Validation of depression screening scales in patients with CKD.
Validation of depression screening scales in patients with CKD.
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DOI：
10.1053/j.ajkd.2009.03.016
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发表时间：
2009-09
期刊：
影响因子：
--
通讯作者：
Rush AJ
中科院分区：
文献类型：
--
作者：
Hedayati SS;Minhajuddin AT;Toto RD;Morris DW;Rush AJ
根据自我报告量表评估，慢性肾病 (CKD) 患者在开始透析时出现抑郁症状的比例高达 45%。这些量表可能强调厌食、睡眠障碍和疲劳等躯体症状，这些症状可能与慢性疾病症状共存，并导致对抑郁症诊断的高估。在开始透析之前，尚无研究在 CKD 患者中验证这些量表。我们对 CKD 参与者进行了一项诊断测试研究，以调查两种抑郁症自我报告量表与金标准结构化精神病学访谈的筛选特征。对 272 名连续招募的未接受透析治疗的 2-5 期 CKD 门诊患者进行了研究。所有参与者均接受贝克抑郁量表 (BDI) 和 16 项抑郁症状快速量表 - 自我报告 (QIDS-SR16) 抑郁筛查量表。基于《精神疾病诊断和统计手册 IV》的结构化访谈，即迷你国际神经精神病学访谈，是由受过培训、对自我报告量表分数不知情的人员进行的。根据参考测试，272 人中有 57 人 (21%) 患有重度抑郁症。根据接收者/应答者操作特征曲线确定重度抑郁发作的最佳截止分数，BDI 为 11，QIDS-SR16 为 10。敏感性分别为 89%、95% CI (78%, 96%) (BDI) 和 91% (80%, 97%) (QIDS-SR16)，而特异性分别为 88% (83%, 92%) (BDI) 和 88% (83%, 92%) (QIDS-SR16)。这些截止值的阳性和阴性似然比分别为 7.6 和 0.1 (BDI) 以及 7.5 和 0.1 (QIDS-SR16)。单中心研究和样本不代表美国人口统计数据。我们发现，贝克抑郁量表评分≥11 是识别未接受透析的 CKD 患者重度抑郁发作的敏感且具体的临界点。贝克抑郁量表和抑郁症状快速量表-自我报告都是有效的筛查工具。
Depressive symptoms as assessed by self-report scales are present at a striking rate of 45% in Chronic Kidney Disease (CKD) patients at dialysis initiation. These scales may emphasize somatic symptoms of anorexia, sleep disturbance, and fatigue, which may co-exist with chronic disease symptoms and lead to an over-estimation of depression diagnosis. No studies have validated these scales in CKD patients prior to dialysis initiation. We conducted a diagnostic test study in CKD participants to investigate the screening characteristics of two depression self-report scales against a gold standard structured psychiatric interview. 272 consecutively recruited outpatients with Stages 2-5 CKD not treated by dialysis were studied. The Beck Depression Inventory (BDI) and the 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) depression screening scales were administered to all participants. A structured Diagnostic and Statistical Manual of Mental Disorders IV-based interview, the Mini International Neuropsychiatric Interview, was administered by trained persons blinded to self-report scale scores. Fifty-seven (21%) of 272 had major depression by the reference test. The best cutoff scores by receiver/responder operating characteristic curves to identify a major depressive episode were 11 for BDI and 10 for QIDS-SR16. Sensitivities were 89%, 95% CI (78%, 96%) (BDI) and 91% (80%, 97%) (QIDS-SR16), while specificities were 88% (83%, 92%) (BDI) and 88% (83%, 92%) (QIDS-SR16). The positive and negative likelihood ratios for these cutoffs were 7.6 and 0.1 (BDI) and 7.5 and 0.1 (QIDS-SR16). Single-center study and a sample not representative of US demographics. We found that a Beck Depression Inventory score of ≥11 was a sensitive and specific cutoff for identifying a major depressive episode in CKD patients not on dialysis. Both the Beck Depression Inventory and the Quick Inventory of Depressive Symptomatology-Self Report are effective screening tools.
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DOI：
10.2215/cjn.00030505
发表时间：
2006-05-01
影响因子：
9.8
作者：
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影响因子：
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DOI：
10.1053/j.ajkd.2009.03.017
发表时间：
2009-09
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Hedayati SS;Minhajuddin AT;Toto RD;Morris DW;Rush AJ
通讯作者：
Rush AJ
影响因子：
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