Axelson David, Birmaher Boris J, Brent David, Wassick Susan, Hoover Christine, Bridge Jeffrey, Ryan Neal
Division of Child Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
J Child Adolesc Psychopharmacol. 2003 Winter;13(4):463-70. doi: 10.1089/104454603322724850.
To construct a mania rating scale designed for children and adolescents.
Fourteen questions from the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode (K-SADS-P) 1986 version plus a new item assessing mood lability were used to construct a clinician-rated mania rating scale (K-SADS-MRS). Interrater reliability was determined prospectively with 22 patients from a bipolar outpatient clinic. Sensitivity to treatment effects was determined in a separate cohort of 23 patients.
Internal consistency (Cronbach's alpha = 0.94) and interrater reliability (intraclass correlation coefficient = 0.97 between two raters) were high. Convergent validity with the Clinical Global Impressions-Severity scale (bipolar version) was good (r(s)= 0.91, p < 0.001). Treatment responders had significantly greater reduction in K-SADS-MRS scores than nonresponders (-15.6 +/- 8.7 vs. 0.3 +/- 8.8), t(21) = 4.2, p < 0.001. The K-SADS-MRS scores differentiated bipolar patients who had clinically significant manic symptoms from those who did not, with a sensitivity of 87% and a specificity of 81%.
The K-SADS-MRS shows promise as a rating scale for measuring manic symptom severity in pediatric bipolar patients.
构建一个针对儿童和青少年的躁狂评定量表。
采用《学龄儿童情感障碍和精神分裂症量表（当前发作）》（K-SADS-P）1986版中的14个问题，外加一个评估情绪不稳定的新项目，构建一个临床医生评定的躁狂评定量表（K-SADS-MRS）。对来自双相情感障碍门诊的22名患者进行前瞻性评估者间信度测定。在另一组23名患者中测定对治疗效果的敏感性。
内部一致性（克朗巴哈系数=0.94）和评估者间信度（两名评估者间的组内相关系数=0.97）较高。与临床总体印象严重程度量表（双相情感障碍版）的收敛效度良好（r(s)=0.91，p<0.001）。治疗有反应者的K-SADS-MRS评分下降幅度显著大于无反应者（-15.6±8.7对0.3±8.8），t(21)=4.2，p<0.001。K-SADS-MRS评分能够区分有临床显著躁狂症状的双相情感障碍患者和无此症状的患者，敏感性为87%，特异性为81%。
K-SADS-MRS有望作为测量儿童双相情感障碍患者躁狂症状严重程度的评定量表。
