Lindenmayer J P, Kay S R, Plutchik R
Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
Psychiatry Res. 1992 Jun;42(3):199-207. doi: 10.1016/0165-1781(92)90112-g.
While it is recognized that depression frequently can occur together with fundamental symptoms of schizophrenia, estimates of the prevalence of schizophrenia-related depression have been very variable. This variability may be due in part to the difficulty in clearly separating depressive symptoms from negative symptoms. A more valid method of assessing depression might combine evaluations from multiple vantage points. This study, which involved 26 hospitalized schizophrenic patients, tested the proposition that complete assessment of depression requires three separate sources of input: self-rating (subjective mood state), clinician rating (affective state), and observer rating (behavioral manifestations). In the present study, patients were evaluated on self-rating instruments for mood states, clinician-rated scales including the Hamilton Rating Scale for Depression, and observer-rated scales. These vantage points, though overlapping in some respects, were found to provide independent information on the experience of depression in schizophrenia. Clinician-rated and observer-rated assessments tended to correlate significantly, while self-rated subjective reports were discordant, thus complementing the assessments from the other two vantage points.
虽然人们认识到抑郁症常常与精神分裂症的基本症状同时出现，但与精神分裂症相关的抑郁症患病率估计差异很大。这种差异部分可能是由于难以将抑郁症状与阴性症状清楚区分开来。一种更有效的评估抑郁症的方法可能是结合多个视角的评估。这项研究涉及26名住院精神分裂症患者，检验了这样一个命题：对抑郁症的全面评估需要三个独立的信息来源：自评（主观情绪状态）、临床医生评估（情感状态）和观察者评估（行为表现）。在本研究中，患者接受了情绪状态自评工具、包括汉密尔顿抑郁评定量表在内的临床医生评定量表以及观察者评定量表的评估。这些视角虽然在某些方面有重叠，但被发现能提供关于精神分裂症患者抑郁体验的独立信息。临床医生评定和观察者评定的评估往往显著相关，而自评主观报告不一致，从而补充了来自其他两个视角的评估。
