DEVELOPMENT OF SCREENERS FOR DEPRESSIVE-DISORDERS AND SUBSTANCE DISORDER HISTORY
DEVELOPMENT OF SCREENERS FOR DEPRESSIVE-DISORDERS AND SUBSTANCE DISORDER HISTORY
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DOI：
10.1097/00005650-199303000-00001
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发表时间：
1993-03-01
期刊：
影响因子：
3
通讯作者：
SMITH, GR
中科院分区：
文献类型：
--
作者：
ROST, K;BURNAM, MA;SMITH, GR
如果筛查仪要广泛纳入临床护理以增加常见精神疾病的检出率，那么筛查仪必须简短、易于评分并且对不同的患者群体具有敏感性。满足这些标准的筛选器很少。本研究通过从诊断访谈计划 (DIS) 中确定问题子集来解决这个问题，该子集预测同时获得的 DIS 诊断。在社区居民、医疗和精神健康患者中测试了一项用于检测去年抑郁症或心境恶劣的两项筛查，以及一项用于终生药物障碍和酒精障碍的三项筛查。抑郁症筛查的灵敏度在 83% 到 94% 之间。药物筛选器的灵敏度在 91% 至 94% 之间，不包括药物问题发生率极低的一个地点。酒精筛查仪的灵敏度在 87% 到 92% 之间。在社区和医学样本中，所有三种筛查的特异性均超过 90%，而在精神健康患者中则略低。这些发现表明，这些简短的筛查可能在各种流行病学研究中有用，以便在无法进行完整的诊断访谈时提供常见精神疾病的估计。如果进一步的验证研究支持这些敏感性和特异性估计，这些新仪器也可能作为两阶段筛查过程中的初步简短筛查有价值，以提高临床医生对常见心理健康问题的认识，这些问题使病例管理复杂化并损害患者功能。
If screeners are going to be widely incorporated in clinical care to increase the detection of common psychiatric disorders, they need to be brief, easy to score, and sensitive across diverse patient populations. Few screeners exist that meet these criteria. This problem is addressed in this study by identifying a subset of questions from the Diagnostic Interview Schedule (DIS), which predicted simultaneously obtained DIS diagnoses. A two-item screener to detect depression or dysthymia within the last year and three-item screeners for lifetime drug disorders and alcohol disorders were tested in community residents, medical, and mental health patients. The sensitivity of the depression screener ranged between 83% and 94%. The sensitivity of the drug screener ranged between 91% and 94%, excluding one site with an extremely low prevalence of drug problems. The sensitivity of the alcohol screener ranged between 87% and 92%. Specificity for all three screeners exceeded 90% in community and medical samples, while being somewhat lower among mental health patients. These findings indicate that these brief screeners may be useful in a variety of epidemiologic studies to provide estimates of common psychiatric disorders when complete diagnostic interviews are not feasible. If further validation studies support these sensitivity and specificity estimates, these new instruments may also be valuable as initial brief screeners in a two-stage screening process to improve clinicians' recognition of common mental health problems that complicate case management and impair patient functioning.