Symptom indicator of severity of depression in cancer patients: a comparison of the DSM-IV criteria with alternative diagnostic criteria
Symptom indicator of severity of depression in cancer patients: a comparison of the DSM-IV criteria with alternative diagnostic criteria
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DOI：
10.1016/j.genhosppsych.2008.12.004
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发表时间：
2009-05-01
影响因子：
7
通讯作者：
Uchitomi, Yosuke
中科院分区：
文献类型：
--
作者：
Akechi, Tatsuo;Ietsugu, Tetsuji;Uchitomi, Yosuke
目的：本研究的目的是探讨判断癌症患者重度抑郁严重程度的几个诊断标准项目的表现。方法：采用现代项目反应理论，对728例已确诊为重度抑郁症的癌症患者的诊断标准（DSM-IV）和两套概念性诊断标准（Endicott标准和Cavanaugh标准）的表现进行了包容性分析。结果：虽然DSM-IV的所有诊断标准，包括无价值感和自杀意念，对抑郁症严重程度的区分能力较低，但两个建议项目（不参与医疗护理和社交退缩）似乎是癌症患者中重度重度抑郁症的良好标志。此外，“恐惧或沮丧的面部或身体姿势”和“沉思，自怜或悲观”可能是轻度重度抑郁症的良好标志，而“不能振作起来，不笑，对好消息或有趣的情况没有反应”可能是严重重度抑郁症的良好标志。结论：本研究结果提示，替代标准可能在诊断癌症患者抑郁严重程度方面具有实用价值。爱思唯尔公司2009年版权所有版权所有。
Objective: The objective of this study was to explore the performances of several diagnostic criteria items for judging the severity of major depression among cancer patients.Method: Using modem item response theory, we examined the performances of the diagnostic criteria outlined by the DSM-IV and two sets of conceptual diagnostic criteria (the Endicott and the Cavanaugh criteria) in a series of 728 cancer patients who had been diagnosed with major depression using an inclusive approach.Results: While all the DSM-IV diagnostic criteria, including feelings of worthlessness and suicidal ideation, had a low ability for discriminating the severity of depression, two proposed items (not participating in medical care and social withdrawal) appeared to be good markers of moderately severe major depressive disorder among cancer patients. In addition, the items "fearfulness or depressed appearance in face or body posture" and "brooding, self-pity or pessimism" may be good markers for mild major depressive disorders, while the item "cannot be cheered up, doesn't smile, no response to good news or funny situations" may be a good marker for severe major depressive disorder.Conclusions: The findings of the present study suggest that alternative criteria may have utility in diagnosing depression severity in cancer patients. Crown Copyright (C) 2009 Published by Elsevier Inc. All rights reserved.