A Systematic Evaluation of the Adaptation of Depression Diagnostic Methods for Stroke Survivors Who Have Aphasia

A Systematic Evaluation of the Adaptation of Depression Diagnostic Methods for Stroke Survivors Who Have Aphasia
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失语症中风幸存者抑郁症诊断方法适应性的系统评价

DOI:
10.1161/strokeaha.107.484238
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发表时间:
2007
期刊:
影响因子:
8.3
通讯作者:
Kirsty McLaughlan
Kirsty McLaughlan
中科院分区:
医学1区
文献类型:
--
作者:
E. Townend;M. Brady;Kirsty McLaughlan

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背景和目的——三分之一的中风幸存者患有失语症(语言理解和表达能力受损)。传统上,抑郁症诊断使用基于语言的方法。我们的目的是系统地回顾用于诊断抑郁症的方法,以及针对失语症患者对这些方法的适应。方法:我们系统地回顾了中风研究(截至2006年1月),包括抑郁症诊断和失语症患者。我们提取了与失语症患者/非失语症患者抑郁症诊断方法相关的数据。我们在需要时寻求作者的澄清。结果——总共有60项研究包括失语症患者。几乎一半的研究(29/60;48%)对失语症患者采用了他们主要的抑郁症诊断方法(最典型的是临床访谈和公布的标准)。适应性方法包括:使用举报人(亲属或工作人员)、临床观察、修改问题和视觉模拟量表。关于这些适应的有效性或可靠性的证据很少被报道。然而,使用举报人或临床观察确实实现了将大多数失语症患者纳入抑郁症的诊断。其余没有报道适应性方法的研究表明,传统的基于语言的方法只适用于“轻度”失语症患者。结论:失语症患者可以并且已经被纳入抑郁症诊断评估。然而,我们建议抑郁症和语言专家合作,为失语症患者开发一种更有效的抑郁症诊断方法,具有良好的可靠性。
Background and Purpose— One in 3 stroke survivors has aphasia (impaired language comprehension and expressive abilities). Conventionally, depression diagnosis uses language-based methods. We aimed to systematically review methods that have been used to diagnose depression and adaptations to these methods intended for people with aphasia. Methods— We systematically reviewed stroke studies (to January 2006) that included a depression diagnosis and individuals with aphasia. We extracted data related to depression diagnostic methods used for individuals with/without aphasia. We sought clarification from authors when required. Results— A total of 60 studies included people with aphasia. Almost half the studies (29/60; 48%) adapted their main depression diagnostic method (most typically a clinical interview and published criteria) for individuals with aphasia. Adaptive methods included: using informants (relatives or staff), clinical observation, modifying questions and visual analogue scales. Evidence of the validity or reliability of these adaptations was rarely reported. However, use of informants or clinical observation did achieve the inclusion of most people with aphasia in the diagnosis of depression. Remaining studies, that did not report adaptive methods, suggested that conventional language-based methods are suitable for individuals with only ‘mild’ aphasia. Conclusions— People with aphasia can be and have been included in depression diagnostic assessments. However, we suggest that depression and language experts collaborate to develop a more valid method of depression diagnosis for patients with aphasia that has good reliability.
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发表时间: 2000-03-01
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