Utility of the Beck Depression Inventory to screen for and track depression in injection drug users seeking hepatitis C treatment
Utility of the Beck Depression Inventory to screen for and track depression in injection drug users seeking hepatitis C treatment
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DOI：
10.1016/j.genhosppsych.2010.02.001
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发表时间：
2010-07-01
影响因子：
7
通讯作者：
Roy-Byrne, Peter
中科院分区：
文献类型：
--
作者：
Holtzheimer, Paul E.;Veitengmber, Jason;Roy-Byrne, Peter
目的：注射吸毒者 (IDU) 的急性丙型肝炎 (HCV) 治疗因精神合并症的高患病率而变得复杂，可能导致干扰素治疗抑郁并发症的风险增加。需要有效的筛查策略来帮助非精神科临床医生识别抑郁症。方法：30 名患有急性 HCV 的注射吸毒者完成了贝克抑郁量表 (BDI)，接受了精神科检查，并随机接受 24 周的聚乙二醇干扰素治疗 (IFA) 或观察 (OBS)。计算 BDI 诊断抑郁症的敏感性、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV)（截止值 >10）。精神科医生的诊断被用作金标准。随着时间的推移，使用 BDI 评估抑郁症的严重程度。结果：47% 的人符合抑郁症的标准。 BDI 的灵敏度 (91%) 和 NPV (92%) 较高；特异性 (58%) 和 PPV (56%) 较低。完成研究的 2 名患者（一名 IFA，一名 OBS）BDI 恶化；两名 IFA 患者因可能的抑郁相关并发症而停止治疗。在基线时，受试者评定的疲劳与丙氨酸氨基转移酶水平相关。结论：BDI 是排除患有急性 HCV 的活动性注射吸毒者抑郁症的充分工具，但特异性较低。建议所有正在考虑接受急性 HCV 治疗的活跃注射吸毒者进行精神病学咨询。 (C) 2010 Elsevier Inc. 保留所有权利。
Objective: Treating acute hepatitis C (HCV) in injection drug users (IDUs) is complicated by a high prevalence of psychiatric comorbidities that may lead to increased risk for depressive complications of interferon treatment. Effective screening strategies are needed to help non-psychiatric clinicians identify depressive disorders.Methods: Thirty IDUs with acute HCV completed the Beck Depression Inventory (BDI), underwent a psychiatric examination, and were randomized to 24 weeks of pegylated interferon treatment (IFA) or observation (OBS). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the BDI for diagnosing depression (with a cutoff >10) were calculated. The psychiatrist's diagnosis was used as the gold standard. Depression severity was assessed over time with the BDI.Results: Forty-seven percent of individuals met criteria for a depressive disorder. Sensitivity (91%) and NPV (92%) were high for the BDI; specificity (58%) and PPV (56%) were low. BDI worsened in 2 patients completing the study (one IFA, one OBS); two IFA patients were discontinued for possible depression-related complications. At baseline, subject-rated fatigue was associated with alanine aminotransferase level.Conclusion: The BDI is an adequate tool for ruling out depressive disorders in active IDUs with acute HCV, but specificity is low. Psychiatric consultation is recommended for all active IDUs being considered for acute HCV treatment. (C) 2010 Elsevier Inc. All rights reserved.