The Hospital Anxiety and Depression Scale: A diagnostic meta-analysis of case-finding ability
The Hospital Anxiety and Depression Scale: A diagnostic meta-analysis of case-finding ability
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DOI：
10.1016/j.jpsychores.2010.04.006
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发表时间：
2010-10-01
影响因子：
4.7
通讯作者：
House, Allan
中科院分区：
文献类型：
--
作者：
Brennan, Cathy;Worrall-Davies, Anne;House, Allan
目的：量化医院焦虑和抑郁量表(HADS)作为焦虑和抑郁障碍病例发现工具的准确性。方法：应用计算机检索Medline1983-01/2006-06期间的文献，检索EMBASE、CINAHL、BNI、AMED等数据库。研究包括实施HADS，使用标准化的精神病学访谈来确定焦虑或抑郁的诊断，并提供足够的敏感性和特异性数据(N=41)。计算每项研究的敏感性、特异性、似然比和诊断优势比。在推荐的临床(7/8)和研究(10/11)截止点进行随机效应荟萃分析合并研究，并构建汇总的受试者操作特征曲线。结果：对于重度抑郁症，>；=8的敏感度为0.82(95%CI，0.73~0.89)，特异度为0.74(95%CI，0.60~0.84)；>；=11的敏感度为0.56(95%CI，0.40~0.71)，特异度为0.92(95%CI，0.79~0.97)。结论：许多研究表明，HADS是一种有用的筛查工具，可以用来识别非精神病人的情绪困扰。然而，在识别身体健康环境中的特定精神障碍方面，它似乎并不优于其他筛查工具。(C)2010 Elsevier Inc.保留所有权利。
Objective: To quantify the accuracy of the Hospital Anxiety and Depression Scale (HADS) as a case-finding instrument for anxiety and depressive disorders. Method: MEDLINE, PSYCHINFO, EMBASE, CINAHL, BNI, and AMED were searched from January 1983 to June 2006. Studies were included that administered the HADS, used a standardized psychiatric interview to establish a diagnosis of anxiety or depression, and provided sufficient data on sensitivity and specificity (N=41). Summary sensitivity, specificity, likelihood ratios, and diagnostic odds ratios were calculated for each study. Random effects meta-analytic pooling across studies at the recommended clinical (7/8) and research (10/11) cutoff points was undertaken and summary receiver operating characteristic curves constructed. Results: For major depressive disorders, a cut point of >= 8 gave a sensitivity of 0.82 (95% CI, 0.73-0.89) and a specificity of 0.74(95% CI, 0.60-0.84) and a cut point >= 11 gave a sensitivity of 0.56 (95% CI, 0.40-0.71) and a specificity of 0.92 (95% CI, 0.79-0.97). Conclusions: Many studies have shown that the HADS is a useful screening tool to identify emotional distress in nonpsychiatric patients. However, it does not appear to be superior to other screening instruments in terms of identifying specific mental disorders in physical health settings. (C) 2010 Elsevier Inc. All rights reserved.