Ludermir Ana Bernarda, Lewis Glyn
Dept. de Medicina Social, Universidade Federal de Pernambuco, Avenida Conselheiro Rosa e Silva, 377/1601, Graças, Recife, Pernambuco, C. E. P 52020-220, Brazil.
Soc Psychiatry Psychiatr Epidemiol. 2005 Jan;40(1):36-41. doi: 10.1007/s00127-005-0840-2.
Previous research among primary care attenders in Latin America has noted that females and those with less education may over-report psychiatric complaints on the SRQ-20, compared with responses to a standardized psychiatric interview administered by a clinician. In this paper, the association between demographic and socioeconomic variables and misclassification by the SRQ-20 were investigated and the size of misclassification estimated in a population-based survey.
A cross-sectional survey of a random sample of private households included 683 adults aged 15 years and over living in Olinda, Recife Metropolitan Region, Pernambuco, Brazil. The SRQ-20 results were compared with an interview administered by a psychiatrist. The effect of demographic and socioeconomic variables on misclassification by the SRQ-20 was assessed by calculating the odds ratio (OR) for being a case on the SRQ-20 after adjustment for being a case on the psychiatric interview. Logistic regression was used to investigate the size of misclassification, adjusting the association between common mental disorders, defined by the SRQ-20,and different variables for the psychiatric interview results.
In the univariate analysis, females, the elderly, the less educated, manual workers, housewives and migrants did tend to over-report complaints in the absence of symptoms. However, the apparent influence of age, education, occupation and migration on misclassification by the SRQ-20 was markedly reduced and became statistically non-significant after adjustment for sex and for the other variables in the table. In contrast, the gender effect was not altered after adjustment.
Our results suggest that misclassification on the SRQ-20 was mostly related to being female, though this did not entirely explain the increased prevalence of CMD in women in the sample. Further research is needed to understand why different ways of measuring CMD can lead to different results.
先前针对拉丁美洲初级保健就诊者的研究指出，与临床医生进行的标准化精神科访谈结果相比，女性以及受教育程度较低者可能会在SRQ-20上过度报告精神科症状。本文调查了人口统计学和社会经济变量与SRQ-20误分类之间的关联，并在一项基于人群的调查中估计了误分类的规模。
对巴西伯南布哥州累西腓大都市区奥林达的私人家庭随机样本进行横断面调查，纳入了683名15岁及以上的成年人。将SRQ-20的结果与精神科医生进行的访谈结果进行比较。通过计算在精神科访谈中确诊为病例后，在SRQ-20上被判定为病例的比值比（OR），评估人口统计学和社会经济变量对SRQ-20误分类的影响。使用逻辑回归研究误分类的规模，调整SRQ-20定义的常见精神障碍与精神科访谈结果的不同变量之间的关联。
在单变量分析中，女性、老年人、受教育程度较低者、体力劳动者、家庭主妇和移民在无症状的情况下确实倾向于过度报告症状。然而，在调整性别和表格中的其他变量后，年龄、教育程度、职业和移民对SRQ-20误分类的明显影响显著降低，且在统计学上不再显著。相比之下，调整后性别效应没有改变。
我们的结果表明，SRQ-20的误分类主要与女性有关，尽管这并不能完全解释样本中女性常见精神障碍患病率的增加。需要进一步研究以了解为什么不同的常见精神障碍测量方法会导致不同的结果。
