Concordance between Composite International Diagnostic Interview and self-reports of depressive symptoms: a re-analysis
Concordance between Composite International Diagnostic Interview and self-reports of depressive symptoms: a re-analysis
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DOI：
10.1002/mpr.1478
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发表时间：
2015-09-01
影响因子：
3.1
通讯作者：
Keltikangas-Jarvinen, Liisa
中科院分区：
文献类型：
--
作者：
Rosenstrom, Tom;Elovainio, Marko;Keltikangas-Jarvinen, Liisa
自我报告的抑郁症状和结构化面试诊断的总分之间的一致性已经被广泛研究，但这些是最好的可实现的自我报告为基础的预测面试诊断？从探索性统计的角度，我们最大限度地提高了世界卫生组织的复合国际诊断访谈（CIDI）诊断与贝克抑郁量表（BDI）和一般健康问卷（GHQ）之间的交叉验证一致性，重新分析了芬兰大陆30岁以上的健康2000一般人群样本（N = 5200-5435）。CIDI诊断的BDI总分预测可以通过使用（1）项目的加权和，（2）由项目构建的分类树，或（3）单个项目来取代。最佳解决方案（2）产生了交叉验证的约登指数0.757 [标准误差（SE）= 0.001，灵敏度= 0.907，特异性= 0.851]，将一致性提高到1.07倍（12个月诊断为1.18倍）。单一项目解决方案最适合GHQ。所有阳性预测值均保持较低（0.09-0.31）。因此，CIDI与问卷的一致性可以通过使用问卷中的所有信息而不仅仅是总分来提高，但问卷的潜在特质理论与访谈诊断不相容（单个项目的一致性优于所有项目的一致性）。自我报告在一般人群中对CIDI诊断的预测价值较低，但在重度抑郁症（MDD）基础率较高的情况下更好。版权所有（c）2015约翰威利父子有限公司
Concordance between sum scores of self-reported depressive symptoms and structured interview diagnoses has been studied extensively, but are these the best attainable self-report-based predictions for interview diagnoses? We maximized the cross-validated concordance between World Health Organization's Composite International Diagnostic Interview (CIDI) diagnosis and Beck's Depression Inventory (BDI), and General Health Questionnaire (GHQ), from the viewpoint of exploratory statistics, re-analysing Health 2000 general-population sample of adults over 30 years in mainland Finland (N = 5200-5435). BDI sum-score prediction of CIDI diagnosis could be superseded by using (1) weighted sums of items, (2) classification trees constructed from items, or (3) a single item. Best solution (2) yielded cross-validated Youden's Index 0.757 [standard error (SE) = 0.001, sensitivity = 0.907, specificity = 0.851], improving the concordance to 1.07-fold (1.18-fold for 12-month diagnosis). A single-item solution was best for the GHQ. All positive predictive values remained low (0.09-0.31). Thus, CIDI-to-questionnaire concordance can be improved by using all information in the questionnaires instead of just sum scores, but latent-trait theory for questionnaires is incompatible with interview diagnoses (single item achieved better concordance than summing all). Self-reports have low predictive value for CIDI diagnoses in the general population, but better in settings with higher major depressive disorder (MDD) base rates. Copyright (c) 2015 John Wiley & Sons, Ltd.