泛性焦虑障碍。     

自我护理能力实施量表中文版在精神分裂症患者中的信效度

目的:评价自我护理能力实施量表(ESCA)中文版在精神分裂症患者中的信度和效度。方法:抽取150例精神分裂症患者进行ESCA初测,进行初步的项目分析;正式施测阶段抽取300例精神分裂症患者,7 d后对其中30例进行重测,计算克朗巴赫α系数、重测信度评价量表内部一致性;采用探索性因子分析方法考评量表结构效度;相关分析来评价量表的效标效度。结果:条目一总分相关法及决断值法对条目的区分度进行分析后,组成35个条目的新量表,经最大方差旋转法旋转后提取4个因子,4个因子累计解释的方差为42.38%;ESCA与日常生活能力评定量表、护士用住院病人观察量表相关系数分别为0.59,0.63;Cranach'sα系数为0.88,重测信度为0.65。结论:ESCA中文版具有较好的信度和效度,用于精神分裂症患者自我护理能力的研究需要反复修订。     

脑卒中吞咽障碍管理知识和行为问卷的编制和信效度检验

目的编制脑卒中吞咽障碍管理知识和行为问卷并对其进行信效度检验。方法严格按照问卷的编制原则,对量表进行翻译、回译、文化调试及预实验;使用问卷初稿对220例神经内科工作的医护人员进行调查,并对测定结果进行信效度分析。结果脑卒中吞咽障碍管理知识和行为问卷各条目与总分的相关系数为0.415~0.744,总问卷的Cronbach’sα系数是0.879,重测信度为0.805。结构性因子分析结果显示提取的5个共因子累积方差贡献率为51.174%,且各条目在其相应公因子上的载荷均>0.4,5个公因子分别命名为筛查评估维度、代偿方法维度、营养风险筛查维度、临床表现和并发症维度、留置胃管护理维度;选择10名专家计算平均内容效度S-CVI(S-CVI/Ave),S-CVI/Ave为0.93。结论编制的脑卒中吞咽障碍管理知识和行为问卷具有较好的信效度,适合评价和测量医护人员吞咽障碍相关知识掌握程度。     

中文版偏头痛患者药物依赖性问卷信度和效度研究

目的评价中文版偏头痛患者药物依赖性问卷的信度和效度。方法选取115例合并药物依赖综合征的偏头痛患者,收集其临床资料并进行中文版偏头痛患者药物依赖性问卷的测试。采用重测信度、内部一致性信度评价分析问卷信度,采用内容效度和结构效度评价分析问卷效度。结果量表的重测信度除条目11和条目16为0.558和0.443以外,其余条目的重测信度均大于0.7。总量表的Cronbach’α系数为0.820,各个维度的Cronbach’α系数均0.7。量表的各条目得分和相应维度总分之间的相关系数在0.595~0.962之间。因子分析共提取7个特征根大于1的因子,可解释总变异的76.3%,在相应项目上均有较强的因子载荷。结论中文版偏头痛患者药物依赖性问卷具有较好的信度和效度,适合临床推广应用。     

12-条目攻击问卷（AQ）在儿童青少年中的应用研究

目的 评价12-条目攻击问卷(12-item aggression questionnaire,12-AQ)在宁波市儿童青少年的信度、效度.方法 对600名9 ～ 14岁小学和初中学生进行12-AQ、Conners父母症状问卷(PSQ)评定,2周后对其中的56名学生进行重测.结果 12-AQ各条目各因子得分与总分的相关系数均在0.40以上,内部一致性检验问卷总分的Cronbach α系数为0.75,重测信度在0.70以上,总分与各因子的相关系数高于各因子的相关系数,体现了良好的结构效度,进一步的验证性因素分析显示原问卷的结构模型与样本有良好的拟合度,与PSQ的品行问题因子分、多动冲动因子分及多动指数之间呈正相关.除愤怒因子外,男生的12-AQ总分和其他各因子分评分均高于女生的得分.结论 12-条目攻击问卷在宁波市的儿童青少年样本中有很好的信度、效度,值得在临床样本中进一步探索.     

病人健康问卷抑郁量表(PHQ-9)在社区老年人群中的应用——信度与效度分析

目的检验病人健康问卷抑郁量表(PHQ-9)在老年人中的信度与效度。方法应用PHQ-9对社区622名老年人进行评定,进行同质性信度研究;1周后对随机抽取的61名老人进行再次评定,进行重测信度研究;从622名老人中抽取195名进行定式精神检查(SCID-Ⅰ)抑郁量表评定,进行PHQ-9的效度研究。结果PHQ-9内部一致性系数(Cronbach′α系数)为0.8325,条目间的相关系数为0.233～0.523,各条目与量表总分的相关系数为0.451-0.693。61名老人重测PHQ-9信度系数0.934,PHQ-9的灵敏度为88%,特异度为99%。结论PHQ-9在我国社区老年人群中也具有良好的信度与效度,并且条目简洁,操作方便,易于掌握和节省时间,值得在临床,尤其是基层社区卫生中心推广使用。     

Morisky问卷测量重性抑郁障碍患者服药依从性的信效度分析

目的:探讨Morisky问卷测量对我国抑郁症患者服药依从性的信效和效度。方法:144例符合美国精神障碍诊断与统计手册第4版重性抑郁障碍诊断标准的住院患者,在出院后2个月使用Morisky问卷评价服药依从性,其中50例患者间隔5~7 d后重测;统计分析Morisky问卷的内部一致性、折半信度、重测信度、结构效度和效标效度。结果:信度分析结果显示,Morisky问卷的内部一致性Cronbach’sα系数为0.74,折半信度为0.77,重测信度为0.86。探索性因子分析共提取1个公共因子,可解释的总变异量为57.53%,4条目的载荷值分别为0.67、0.78、0.82和0.76。用Morisky问卷法和药片计数法对患者服药依从性评价的一致性检验:Kappa系数为0.80(P0.001),呈高度一致。结论:Morisky问卷作为我国抑郁症患者服药依从性的评估工具具有良好的信度和效度。     

军校硕士研究生择偶偏好问卷的编制

目的 编制具有良好信度和效度的军校硕士研究生择偶偏好问卷。方法 于2020年12月,随机选取某军校全日制硕士研究生为研究对象。采用自编开放式问卷采集学生的择偶偏好,经过筛选与专家咨询,整理条目形成军校硕士研究生择偶偏好初始问卷,并对89名军校硕士研究生进行施测。采用项目分析和探索性因素分析对问卷进行检验,采用Pearson相关分析、Cronbach’s α系数和分半信度以检验问卷信效度。结果 形成了由4个因子（内在品质、个人能力、外在条件、生活质量）组成,包含25个条目的军校硕士研究生择偶偏好问卷。该问卷总评分与4个因子评分的相关系数为0.739～0.864,总问卷及各因子Cronbach’s α系数为0.723～0.926,分半信度为0.682～0.899。结论 所编制的军校硕士研究生择偶偏好问卷具有较好的信度和效度,可作为采集军校硕士研究生择偶偏好等婚恋心理数据的工具。     

大学生童年期社会挫败问卷的编制及其信效度分析

目的 编制童年期社会挫败问卷（CSDQ）并进行信效度评价。方法 初步编制67条目的问卷,预测验后选取其中42条目。在790名大学生中进行正式测量和重测。结果 探索性和验证性因素分析后建立三因子模型：家庭关系挫败、社会关系挫败、社会地位挫败。CSDQ的α系数为0.896,分半信度为0.808,重测信度为0.696。CSDQ得分与儿童期虐待问卷（CTQ）和DSM-5自评一级跨界症状量表（DSM-5 L1）得分显著正相关（P<0.001）;CSDQ总分与DSM-5 L1得分的相关系数高于CTQ总分。在男性中社会地位挫败与多种精神症状的相关系数更高,而女性中家庭关系挫败与人格功能的相关系数更高。结论 CSDQ的信、效度符合心理测量学要求,可用于评定大学生中多种性质和来源的童年期社会挫败应激。     

居民心理健康状况筛查记录表的编制及信效度检验

目的 为建立社区心理健康档案、筛查社区里有心理疾病的居民而编制居民心理健康状况筛查记录表并进行信效度检验.方法 通过文献阅读并结合社区和临床实践经验,参考中文版复合性国际诊断交谈表3.0(CIDI-3.0),提出项目,以37名某课程培训班学员、32例精神科住院病人及5.12地震灾区1800名灾民进行信度、效度评定.结果 Cuttman系数(Cronbach's α)为0.682,分半信度系数为0.624,重测信度为0.880,ICC值为0.909.各因子与总分之间的相关为0.302～0.839,各条目与总分之间的相关为0.126～0.547.总分得分≥4时,筛选灵敏度为0.605,特异性为0.395.结论 居民心理健康状况筛查记录表适合做为社区居民的心理疾病的筛查量表.     

The development and validation of Huaxi emotional-distress index (HEI): A Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings

BackgroundDepression and anxiety among general hospital patients are common and under-recognized in China. This study aimed toward developing a short questionnaire for screening depression and anxiety in non-psychiatric clinical settings, and to test its reliability and validity.MethodsThe item pool which included 35 questions about emotional distress was drafted through a comprehensive literature review. An expert panel review and the first clinical test with 288 general hospital patients were conducted for the primary item selection. The second clinical test was performed to select the final item in 637 non-psychiatric patients. The reliability and validity of the final questionnaire were tested in 763 non-psychiatric patients, in which 211 subjects were interviewed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). Multiple data analysis methods including principal components analysis (PCA), item response theory (IRT), and receiver operating characteristic (ROC) curve were used to select items and validate the final questionnaire.ResultsThe series selection of items resulted in a 9-item questionnaire, namely Huaxi Emotional-distress Index (HEI). The Cronbach's α coefficient of HEI was 0.90. The PCA results showed a unidimensional construct. The area under the ROC curve (AUC) was 0.88 when compared with MINI interview. Using the optimal cut-off score of HEI (11/12), the sensitivity and specificity were 0.880 and 0.766, respectively.ConclusionsThe HEI is considered as a reliable and valid instrument for screening depression and anxiety, which may have substantial clinical value to detect patients' emotional disturbances especially in the busy non-psychiatric clinical settings in China.     

Prevalence and risk factors for depression in a rural setting. Results from the North Wales arm of the ODIN project

BACKGROUND: Depressive disorders are common, and result in high individual and societal costs. The majority of research assessing depression has occurred in urban areas. There is a paucity of research examining the prevalence of and risk factors for depression in rural general practice. AIM: The aim of this study was to examine the prevalence of and risk factors for depression in a rural area of North Wales in the context of a large multi-centre European study. METHOD: One thousand nine hundred and ninety-nine people randomly selected from a health authority database underwent a two-phase screening method to identify depression. The first phase involved patients completing a self-rating postal questionnaire (the Beck Depression Inventory or BDI). In the second phase, those scoring above cut-off underwent detailed diagnostic interview (Schedules of Clinical Assessment in Neuropsychiatry or SCAN). The SCAN diagnostic interview can generate either DSM-IV or ICD-10 diagnoses; the DSM-IV classification system was used here. RESULTS: One thousand two hundred and thirty-nine (63 %) people responded to the initial screening questionnaire. The prevalence rate for all DSM-IV depressive disorders was calculated to be 6.1 % (95 % CI 4.1, 9.0) whereas the prevalence rate for DSM-IV major depressive disorder was 5.1 % (CI 3.37, 7.66). Multivariate analysis indicated that several variables were related to BDI caseness, including gender, employment status, social support and negative life events. CONCLUSION: Levels of reported depression are relatively low in North Wales compared to those observed in a neighbouring urban area using comparable data collection methods. A number of factors traditionally associated with increased risk from depression were predictive of scoring above cut-off on the BDI in a rural North Wales sample.     

Longitudinal follow-up of naturalistic treatment outcome in patients with trichotillomania

BACKGROUND: Little is known about the longitudinal course of treatment outcome in patients with trichotillomania. The authors conducted a second follow-up assessment on a cohort of hair pullers previously studied. METHOD: Forty-four subjects completed a hair-pulling questionnaire and paper-and-pencil measures of hair-pulling severity and impact, psychosocial functioning, depression, anxiety, and self-esteem. Mean time elapsed between the first and second follow-up assessment was 2.5 years (index evaluation to first follow-up = 3.5 years). RESULTS: Twenty-seven subjects (61.4%) had active treatment since the first follow-up. No significant changes in hair pulling, depression, anxiety, or psychosocial functioning were reported from first to second follow-up. Self-esteem scores significantly worsened during this period (p = .000). A trend toward worsening also existed for psychosocial impact scores. Comparison of scores at index evaluation with second follow-up still showed significant improvement over time for hair pulling (p = .001) but significant worsening in self-esteem (p = .000). Treatment and responder status were unrelated to clinical functioning, with the exception of depression and psychosocial impact. CONCLUSION: Although hair pullers exhibit initial improvement with treatment, scale scores plateau or worsen by second follow-up. Significant worsening in self-esteem at second follow-up may be related to the absence of further improvements in hair-pulling severity. Future research should focus on the interrelationships among self-esteem, depression, and hair pulling during treatment for this disorder.     

Evaluation of clinical aspects and quality of life as risk factors for depression in patients with epilepsy

The purpose of this study was to investigate clinical aspects and quality of life (QOL) as risk factors for depression in patients with epilepsy. One hundred and forty outpatients with a diagnosis of epilepsy who were attending our epilepsy center participated. Patients anonymously filled out a questionnaire with clinical data related to epilepsy. Depression level was evaluated by the Hamilton Depression Rating Scale-17 (HAMD-17), and quality of life was evaluated by the Quality of Life in Epilepsy-31 (QOLIE-31). Thirty-six patients with epilepsy suffered from depression (25.7%). Complex partial seizures (OR=0.112) and number of seizure types (OR=3.773) were found to be clinical risk factors for depression. Low scores for seizure worry (OR=0.947) and social function (OR=0.947) on the QOLIE-31 increased the probability of depression in patients with epilepsy.     

Negative thoughts after childbirth: development and preliminary validation of a self-report scale

This study describes the development and initial validation of a questionnaire that is suitable for detecting and measuring postpartum negative thoughts. Semistructured interviews with mothers who had suffered from postnatal depression were conducted to inform the content of the questionnaire. The initial questionnaire, alongside other measures, was then administered to a nonclinical sample of mothers with babies aged 0-7 months. Using principal components analysis, a two-factor structure was obtained for the Postnatal Negative Thoughts Questionnaire (PNTQ). The factors included appraisal of cognition, emotion, and situation (ACES) and baby-related and motherhood negative thoughts (BRM-NT). The psychometric properties demonstrated acceptable validity, satisfactory test-retest reliability, and internal consistency. These findings suggest that the PNTQ is a reliable and valid measure for assessing postpartum negative thoughts. Consistent with previous research, findings also suggest that appraisal of negative thoughts is more strongly related to postpartum depression than to the experience of negative thoughts per se. Clinicians may use the PNTQ to offer new mothers the opportunity to assess whether negative thoughts or metacognitive appraisals are being experienced as problematic. Additionally, a direct focus upon the metacognitive appraisals of postpartum negative thoughts may provide a useful adjunct to traditional cognitive therapy approaches. Recommendations for future research are discussed.     

Platelet 3H-imipramine binding during recovery from depression.

Decreased binding of tritiated imipramine to platelets has been considered to be a potential biological marker of depression. However, it has been unclear how binding values alter during treatment and recovery. This study investigated imipramine binding parameters and depressive symptoms in 25 patients suffering from major depression at entry to the study and 1, 3 and 6 months later. Although the initial Bmax values were significantly lower in the depressed patients than in healthy subjects, it was not possible to establish a clear relationship between recovery from depression and Bmax. The power of this study to detect an effect of at least 10% of the variance in Bmax due to factors related to recovery from depression was 0.78.     

Synaptic depression at a synapse in Aplysia californica: analysis in terms of a material flow model of neurotransmitter.

When a pair of stimuli separated by an appropriate interval is given to the right visceropleural connective of Aplysia californica the amplitude of the second EPSP elicited in cell R15 is usually smaller than the amplitude of the first EPSP. In the present paper we show that this phenomenon, synaptic depression, can be analyzed in terms of the material flow model of neurotransmitter economics developed in our preceding publications. We specifically show how changes in the 4 model parameters; A, the available pool of transmitter; F, the fraction of the available pool released by a presynaptic action potential; M, the rate of transmitter mobilization into the available pool; and D, the rate constant of demobilization of transmitter from the available pool, all effect synaptic depression. In addition, we show how transient changes in F and M, that are observed immediately and for seconds after a stimulus, influence the time course of synaptic depression. Using this analysis we then tested our previous inferences about changes in the model parameters produced either by pharmacological manipulations or repetitive stimulation, by comparing the observed effects of these manipulations on synaptic depression with the theoretical predictions. The theoretical and experimental findings agreed, thereby strengthening both our previous conclusions of the mode of action of these manipulations and the model itself.     

Botulinum toxin improves the quality of life and reduces the intensification of depressive symptoms in patients with blepharospasm

Blepharospasm (BSP) is a focal dystonia that results in hyperactivity of orbicular muscles of eyes. These symptoms often result in decreased quality of life (QoL) and symptoms of depression. Botulinum toxin type A is the current first line therapy. The aim of the present study was to analyze the impact of botulinum toxin treatment on the QoL and depressive symptoms in patients with BSP. The QoL was evaluated by means of the Short Form 36 questionnaire. The degree of the intensity of depression was evaluated by means of the Montgomery-Äsberg Depression Rating Scale. Botulinum toxin treatment significantly improves the QoL and reduces the intensity of depressive symptoms in all our study patients with BSP.