功能性胃肠病患者述情障碍的身心研究诊断标准的效标关联效度。

Criterion-related validity of the diagnostic criteria for psychosomatic research for alexithymia in patients with functional gastrointestinal disorders.

作者信息

Porcelli P, De Carne M

机构信息

Scientific Institute of Gastroenterology, Castellana Grotte, Bari, Italy.

出版信息

Psychother Psychosom. 2001 Jul-Aug;70(4):184-8. doi: 10.1159/000056251.

Abstract

BACKGROUND

Because of criticism made against psychiatric assessment of somatization, alternative Diagnostic Criteria for Psychosomatic Research (DCPR) have been proposed by an international group of psychosomatic investigators. One of these criteria concerns the alexithymia construct. The main aim of the present study was to investigate the criterion-related validity of the DCPR for alexithymia syndrome (DCPR-A). A secondary aim was to explore the relationship between alexithymia and depressed mood.

METHOD

The study included 190 consecutive outpatients with functional gastrointestinal disorders. Alexithymia was assessed by means of the DCPR-A and the 20-item Toronto Alexithymia Scale (TAS-20). Depressed mood was assessed on the basis of the Depression subscale of the Hospital Anxiety and Depression Scale (HDS) and the DSM-IV criteria.

RESULTS

The sensitivity of the DCPR-A together with the TAS-20 was 70.2%, specificity was 81.6%, positive predictive power 88.9%, negative predictive power 66.0% and overall hit rate 46.8%. DCPR-A positives scored significantly higher than DCPR-A negatives on the TAS-20 scores (t = 9.86, p < 0.001). The TAS-20 was not associated with any measure of depression, while the DCPR-A was significantly associated with the HDS and DSM-IV criteria.

CONCLUSIONS

The DCPR-A had adequate sensitivity, specificity and accuracy, thus proving that the criterion has good validity. The differences in association found between alexithymia and depression suggest that they may be due to differences in the methods of investigation rather than to the constructs per se.

摘要

背景

由于对躯体化的精神科评估存在批评意见,一组国际心身研究人员提出了替代性的心身研究诊断标准(DCPR)。其中一项标准涉及述情障碍这一概念。本研究的主要目的是调查DCPR用于述情障碍综合征(DCPR-A)的标准关联效度。次要目的是探讨述情障碍与抑郁情绪之间的关系。

方法

该研究纳入了190例连续性的功能性胃肠病门诊患者。通过DCPR-A和20项多伦多述情障碍量表(TAS-20)评估述情障碍。基于医院焦虑抑郁量表(HDS)的抑郁分量表和《精神疾病诊断与统计手册》第四版(DSM-IV)标准评估抑郁情绪。

结果

DCPR-A与TAS-20联合使用时,敏感性为70.2%,特异性为81.6%,阳性预测值为88.9%,阴性预测值为66.0%,总命中率为46.8%。在TAS-20得分上,DCPR-A阳性者显著高于DCPR-A阴性者(t = 9.86,p < 0.001)。TAS-20与任何抑郁指标均无关联,而DCPR-A与HDS及DSM-IV标准显著相关。

结论

DCPR-A具有足够的敏感性、特异性和准确性,从而证明该标准具有良好的效度。述情障碍与抑郁之间在关联性上的差异表明,它们可能是由于调查方法的不同而非概念本身的差异所致。

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