Fink Per, Ørbøl Eva, Hansen Morten Steen, Søndergaard Lene, De Jonge Peter
Research Unit for Functional Disorders, Psychosomatics and CL Psychiatry, Aarhus University Hospital, Noerrebrogade 44, DK-8000 Aarhus C, Denmark.
J Psychosom Res. 2004 Mar;56(3):371-5. doi: 10.1016/S0022-3999(03)00071-0.
The objective of this study is to validate the eight-item dichotomised version of the Symptoms Check List (SCL-8d) as a screening tool for psychiatric disorders.
The study population included 198 consecutive new neurological inpatients and outpatients and 294 consecutive internal medical inpatients, aged 18 or older. All patients received the SCL-8d questionnaire, and a stratified subsample was interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. We tested the external SCL-8d validity using the SCAN interview as gold standard. The test was performed based on weighted data to correct for the skewness introduced by stratification.
The diagnostic performance of the SCL-8d was excellent in the internal medical setting but not quite as good in the neurological sample. It performed better among the older compared with the younger patients, whereas the scale was not affected by gender. In the combined sample at the cut point 0/1, the sensitivity (SE) of the SCL-8d was 0.73 (confidence interval CI: 0.60-0.82), the specificity (SP) 0.61 (CI(95%): 0.53-0.68) and the positive predictive value (PPV) 0.42 (CI(95%): 0.34-0.50), using any International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) psychiatric disorder, excluding somatoform and substance abuse disorders, as gold standard. The risk of a patient having a mental disorder (except phobia, substance abuse or somatoform disorder) was less than 6% in case of a negative screening test. In patients with a current depressive disorder, 87.1% (27/31) were screening positive, and all except 1 (93.0%) of the 14 patients with a modest to severe depression scored 1 or higher on the SCL-8d. All 17 patients with an anxiety disorder, excluding phobias, were screening positive.
The study suggests that the SCL-8d is a valid, brief screening tool for use in nonpsychiatric medical settings, especially to detect emotional psychiatric disorders (EPDs).
本研究旨在验证症状清单（SCL - 8d）的八项二分法版本作为精神疾病筛查工具的有效性。
研究人群包括198名连续的新神经科住院患者和门诊患者以及294名连续的内科住院患者，年龄均在18岁及以上。所有患者均接受SCL - 8d问卷，并且使用神经精神病学临床评估量表（SCAN）访谈对一个分层子样本进行了访谈。我们以SCAN访谈作为金标准来测试SCL - 8d的外部效度。该测试基于加权数据进行，以校正分层引入的偏态。
SCL - 8d在内科环境中的诊断性能极佳，但在神经科样本中表现稍逊。与年轻患者相比，其在老年患者中表现更好，而该量表不受性别的影响。在联合样本中，切点为0/1时，以任何国际疾病及相关健康问题统计分类第十版（ICD - 10）精神疾病（不包括躯体形式障碍和物质滥用障碍）作为金标准，SCL - 8d的敏感性（SE）为0.73（95%置信区间[CI]：0.60 - 0.82），特异性（SP）为0.61（CI(95%)：0.53 - 0.68），阳性预测值（PPV）为0.42（CI(95%)：0.34 - 0.50）。筛查试验结果为阴性时，患者患有精神障碍（恐惧症、物质滥用或躯体形式障碍除外）的风险低于6%。在当前患有抑郁症的患者中，87.1%（27/31）筛查呈阳性，在14例中度至重度抑郁症患者中，除1例（93.0%）外，所有患者在SCL - 8d上的得分均为1分或更高。所有17例焦虑症患者（不包括恐惧症）筛查均呈阳性。
该研究表明，SCL - 8d是一种有效的简短筛查工具，可用于非精神科医疗环境，尤其是用于检测情感性精神障碍（EPDs）。
