Pedersen J K, Damsbo N, Kragstrup J
Odense Universitet, Forskningsenheden og Fagomradet for Almen Medicin.
Ugeskr Laeger. 1999 Feb 8;161(6):787-90.
Depressed patients in general practice may be difficult to identify. Questionnaires may be used for screening but some of the existing instruments are difficult to use and have only to a limited degree been introduced in general practice. In this study 798 patients' answers to the COOP/WONCA chart "Feelings" were compared to GPs' diagnosis according to ICD-10 criteria for depressive single episode (F32). At cut-off2/3 (slight/moderate problems) the chart had a sensitivity of 89% (76-100%) and specificity of 75% (72-78%). The predictive value of a positive test was not higher than 33% for any cut-off point and the predictive value of a negative test never less than 98%. A two-phased diagnostic strategy with the COOP/WONCA chart as step one is suggested as a possible and relatively simple way to optimize recognition of depressive patients in general practice.
综合医疗中抑郁患者可能难以识别。可使用问卷进行筛查，但一些现有工具使用困难，且仅在有限程度上被引入综合医疗中。在本研究中，将798名患者对COOP/WONCA图表“感受”部分的回答与全科医生根据国际疾病分类第10版（ICD - 10）中单次抑郁发作（F32）标准做出的诊断进行了比较。在临界值为2/3（轻微/中度问题）时，该图表的敏感度为89%（76 - 100%），特异度为75%（72 - 78%）。对于任何临界值，阳性检测的预测值均不高于33%，阴性检测的预测值从不低于98%。建议采用以COOP/WONCA图表为第一步的两阶段诊断策略，作为在综合医疗中优化识别抑郁患者的一种可能且相对简单的方法。
