Depression Screening in Stroke A Comparison of Alternative Measures With the Structured Diagnostic Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Major Depressive Episode) as Criterion Standard
Depression Screening in Stroke A Comparison of Alternative Measures With the Structured Diagnostic Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Major Depressive Episode) as Criterion Standard
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DOI：
10.1161/strokeaha.111.643296
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发表时间：
2012-04-01
期刊：
影响因子：
8.3
通讯作者：
Hackett, Maree
中科院分区：
文献类型：
--
作者：
Turner, Alyna;Hambridge, John;Hackett, Maree
背景和目的--在医疗环境中常用的抑郁症和心理困扰筛查工具尚未在中风人群中得到很好的验证。我们的目的是以临床医生管理的结构化临床访谈为金标准，以临床医生管理的结构化临床访谈为金标准，确定常见的抑郁或苦恼筛查工具在诊断重大抑郁发作方面的准确性。方法：72名中风后3周的参与者接受了严重抑郁发作的诊断性访谈，并完成了患者健康问卷-2和-9、医院焦虑和抑郁量表、贝克抑郁问卷-II、痛苦体温计和凯斯勒-10。计算内部一致性、敏感度、特异度、似然比和后测概率。使用接收器操作特征曲线并比较所有测量的曲线下面积，对照黄金标准对每个测量进行验证。结果：所有测量的内部一致性从可接受到优秀(Cronbachα=0.78-0.94)。患者健康问卷-2、患者健康问卷-9、医院焦虑和抑郁量表抑郁及总分、Beck抑郁问卷-II和Kessler-10的曲线下面积(95%CI)从Kessler-10的0.80(0.69-0.89)到Beck抑郁问卷-II的0.89(0.79-0.95)不等，两种测量方法之间没有显著差异。苦恼温度计的曲线下面积(95%CI)为0.73(0.61-0.83)，显著小于Beck抑郁量表-II(P<；0.05)。结论：除苦恼温度计外，所选量表在卒中人群中表现良好，两次测量之间没有显著差异。患者健康调查问卷-2将是最有用的单一屏幕，因为它可以免费获得，而且条目数量最少。(笔划。2012；43：1000-1005。)
Background and Purpose-Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard.Methods-Seventy-two participants >= 3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures.Results-Internal consistency ranged from acceptable to excellent for all measures (Cronbach alpha=0.78-0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69-0.89) for the Kessler-10 to 0.89 (0.79-0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61-0.83), significantly smaller than the Beck Depression Inventory-II (P < 0.05).Conclusions-Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items. (Stroke. 2012;43:1000-1005.)