双相障碍缓解期残留症状自评与他评的一致性研究

目的:探讨双相障碍(BD)缓解期残留症状自评与他评的一致性。方法:收集240例经过急性期治疗有效的BD患者人口学资料、疾病临床特征;分别于急性期治疗后(基线)及此后的3个月和6个月时采用抑郁症状快速评估量表(QIDS-SR16)、心境障碍问卷(MDQ)自评方式与汉密尔顿抑郁量表17项(HAMD-17)、杨氏躁狂量表(YMRS)他评方式对入组者进行残留症状评估;采用组内相关系数(ICC)对连续变量做一致性检验。结果:HAMD-17与QIDS-SR16基线、3个月和6个月的总分、核心条目呈较强一致性(ICC=0.62～0.85;P均<0.01);睡眠条目在基线呈中等一致性(ICC=0.49,P<0.01),3及6个月呈较强一致性(ICC=0.65;P均<0.01);自杀条目随着缓解时间延长,一致性逐渐增强;躯体症状一致性一般(ICC=0.49～0.52;P均<0.01),且随着缓解期延长,一致性减弱。YMRS与MDQ在总分、精力充沛和/或心境高涨、冒险和/或易激惹条目上随着缓解时间延长,从基线呈一般或中等一致性(ICC=0.37～0.50;P均<0.01)到6...

Consistency between self-assessment and clinician-assessment in residual symptoms of remitted bipolar disorder

Objective:To explore the consistency between self-assessment and clinician-assessment in residual symptoms of remitted bipolar disorder(BD).Method:The demographic and clinical characteristics of 240 patients with bipolar disorder who received effective treatment in acute phase were collected.Residual symptoms were assessed by self-assessment of 16-item Quick Inventory of Depressive Symptomatology Self-Report(QIDS-SR16),Mood Disorders Questionnaire(MDQ)and clinician-assessment of 17-item Hamilton Depression Scale(HAMD-17),Young's Manic Scale(YMRS)after the acute treatment of baseline,3 and 6 months respectively.The internal consistency of continuous variables was evaluated by intra class correlation efficient(ICC).Results:The total score and the core item score of HAMD-17 and QIDS-SR16 at baseline,after 3 months and 6 months showed strong consistency(ICC=0.62-0.85;all P<0.01).Sleep item score between the two scales showed moderate consistency(ICC=0.49,P<0.01)at baseline and strong consistency(ICC=0.65,P<0.01)after 3 and 6 months.With the recovery of BD,the consistency of suicidality item was increased.Physical item showed moderate consistency(ICC=0.49-0.52;all P<0.01),and the consistency decreased as the remission phase prolonged.YMRS and MDQ scores showed moderate consistency(ICC=0.37-0.50;all P<0.01)to strong consistency(ICC=0.60-0.71;all P<0.01)from baseline to 6 months in total scores,high energy and/or mood,risk-taking and/or irritability as the remission phase prolonged.Conclusion:Residual depressive symptoms are more common in remission phase of BD.Self-assessment QIDS-SR16 has strong consistency with HAMD-17,which could be used as an effective assessment tool.MDQ can be used as a tool for screening residual manic symptoms in remission phase.