Short screening scales to monitor population prevalences and trends in non-specific psychological distress
Short screening scales to monitor population prevalences and trends in non-specific psychological distress
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DOI：
10.1017/s0033291702006074
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发表时间：
2002-08-01
影响因子：
6.9
通讯作者：
Zaslavsky, AM
中科院分区：
文献类型：
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作者：
Kessler, RC;Andrews, G;Zaslavsky, AM
背景为重新设计的美国国民健康访谈调查（NHIS）开发了一个10个问题的心理困扰筛选量表和一个嵌入10个问题量表的6个问题的简短量表。在美国全国邮件调查（N = 1401）中管理初始试点问题。随后在美国全国电话调查（N = 1574）中管理了一组简化的问题。10个问题和6个问题的量表，我们称之为K10和K6，是根据项目反应理论模型从简化的问题集构建的。该量表随后在两个阶段的临床再评估调查（N = 1000电话筛选访谈，在第一阶段，然后由N = 153面对面的临床访谈，在第二阶段，过采样的第一阶段的受访者筛选积极的情绪问题）在当地的便利样本进行验证。第二阶段的样本进行了筛选量表沿着与结构化临床访谈的DSM-IV（SCID）。随后，K6被纳入1997年（N = 36116）和1998年（N = 32440）美国国家健康访谈调查，而K10被纳入1997年（N = 10641）澳大利亚国家心理健康和福祉调查。K10和K6在人群分布的第90 - 99百分位数范围内具有良好的精度（标准化评分的标准误在0（.）20-0（.）25)以及在主要社会人口统计子样本中一致的心理测量特性。该量表强烈区分DSM-IV/SCID疾病的社区病例和非病例，受试者工作特征（ROC）曲线下面积为0（.）87-0（.）88，对于功能总体评估（GAF）评分为0-70和0（.）95-0（.）GAF评分为0- 50的疾病96例。简洁，强大的心理测量特性，以及区分DSM-IV病例和非病例的能力，使K10和K6在通用健康调查中具有吸引力。美国和加拿大的年度政府健康调查以及世卫组织的世界精神健康调查已经使用了这些量表。在临床研究中常规纳入K10或K6将在社区和临床流行病学之间建立一个重要的、迄今为止缺失的交叉通道。
Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS).Methods. Initial pilot questions were administered in a US national mail survey (N = 1401). A reduced set of questions was subsequently administered in a US national telephone survey (N = 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey (N = 1000 telephone screening interviews in the first stage followed by N = 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 (N = 36116) and 1998 (N = 32440) US National Health Interview Survey, while the K10 was included in the 1997 (N = 10641) Australian National Survey of Mental Health and Well-Being.Results. Both the K10 and K6 have good precision in the 90th-99th percentile range of the population distribution (standard errors of standardized scores in the range 0(.)20-0(.)25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV/SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0(.)87-0(.)88 for disorders having Global Assessment of Functioning (GAF) scores of 0-70 and 0(.)95-0(.)96 for disorders having GAF scores of 0-50.Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.