Mood Instability and Irritability as Core Symptoms of Major Depression: An Exploration Using Rasch Analysis.
Mood Instability and Irritability as Core Symptoms of Major Depression: An Exploration Using Rasch Analysis.
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情绪不稳定性和易怒作为重度抑郁症的核心症状：使用Rasch分析进行探索。
DOI：
10.3389/fpsyt.2016.00174
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发表时间：
2016
影响因子：
4.7
通讯作者：
Marwaha S
中科院分区：
文献类型：
--
作者：
Balbuena L;Bowen R;Baetz M;Marwaha S
情绪不稳定（MI）和易怒与抑郁症有关，但不被认为是核心症状。仪器通常编码用于定义综合征性抑郁症的症状群，但MI和易怒的地位尚未得到充分研究。它们是否为核心症状可以用Rasch分析来检查。我们使用英国精神病发病率调查2000年的数据（n = 8,338）来确定九种ICD/DSM症状，加上MI和易怒，是否构成有效的抑郁量表。使用Rasch分析，这是一种确保项目构成稳健量表的方法，并测试症状的计数是否反映了潜在的间隔水平测量。随机抽取两个样本500个，作为校准和验证样本。作为分析的一部分，我们检查了候选症状是否单维，是否遵循Guttman模式，是否局部独立，与年龄和性别无关，是否可靠地区分不同程度的抑郁严重程度。五种症状的子集（悲伤、没有兴趣、睡眠、认知、自杀念头）以及情绪不稳定和易怒令人满意地符合Rasch模型。然而，这七种症状并不能可靠地将临床抑郁症患者与其他人群区分开来（Cronbach α = 0.58; Person Separation Index = 0.35），但可以作为量表开发的基础。同样，最初的九种DSM抑郁症状也未能达到令人满意的信度（Cronbach α = 0.67; Person Separation Index = 0.51）。出现症状的时间范围各不相同，有些症状需要在过去一年内召回。这些症状之外的症状也可能是核心抑郁症状。情绪不稳定和易怒是抑郁综合征的候选核心症状，应作为其临床评估的一部分。
Mood instability (MI) and irritability are related to depression but are not considered core symptoms. Instruments typically code clusters of symptoms that are used to define syndromic depression, but the place of MI and irritability has been under-investigated. Whether they are core symptoms can be examined using Rasch analysis. We used the UK Psychiatric Morbidity Survey 2000 data (n = 8,338) to determine whether the nine ICD/DSM symptoms, plus MI and irritability, constitute a valid depression scale. Rasch analysis was used, a method concerned with ensuring that items constitute a robust scale and tests whether the count of symptoms reflects an underlying interval-level measure. Two random samples of 500 were drawn, serving as calibration and validation samples. As part of the analysis, we examined whether the candidate symptoms were unidimensional, followed a Guttman pattern, were locally independent, invariant with respect to age and sex, and reliably distinguished different levels of depression severity. A subset of five symptoms (sad, no interest, sleep, cognition, suicidal ideas) together with mood instability and irritability satisfactorily fits the Rasch model. However, these seven symptoms do not separate clinically depressed persons from the rest of the population with adequate reliability (Cronbach α = 0.58; Person Separation Index = 0.35), but could serve as a basis for scale development. Likewise, the original nine DSM depression symptoms failed to achieve satisfactory reliability (Cronbach α = 0.67; Person Separation Index = 0.51). The time frame over which symptoms were experienced varied, and some required recall over the last year. Symptoms other than those examined here might also be core depression symptoms. Mood instability and irritability are candidate core symptoms of the depressive syndrome and should be part of its clinical assessment.
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影响因子：
3.6
作者：
Forkmann T;Boecker M;Wirtz M;Glaesmer H;Brähler E;Norra C;Gauggel S
通讯作者：
Gauggel S
影响因子：
6.6
作者：
Kendel, Friederike;Wirtz, Markus;Regitz-Zagrosek, Vera
通讯作者：
Regitz-Zagrosek, Vera
影响因子：
1.9
作者：
Ben-Zeev, Dror;Young, Michael A.
通讯作者：
Young, Michael A.
DOI：
10.1146/annurev-clinpsy-050212-185608
发表时间：
2013-01-01
期刊：
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 9
影响因子：
--
作者：
Borsboom, Denny;Cramer, Angelique O. J.
通讯作者：
Cramer, Angelique O. J.
影响因子：
25.8
作者：
Judd, Lewis L.;Schettler, Pamela J.;Fiedorowicz, Jess G.
通讯作者：
Fiedorowicz, Jess G.