Screening for depression in systemic lupus erythematosus with the British Columbia Major Depression Inventory
Screening for depression in systemic lupus erythematosus with the British Columbia Major Depression Inventory
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DOI：
10.2466/pr0.90.4.1091-1096
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发表时间：
2002-06-01
影响因子：
2.3
通讯作者：
Iverson, GL
中科院分区：
文献类型：
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作者：
Iverson, GL
系统性红斑狼疮（SLE）患者抑郁症的准确识别特别复杂，因为抑郁症的植物人症状也反映了这种自身免疫性疾病的核心特征。自我报告的症状，SLE患者（n = 103）和社区对照组（n 13 6）进行了检查与不列颠哥伦比亚省抑郁量表和贝克抑郁量表-II。狼疮患者在前一量表的大多数项目上得分较高。逻辑回归分析评估是否这些项目的子集是唯一相关的组成员。临床上显著的疲劳在狼疮患者中比对照组更常见。与睡眠障碍有关的两个项目也作为独特的预测因子进入方程。三变量模型导致85%的对照受试者和66%的患者被正确分类。根据Beck量表（17或更高），选择了一个抑郁症患者亚组（n = 41）。他们在不列颠哥伦比亚省的清单上最常被认可的症状是疲劳（90.2%），入睡困难（70.7%），认知困难（61%）和精神发育迟缓（58.5%）。只有29.3%的人表示非常悲伤。在不列颠哥伦比亚省的调查中，这些受试者中有15%被归类为不抑郁，46%被归类为可能抑郁，39%被归类为可能抑郁。在得出结论，筛查测试的高分对应于可能的抑郁症之前，建议评估患者是否经历了显著的悲伤或失去兴趣。
Accurate identification of depression in patients with systemic lupus erythematosus (SLE) is particularly complicated because the vegetative symptoms of depression also reflect core features of this autoimmune disease. Self-reported symptoms in patients with SLE (n = 103) and community control subjects (n 13 6) were examined with the British Columbia Major Depression Inventory and the Beck Depression Inventory-II. The patients with lupus obtained higher scores on most items of the former inventory. A logistic regression analysis assessed whether a subset of these items were uniquely related to group membership. Clinically significant fatigue was much more common in patients with lupus than in the control group. Two items relating to sleep disturbance also entered the equation as unique predictors. The three-variable model resulted in 85% of the control subjects and 66% of the patients being correctly classified. A subset of patients with depression, according to the Beck inventory (17 or higher), were selected (n=41). Their most frequently endorsed symptoms on the British Columbia Inventory were fatigue (90.2%), trouble falling asleep (70.7%), cognitive difficulty (61%), and psychomotor slowing (58.5%). Only 29.3% reported significant sadness. 15% of these subjects were classified as not depressed, 46% as possibly depressed, and 39% as probably depressed on the British Columbia Inventory. It is advisable to assess whether patients are experiencing significant sadness or loss of interest before concluding that a high score on a screening test corresponds to probable depression.