Validity of Center for Epidemiologic Studies Depression (CES-D) scale in a sample of Iraq and Afghanistan Veterans.
Validity of Center for Epidemiologic Studies Depression (CES-D) scale in a sample of Iraq and Afghanistan Veterans.
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DOI：
10.1177/2050312116643906
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发表时间：
2016
影响因子：
2.3
通讯作者：
Andresen EM
中科院分区：
文献类型：
--
作者：
Quiñones AR;Thielke SM;Clark ME;Phillips KM;Elnitsky C;Andresen EM
最佳的抑郁症筛查需要在不同人群和合并症的存在下有效的测量工具。本研究评估了流行病学研究中心抑郁量表的两个版本的测试属性对精神病诊断的迷你国际神经精神访谈中的美国退伍军人部署在持久自由行动，伊拉克自由，和新黎明的临床样本。参与者（N = 359）从两个退伍军人事务部医院招募完成了临床访谈，结构化诊断访谈，自我报告的措施。根据诊断性访谈和《精神障碍诊断和统计手册》第4版标准，29.5%的样本符合重度抑郁症的诊断标准，26.5%符合创伤后应激障碍的诊断标准。流行病学研究中心抑郁症-20和流行病学研究中心抑郁症-10量表在识别退伍军人重度抑郁症方面表现良好，并且与小型国际神经精神访谈-重度抑郁症几乎相同（流行病学研究中心抑郁症-20受试者工作特征曲线下的面积91%;流行病学研究中心抑郁症-10 ROC曲线下面积90%）。总体而言，流行病学研究中心抑郁量表的较高临界点在正确识别重度抑郁症的真阳性和真阴性方面表现更好（流行病学研究中心抑郁-20临界点18+灵敏度92%特异性72%;流行病学研究中心抑郁-10临界点10+灵敏度92%特异性69%）。流行病学研究中心抑郁量表的特异性较差的退伍军人与共同发生的创伤后应激障碍（13%和16%）。患有创伤后应激障碍的退伍军人谁有积极的抑郁症屏幕应该有一个更彻底的评估心理健康症状和合并症，而不是立即诊断和治疗抑郁症。
Optimal depression screening necessitates measurement tools that are valid across varied populations and in the presence of comorbidities. This study assessed the test properties of two versions of the Center for Epidemiologic Studies Depression scale against psychiatric diagnoses established by the Mini International Neuropsychiatric Interview among a clinical sample of US Veterans deployed during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. Participants (N = 359) recruited from two Department of Veterans Affairs hospitals completed a clinical interview, structured diagnostic interview, and self-reported measures. Based on diagnostic interview and the Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria, 29.5% of the sample met diagnostic criteria for major depressive disorder and 26.5% met diagnostic criteria for post-traumatic stress disorder. Both Center for Epidemiologic Studies Depression-20 and Center for Epidemiologic Studies Depression-10 scales performed well and almost identically against the Mini International Neuropsychiatric Interview-major depressive disorder in identifying Veterans with major depressive disorder (Center for Epidemiologic Studies Depression-20 area under the Receiver Operating Characteristic curve 91%; Center for Epidemiologic Studies Depression-10 area under the ROC curve 90%). Overall, higher cut points for the Center for Epidemiologic Studies Depression scales performed better in correctly identifying true positives and true negatives for major depressive disorder (Center for Epidemiologic Studies Depression-20 cut point 18+ sensitivity 92% specificity 72%; Center for Epidemiologic Studies Depression-10 cut point 10+ sensitivity 92% specificity 69%). The specificity of the Center for Epidemiologic Studies Depression scales was poor among Veterans with co-occurring post-traumatic stress disorder (13% and 16%). Veterans with post-traumatic stress disorder who have a positive depression screen should have a more thorough assessment of mental health symptoms and comorbidities, rather than immediate diagnosis of and treatment for depression.