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[基层医疗中抑郁症的筛查测试。COOP/WONCA图表]

[A screening test for depression in general practice. The COOP/WONCA chart].

作者信息

Pedersen J K, Damsbo N, Kragstrup J

机构信息

Odense Universitet, Forskningsenheden og Fagomradet for Almen Medicin.

出版信息

Ugeskr Laeger. 1999 Feb 8;161(6):787-90.

Abstract

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.

摘要

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。

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