Validity of the Brief Symptom Inventory-18 (BSI-18) for identifying depression and anxiety in young adult cancer survivors: Comparison with a Structured Clinical Diagnostic Interview.
Validity of the Brief Symptom Inventory-18 (BSI-18) for identifying depression and anxiety in young adult cancer survivors: Comparison with a Structured Clinical Diagnostic Interview.
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DOI：
10.1037/pas0000427
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发表时间：
2017-10
影响因子：
3.6
通讯作者：
Chang G
中科院分区：
文献类型：
--
作者：
Recklitis CJ;Blackmon JE;Chang G
简明症状自评量表(BSI-18)被广泛用于评估癌症幸存者的心理症状，但传统的BSI-18临界值在这一人群中的有效性受到质疑。这项研究评估了BSI-18在识别年轻成年癌症幸存者(YAC)显著焦虑和抑郁方面的准确性，并将其与“金标准”诊断性访谈测量进行了比较。250名18-40岁的年轻成年癌症幸存者(YAC)完成了BSI-18和结构化临床访谈DSM-IV(SCID)面试，评估焦虑和抑郁障碍。使用ROC分析将BSI-18结果与SCID标准进行比较。44名参与者(17.7%)符合≥-1 SCID诊断标准，另外20名(8.0%)在没有诊断的情况下满足临床上有意义的SCID症状标准。BSI-18GSI量表与SCID诊断的总体一致性良好(AuC=0.848)，但最广泛使用的两个BSI-18病例规则未能识别大多数被诊断为SCID的幸存者，也没有替代的BSI-18分界值符合临床筛查的研究标准。旨在识别有明显SCID症状或SCID诊断的幸存者的分析得出了类似的结果，分别检查抑郁和焦虑的分析也是如此。BSI-18与精神病学访谈总体上显示出良好的一致性，但推荐的分界值未能确定大多数YACS患者有精神病学诊断。临床医生不应仅依赖BSI-18作为YACS的筛查手段。为检测YACS的精神症状而优化的替代BSI-18评分算法可能是解决这一限制的重要一步。
The Brief Symptom Inventory-18 (BSI-18) is widely used to assess psychological symptoms in cancer survivors, but the validity of conventional BSI-18 cut-off scores in this population has been questioned. This study assessed the accuracy of the BSI-18 for identifying significant anxiety and depression in young adult cancer survivors (YACS), by comparing it to a “gold standard” diagnostic interview measure. Two hundred and fifty young adult cancer survivors (YACS), age 18–40 completed the BSI-18 and the Structured Clinical Interview for DSM-IV (SCID) interview assessing anxiety and depressive disorders. BSI-18 results were compared to SCID criteria using ROC analyses. Forty-four participants (17.7%) met criteria for ≥ 1 SCID diagnoses, and an additional 20 (8.0%) met criteria for clinically significant SCID symptoms without a diagnosis. General concordance between the BSI-18 GSI scale and SCID diagnosis was good (AUC = 0.848), but the two most widely used BSI-18 case-rules failed to identify a majority of survivors with SCID diagnoses, and no alternative BSI-18 cut-off scores met study criteria for clinical screening. Analyses aimed at identifying survivors with significant SCID symptoms or a SCID diagnosis had similar results, as did analyses examining depression and anxiety separately. The BSI-18 shows good overall concordance with a psychiatric interview, but recommended cut-off scores fail to identify a majority of YACS with psychiatric diagnosis. Clinicians should not rely on the BSI-18 alone as a screening measure for YACS. Alternative BSI-18 scoring algorithms optimized for detecting psychiatric symptoms in YACS may be an important step to address this limitation.
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