Validity and Clinical Utility of Subtyping by the Beck Depression Inventory in Women Seeking Gastric Bypass Surgery.
Validity and Clinical Utility of Subtyping by the Beck Depression Inventory in Women Seeking Gastric Bypass Surgery.
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DOI：
10.1007/s11695-016-2047-x
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发表时间：
2016-09
期刊：
影响因子：
2.9
通讯作者：
Grilo, Carlos M.
中科院分区：
文献类型：
--
作者：
Ivezaj, Valentina;Barnes, Rachel D.;Grilo, Carlos M.
尽管该患者群体的心理测量证据相对有限，但贝克抑郁量表 (BDI) 通常用于减肥手术候选者的筛选和评估过程。我们检查了 BDI 的有效性及其对寻求胃绕道手术的女性分型的临床实用性。 124 名接受胃绕道手术评估的女性接受了 DSM-IV 结构化临床访谈 (SCID-I/P)，并完成了包括 BDI 在内的一系列心理社会测量的自我报告。根据 SCID-I/P，12.9% (n=16) 符合当前情绪障碍的标准。受试者工作特征 (ROC) 曲线分析显示，BDI 在预测 SCID-I/P 情绪障碍诊断方面具有良好的曲线下面积 (0.788)； BDI 评分 >15 优化了敏感性和特异性。与没有情绪障碍的患者相比，被诊断为 SCID-I/P 情绪障碍的患者的饮食失调精神病理学、自尊和羞耻程度显着更高。根据 BDI 截止分数 >15，41.9% (n=52) 被归类为高 BDI，58.1% (n=72) 被归类为低 BDI。高 BDI 患者的所有相关指标水平也显着高于低 BDI 患者； BDI 亚型差异的效应大小通常比比较基于 SCID-I/P 的情绪与无情绪障碍亚组时观察到的效应大小大 2-3 倍。在寻求胃绕道手术的女性中，BDI 在识别切点分数 >15 的情绪障碍方面表现出可接受的有限效率。然而，在确定临床严重程度时，通过 BDI 评分 > 15 对女性进行亚型分类可能会比依赖 SCID-I/P 产生的情绪障碍诊断来识别更加不安的亚组。
The Beck Depression Inventory (BDI) is commonly used in the screening and evaluation process with bariatric surgery candidates despite relatively limited psychometric evidence in this patient group. We examined the validity of the BDI and its clinical utility for subtyping women seeking gastric bypass surgery. One hundred twenty-four women evaluated for gastric bypass surgery were administered the Structured Clinical Interview for DSM-IV (SCID-I/P) and completed a self-report battery of psychosocial measures including the BDI. Based on the SCID-I/P, 12.9% (n=16) met criteria for current mood disorder. Receiver operating characteristic (ROC) curve analysis revealed the BDI had a good area under the curve (.788) for predicting SCID-I/P mood disorder diagnosis; BDI score of >15 optimized both sensitivity and specificity. Patients diagnosed with SCID-I/P mood disorders had significantly higher levels of eating-disorder psychopathology, self-esteem, and shame, than those without mood disorders. Based on a BDI cut-off score of >15, 41.9% (n=52) were categorized as High-BDI and 58.1% (n=72) as Low-BDI. Patients characterized as High-BDI also had significantly higher levels of all associated measures than those with Low-BDI; effect sizes for the differences by BDI subtyping were generally 2–3 times greater than those observed when comparing SCID-I/P-based mood versus no mood disorder subgroups. In women seeking gastric bypass surgery, the BDI demonstrated limited acceptable efficiency for identifying mood disorders with a cut-point score of >15. When identifying clinical severity, however, subtyping women by BDI scores of >15 may identify a significantly more disturbed subgroup than relying on a SCID-I/P-generated mood disorder diagnosis.
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