Screening for serious mental illness in the general population
Screening for serious mental illness in the general population
复制标题
DOI：
10.1001/archpsyc.60.2.184
复制
发表时间：
2003-02-01
影响因子：
--
通讯作者：
Zaslavsky, AM
中科院分区：
文献类型：
--
作者：
Kessler, RC;Barker, PR;Zaslavsky, AM
背景资料：公法102-321建立了一个整体补助金的成年人与“严重的精神疾病”（SMI），并要求物质滥用和精神卫生服务管理局（SAMHSA）制定一种方法来估计患病率的SMI.Methods：三SMI筛选量表开发可能使用的SAMHSA全国家庭药物滥用调查：综合国际诊断访谈简表（CIDI-SF）量表、K10/K6非特异性痛苦量表和世界卫生组织残疾评估量表（WHO-DAS）。对155名受访者进行了所有筛选量表的丰富便利样本，随后进行了为期12个月的DSM-IV结构化临床访谈和全球功能评估（GAF）。我们将SMI定义为任何12个月的DSM-IV疾病，除了物质使用障碍，GAF评分小于60。结果：所有筛选量表与SMI显著相关。然而，无论是CIDI-SF还是WHO-DAS都没有显著改善K10或K6量表的预测。SMI的受试者工作特征曲线下面积分别为K10和K6的0.854和0.865。最有效的筛查量表K6预测SMI的灵敏度（SE）为0.36（0.08），特异度为0.96（0.02）。结论：K6和K10量表的简洁和准确性使其成为SMI的有吸引力的筛查量表。在临床研究中常规纳入任何一种量表都将在社区和临床流行病学之间建立一个重要的、迄今为止缺失的交叉通道。
Background: Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a method to estimate the prevalence of SMI.Methods: Three SMI screening scales were developed for possible use in the SAMHSA National Household Survey on Drug Abuse: the Composite International Diagnostic Interview Short-Form (CIDI-SF) scale, the K10/K6 nonspecific distress scales, and the World Health Organization Disability Assessment Schedule (WHO-DAS). An enriched convenience sample of 155 respondents was administered all screening scales followed by the 12-month Structured Clinical Interview for DSM-IV and the Global Assessment of Functioning (GAF). We defined SMI as any 12-month DSM-IV disorder, other than a substance use disorder, with a GAF score of less than 60.Results: All screening scales were significantly related to SMI. However, neither the CIDI-SF nor the WHO-DAS improved prediction significantly over the K10 or K6 scales. The area under the receiver operating characteristic curve of SMI was 0.854 for K10 and 0.865 for K6. The most efficient screening scale, K6, had a sensitivity (SE) of 0.36 (0.08) and a specificity of 0.96 (0.02) in predicting SMI.Conclusions: The brevity and accuracy of the K6 and K10 scales make them attractive screens for SMI. Routine inclusion of either scale in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.