痴呆患者的攻击行为与抑郁的关系

目的了解痴呆病人攻击行为与抑郁等相关因素的关系.方法对78例住院痴呆病人进行资料分析,评价工具主要采用Cornell痴呆抑郁量表、简易智力状态检查(MMSE)、日常生活能力量表(BEHAVE-AD)、Cohen-Mansfieid激越问卷(CMAI)、汉密顿抑郁量表(HAMD)、总体退化量表(GDS).结果抑郁组与非抑郁组的攻击行为比较有显著性差异(P＜0.01),抑郁与攻击行为相关(P＜0.01).结论攻击行为与抑郁症状、病程长、文化程度高、丧偶、日常生活能力差等相关.     

阿尔茨海默病病理行为评分表信度和效度

目的 :评定阿尔茨海默病 (AD)病理行为评分表 (BEHAVE- AD)的信度和效度。　方法 :8名医生对 6例痴呆病人进行联合测定。对 6 3例痴呆病人进行 BEHAVE- AD和简明精神病评定量表 (BPRS)评定 ,48小时后重复 BEHAVE- AD评定。　结果 :同质性信度系数 Cronbach'sα=0 .770 3。联合检测一致性系数 ICC=0 .95 95 ,重测一致性系数 r=0 .96 1,P均 <0 .0 1。与 BPRS评分相比 ,相关系数 r=0 .475 ,P<0 .0 1。根据医生总体评定结果 ,将病人分组 ,各组病人的量表评分有显著差异。　结论 :BEHAVE- AD中译本有较好的信度和效度 ,值得推广应用     

个人和社会功能量表在抑郁症中的适用性研究

目的 检测个人和社会功能量表(Personal and Social Performance scale,PSP)在抑郁症患者中的信度和效度,了解PSP在抑郁症中的适用性.方法 在全国6个精神卫生中心收集84例门诊抑郁症患者.所有的病例进行PSP、Montgomery- Asberg抑郁量表(Montgomery- Asberg Depression Rating Scale,MADRS)、大体社会功能量表(Global Assessment of Functioning Scale,GAF)评定,分析PSP在抑郁症患者中的内部一致性、与GAF的一致性以及与MADRS的相关性.另外,6例抑郁症病例在首次评定后的1周进行再次评定用以PSP重测一致性的检验.结果 PSP的内部一致性Cronbach α系数为0.760,PSP总分与GAF评分具有良好的正相关(r=0.906,P＜0.01),与MADRS总分呈负相关,具有统计学意义(r=-0.652,P＜0.01),重测一致性的kappa值为0.945(n=6,P=0.01).结论 PSP是一个操作简单、稳定性高的评估工具,可用于抑郁症患者社会功能的评估.量表中d维度(冲动和攻击行为)对整个量表的权重大,在抑郁症患者中与总分相关性欠佳.     

儿童抑郁障碍自评量表的河南农村常模和信效度

目的:对儿童抑郁障碍自评量表应用于河南农村儿童的信效度检验,并建立河南农村常模.方法:在河南全省6个市6个乡镇小学校中采样1742人(男900,女842),平均年龄(11.6±1.7)岁,同时抽取抑郁障碍患儿47例,填写儿童抑郁障碍自评量表. 结果:量表项目分析中各条目与总分相关系数r在0.318 ～0.645之间(P＜0.01).各项目内部一致性Cronbach α系数为0.730.重测信度r=0.686(P ＜0.01).抑郁儿童得分低于常模儿童(t=-8.839,P=0.000).根据ROC曲线,常模划界分为14. 结论:儿童抑郁障碍自评量表可用于河南农村儿童抑郁症状的评估,并可用于儿童抑郁障碍的筛查.     

激惹、抑郁和焦虑量表(IDA)的信度和效度研究

目的 评价IDA量表的信度和效度。方法 使用IDA、SDS和SAS对291例大学生和64例抑郁症患者进行评定。结果 IDA具有良好的心理测量特性，Cronbach α系数在0.419-0.769,IDA各分量表的劈半相关系数在0.427-0.639,IDA各分量表与SDS、SAS间的相关系数均在0．400－0．776，IDA各分量表得分在非抑郁大学生、抑郁大学生和抑郁症患者之间存在非常显著性差异。结论 IDA量表具有良好的信度和效度，值得推广使用。     

中文版剑桥人格解体量表的信度和效度检验

目的 翻译英文版剑桥人格解体量表（CDS）并对中文版CDS进行信、效度检验.方法 对119例健康受试者分别间隔2、3、4周进行CDS测验以计算其重测信度;临床医生按DSM-IV-TR诊断标准对76例门诊患者做出诊断,之后进行CDS测验,计算测验的重测信度、内部一致性、折半信度和效标关联效度、结构效度.结果 中文版CDS重测信度中等（0.651）,内部一致性和分半信度良好（Cronbach＇s α系数为0.938,Guttman折半信度为0.957）,效标关联效度良好（Mann-WhitneyZ值为-6.059,P＜0.001）,项目-总分相关系数从0.321～0.777,均达到显著性,结构效度尚可.结论 中文版CDS具有良好的信、效度,可以很好地评定人格解体症状.     

PHQ-9在综合医院住院患者中信效度研究

目的检验病人健康问卷抑郁量表(PHQ-9)在综合医院住院患者中应用的信度和效度,探索PHQ-9在综合医院住院患者中快速筛查抑郁的可行性。方法方便抽取四川大学华西医院569名住院患者,在规定指导语下完成PHQ-9评定,采用随机数字表法随机抽取38名患者在完成初次评定2周后进行PHQ-9重测;以简明国际神经精神访谈(MINI)作为"金标准",评估中文版PHQ-9的效标效度,共139名患者接受MINI中文版访谈。结果 PHQ-9在本研究中的Cronbach'sα系数为0.839,各条目与总评分的相关系数r=0.484~0.724(P0.01),各条目间相关系数r=0.229~0.520(P0.01);两周后重测系数r=0.846(P0.01);因子分析获得3个公因子,分别为自我评价因子、情感因子和躯体化因子;最佳诊断划界分为8分,敏感度为92.6%,特异度为60.6%;PHQ-9的ROC曲线下面积为0.841(95%CI:0.777~0.905)。结论 PHQ-9应用于综合医院住院患者抑郁评估中具有良好的信效度,8分为该量表的最佳划界分。     

阴性症状自评量表中文版的效度和信度检验

目的 考察阴性症状自评量表（SNS）中文版的效度和信度,为精神分裂症患者阴性症状 的评定提供有效和实用的新工具。方法 选取符合美国精神障碍诊断与统计手册第4 版（DSM- Ⅳ）诊断 标准的住院精神分裂症患者120 例,进行认知功能成套测验（MCCB）的评定,选取认知功能保存相对完 好（总分≥ 40 分）的患者79 例,进行SNS、简明阴性症状量表（BNSS）、阳性与阴性症状评估量表（PANSS） 及卡尔加里抑郁量表（CDSS）评定,来评估量表的结构效度、关联效度和内部一致性信度;2 周后,随机 选取其中30 例患者进行重测。结果 探索性因子分析抽取主观体验缺损和情感表达缺损2 个因子,共 解释总方差的72.56%。效度分析表明,SNS 总分与BNSS 总分、PANSS 阴性症状分、PANSS 总分正相关 （r=0.36、0.26、0.30,P＜ 0.05）,各维度分与BNSS总分正相关（r=0.25～0.37,均P＜ 0.05）。量表内部一致 性系数为0.88,各维度内部一致性系数介于0.58～0.76;量表重测信度（ICC）为0.79,各维度的ICC分别 为0.42、0.82、0.41、0.81、0.34（P＜ 0.01）。结论 阴性症状自评量表中文版具备较好的心理计量学特征, 可以用于临床量化评估具备一定认知功能的精神分裂症患者的阴性症状。     

蒙特利尔认知评估量表在乌鲁木齐维吾尔族人群中应用的初步研究

目的 对维吾尔文版蒙特利尔认知评估量表( MoCA-U)在乌鲁木齐地区维吾尔族人群中应用的信度及效度进行检验,并初步确定该量表筛查维吾尔族认知障碍人群的最佳界值.方法 对英文版MoCA量表进行翻译并修订成维吾尔文版,选择188名50～75岁的维吾尔族研究对象,其中正常对照组80名、轻度认知功能障碍(MCI)组68例、痴呆组40例,分别用MoCA-U、简易精神状态量表(MMSE)、临床痴呆量表(CDR)等神经心理学量表进行评估比较.结果 (1)MoCA-U的克朗巴赫α系数为0.801,评定者间一致性组内相关系数为=0.977(95％可信区间;0.949～0.990),重测信度r =0.987(P ＜0.001).(2)正常对照组、MCI组、痴呆组的MoCA-U总分分别为(22.65±2.57)、(18.56±3.08)、(9.43±3.89)分,3组比较差异有统计学意义(F=27.991,P＜0.001);MoCA-U与MMSE、CDR量表总分的相关系数分别为r=0.84(P ＜0.001)和r=-0.77(P ＜0.001).(3)当研究对象受教育年限≤5年时,MoCA-U筛查MCI的最佳界值为20分,此时MoCA-U灵敏度为86.4％,特异度为84.2％;筛查痴呆的最佳界值为13分,此时的灵敏度为94.1％、特异度为100％.受教育年限6～10年时,MoCA-U筛查MCI的最佳界值为21分,灵敏度为84.6％,特异度为94.1％;筛查痴呆的最佳界值为15分,此时的灵敏度为100％,特异度为92.3％.受教育年限≥11年时,MoCA-U筛查MCI的最佳界值为22分,灵敏度为75.8％,特异度为70.5％;筛查痴呆的最佳界值为17分,此时的灵敏度为100％,特异度为84.8％.结论 MoCA-U具有良好的信效度及可行性,适合对乌鲁木齐中老年维吾尔族人群认知功能进行评估;不同受教育程度人群筛查MCI的最佳界值为20～22分,筛查痴呆的最佳界值为13～17分.     

痴呆行为和精神症状的临床评定

对评估痴呆及精神症状的各种量表研究进展、评定方法、信度和效度等作一介绍.     

The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study

The study is a validation study of two psychogeriatric depression rating scales, The Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD). The sensitivity and specificity, and the convergent and criterion validity of the two scales as well as the inter-rater reliability of the CSDD are reported. Two independent clinicians using the ICD-10 for depression and dementia, the Clinical Global Impression (CGI), the Hamilton Depression rating scale 17-items and the Mini-Mental-State Examination (MMSE), interviewed each patient or control subject. One hundred forty-five persons of 65 years or more of age were included, 73 were depressed only, 36 depressed and demented; 36 persons were control subjects, 11 of these were demented. The inter-rater reliabilities were high or very high equalling perfect correlation. There was very high convergent validity between the screening tools and the severity scales; the shorter versions of the GDS (15-, 10- or four-item version) had lower though still almost perfect correlations. The criterion validity in the total population showed the CSDD as the better scale with sensitivity and specificity of 93% and 97% with a cut-off value of > or =6. The GDS versions had sensitivities and specificities ranging from 82% to 90% and 75% to 94% respectively with cut-off values > or =9, 4, 3 and 1. The CSDD retained its validity and specificity as a screening tool for depression in a population of demented, while the GDS versions all diminished in validity. The GDS and the CSDD are both valid screening tools for depression in the elderly; however, the CSDD alone seems to be equally valid in populations of demented and non-demented.     

The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study

The study is a validation study of two psychogeriatric depression rating scales, The Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD). The sensitivity and specificity, and the convergent and criterion validity of the two scales as well as the inter-rater reliability of the CSDD are reported. Two independent clinicians using the ICD-10 for depression and dementia, the Clinical Global Impression (CGI), the Hamilton Depression rating scale 17-items and the Mini-Mental-State Examination (MMSE), interviewed each patient or control subject. One hundred forty-five persons of 65 years or more of age were included, 73 were depressed only, 36 depressed and demented; 36 persons were control subjects, 11 of these were demented. The inter-rater reliabilities were high or very high equalling perfect correlation. There was very high convergent validity between the screening tools and the severity scales; the shorter versions of the GDS (15-, 10- or four-item version) had lower though still almost perfect correlations. The criterion validity in the total population showed the CSDD as the better scale with sensitivity and specificity of 93% and 97% with a cut-off value of ≥6. The GDS versions had sensitivities and specificities ranging from 82% to 90% and 75% to 94% respectively with cut-off values ≥9, 4, 3 and 1. The CSDD retained its validity and specificity as a screening tool for depression in a population of demented, while the GDS versions all diminished in validity. The GDS and the CSDD are both valid screening tools for depression in the elderly; however, the CSDD alone seems to be equally valid in populations of demented and non-demented.     

Validity of the Cornell scale for depression in dementia in Parkinson's disease with and without cognitive impairment

Valid tools are needed to assess depression across the spectrum of cognitive impairment in Parkinson's disease (PD). The validity of the Cornell scale for depression in dementia (CSDD) was tested in a PD sample with a range of cognitive impairment. Psychiatric diagnoses were established according to DSM‐IV‐TR. Receiver operating characteristic curves tested the discriminant validity of the CSDD compared to the clinical diagnoses of major and minor depression. The curve for symptomatic depression had an area under the curve of 0.82. For the cut‐off score ≥ 6, sensitivity was 0.83 and specificity was 0.73; for the cut‐off score ≥ 8, sensitivity was 0.75 and specificity was 0.82. There was no evidence for differential measurement with respect to cognitive impairment or any other demographic or clinical variables. This study suggests that the CSDD is a valid tool for identifying depressive disorders in patients with PD across a spectrum of cognitive impairment. © 2008 Movement Disorders Society     

A psychometric evaluation of the Cornell Scale for Depression in Dementia in a frail, nursing home population.

OBJECTIVE: The authors conducted a psychometric evaluation of the Cornell Scale for Depression in Dementia (CSDD) through factor analysis and assessment of criterion validity in an older, frail nursing home population, with a secondary analysis of pre-intervention data from a longitudinal clinical trial aimed at reducing restraints in nursing homes. METHODS: The sample for the present study was 642 nursing home residents (mean [SD] age 84.3 [7.6] years; range: 61-105; 82% women) with completed CSDD scores, who were interviewed immediately before the intervention. Nursing home residents' scores from the 19-item CSDD were subjected to exploratory factor analysis and criterion-validity analysis. RESULTS: The factor analysis resulted in four distinct clinically interpretable domains: Depression, Somatic/Vegetative, Disturbed Sleep, and Anxiety. Sixteen items were retained in these domains, and summated score indices and a global score were constructed. The global score and the four indices demonstrated adequate internal consistency and reliability. The indices generated by the factor analysis correlated as expected with criterion variables. CONCLUSION: Results suggest that in frail, institutionalized older adults with high rates of dementia, medical illness, and functional disability, depression measurement methods that are less dependent on items highly sensitive to comorbid conditions and not necessarily associated with depression may be more appropriate. Authors recommend further validity testing of the CSDD with similar populations of frail, institutionalized older adults.     

Reliability and Validity of the Korean Version of the Cornell Scale for Depression in Dementia

Objective

The aim of this study was to explore the reliability and validity of the Korean version of the Cornell Scale for Depression in Dementia (CSDD-K), a scale for assessment of depression in dementia.

Methods

The original CSDD was translated into Korean and the content was verified through back-translation procedures. This study included 59 depressive patients with Alzheimer''s disease (AD), 62 non-depressive patients with AD and 36 healthy elderly controls. The subjects were assessed using CSDD-K, the 17-item Hamilton Depression Rating Scale (HAM-D₁₇), the 15-item Korean version of Geriatric Depression Scale (GDS₁₅) and the Korean version of Mini-mental Status Examination (MMSE-K).

Results

In the reliability test, Cronbach''s α coefficient and test-retest reliabilities were 0.92 and 0.91, respectively, indicating that the CSDD-K has good internal consistency. There were significant differences in CSDD-K total scores between AD patients with depression and AD patients without depression (p<0.001). In the analysis of the concurrent validity of the CSDD-K, there were significant correlations between the CSDD-K and HAM-D₁₇ (r=0.91, p<0.001) and between the CSDD-K and GDS₁₅ (r=0.75, p<0.001). ROC curve analysis identified a cut-off score of 7 for the CSDD-K, where the sensitivity was 87.5% and the specificity was 100%. Factor analysis resulted in a four-factor solution accounting for 63.8% of the common variance.

Conclusion

The CSDD-K showed good reliability and validity for the assessment of depressive symptom severity in AD patients. The CSDD-K is a useful instrument for assessing AD patients with depressive symptoms in Korean ethnic population.     

Computerized cognitive testing battery identifies mild cognitive impairment and mild dementia even in the presence of depressive symptoms

Cognitive and depressive symptoms co-occur, complicating detection of mild cognitive impairment (MCI) and early dementia. In this study, discriminant validity of a novel computerized cognitive battery for MCI detection was evaluated after covariation for depressive symptom severity. In addition to the computerized battery, participants at two sites received the 30-item self-administered Geriatric Depression Scale (GDS; n=72); those at two other centers received the observer-administered Cornell Scale for Depression in Dementia (CSDD; n=88). In both cohorts, a Global Cognitive Score and memory, executive function, visual spatial, and verbal index scores discriminated among cognitively healthy, MCI, and mild dementia groups after covariation for GDS or CSDD, respectively (p < 0.05). Thus, the computerized battery for detection of mild impairment is robust to comorbid depressive symptoms, supporting its clinical utility in identifying neurodegenerative disease even in elderly with depression.     

Whose quality of life is it anyway? The validity and reliability of the Quality of Life-Alzheimer's Disease (QoL-AD) scale

Quality of life (QoL) is becoming an increasingly used outcome measure in both clinical practice and research. There are now more than 1000 scales available to measure QoL, and it is important that they are assessed for reliability and validity. This study aims to assess the reliability and validity of the Quality of Life-Alzheimer's Disease (QoL-AD) scale, which is dementia specific and brief and uses the patient's own responses. Two separate samples of people with dementia (sample 1, n = 60; sample 2, n = 201) were assessed. Five focus groups were conducted involving both people with dementia and their caregivers; the focus groups showed that people with dementia had higher hopes for their QoL than their caregivers did for them. Questionnaires about the scale were completed by 71 health care professionals working with people with dementia. The scale was found to have good content validity with no additional items required and all items necessary. It also correlated well with the Dementia Quality of Life scale (0.69) and with the Euroqol-5D scale (0.54), indicating good criterion concurrent validity. Construct validity was also good with the principal components analysis showing all 13 items of the QoL-AD loaded on component 1. Interrater reliability was excellent with all Cohen's kappa values >0.70. Internal consistency was excellent with a Cronbach's alpha coefficient of 0.82. Some people with severe dementia and a Mini-Mental State Examination score as low as 3 were able to satisfactorily complete the QoL-AD. The QoL-AD has very good psychometric properties and can be completed with people with a wide range of severity of dementia.