使用医院焦虑抑郁量表作为头痛患者的筛查工具。

Use of the hospital anxiety and depression scale as a screening tool for patients with headache.

作者信息

Juang K D, Wang S J, Lin C H, Fuh J L

机构信息

Department of Psychiatry, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.

出版信息

Zhonghua Yi Xue Za Zhi (Taipei). 1999 Nov;62(11):749-55.

PMID:10575802

Abstract

BACKGROUND

The Hospital Anxiety and Depression Scale (HADS) is becoming widely used in medical settings to screen for anxiety or depressive disorders. It has been shown to be a good screening instrument in different ethnic and disease populations. The objective of this study was to evaluate the validity and reliability of HADS in patients with headache at a headache clinic.

METHODS

Consecutive new patients to a headache clinic at the Taipei Veterans General Hospital from September to December, 1998, were recruited in the study. The participants completed the HADS questionnaire and underwent a psychiatric semistructured interview according to the Diagnostic and Statistical Manual (4th revision). The reliability and validity of the HADS were evaluated with respect to headache.

RESULTS

A total of 62 patients (21 men, 41 women) completed the study. The HADS had a good internal consistency when applied to patients suffering from headache, with a Cronbach's alpha coefficient of 0.84 and a split-half reliability of 0.84. Factor analysis in this sample revealed four factors: anxiety, depression, panic and somatic factors. A total of 48 patients (77%) had a psychiatric diagnosis. The frequency of depressive disorders was 57% and anxiety disorders 31%. A total HADS score of 10 or more was the optimal cut-off point for depressive disorders. The sensitivity was 85.7%, and the specificity 33.3%. A total score of at least 13 was the optimal cut-off point for anxiety disorder. The sensitivity was 84.2%, while the specificity was 41.9%.

CONCLUSIONS

Depression and anxiety were quite common among patients with headache in a headache clinic. The HADS can be used as a screening instrument for depressive and anxiety disorders. Because of the low specificity, the HADS should not be used solely as an indicator of psychiatric comorbidity among patients with headache in a headache clinic. This is the first study that verifies the use of the HADS as a psychiatric screening tool in patients with headache by comparing the scores of the HADS with psychiatric diagnoses.

摘要

背景

医院焦虑抑郁量表（HADS）在医疗环境中被广泛用于筛查焦虑或抑郁障碍。它已被证明在不同种族和疾病人群中是一种良好的筛查工具。本研究的目的是评估HADS在头痛门诊头痛患者中的有效性和可靠性。

方法

选取1998年9月至12月在台北荣民总医院头痛门诊连续就诊的新患者纳入研究。参与者完成HADS问卷，并根据《诊断与统计手册》（第4版）接受精神科半结构化访谈。针对头痛评估HADS的可靠性和有效性。

结果

共有62例患者（21例男性，41例女性）完成研究。HADS应用于头痛患者时具有良好的内部一致性，Cronbach's alpha系数为0.84，分半信度为0.84。该样本的因子分析显示有四个因子：焦虑、抑郁、惊恐和躯体因子。共有48例患者（77%）有精神科诊断。抑郁障碍的发生率为57%，焦虑障碍为31%。HADS总分10分及以上是抑郁障碍的最佳截断点。敏感性为85.7%，特异性为33.3%。总分至少13分是焦虑障碍的最佳截断点。敏感性为84.2%，特异性为41.9%。