Forsell Yvonne
Inst. of Public Health, Division of Social Medicine, Norrbacka, Karolinska Hospital, 17176, Stockholm, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 2005 Mar;40(3):209-13. doi: 10.1007/s00127-005-0876-3.
This study examined the association between the Major Depression Inventory (MDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).
A questionnaire including the MDI was sent out to an adult population and was completed by a total of 10,448 persons. Psychiatrists used SCAN and interviewed a subsample (n=1093).
The specificity of the MDI was 0.22, the sensitivity 0.67 and Kappa 0.25 when Major Depression according to SCAN was considered as the index of validity, and with all depressive disorders the specificity was 0.44, the sensitivity 0.51 and Kappa 0.33. Higher educated persons and those with reported disability were less likely to be false negatives. The sensitivity and specificity for different cut-off scores when using the MDI total score were calculated.
The result from this study suggests that, when MDI is used in population-based samples, cut-off scores rather than the algorithm for depression should be used. The optimal cut-off score must be chosen according to the aims of the study.
本研究探讨了抑郁自评量表(MDI)与神经精神病学临床评定量表(SCAN)之间的关联。
向成年人群发放包含MDI的问卷,共10448人完成问卷。精神科医生使用SCAN对一个子样本(n = 1093)进行访谈。
以SCAN诊断的重度抑郁作为效度指标时,MDI的特异度为0.22,敏感度为0.67,kappa值为0.25;以所有抑郁障碍作为效度指标时,特异度为0.44,敏感度为0.51,kappa值为0.33。受教育程度较高者和报告有残疾者出现假阴性的可能性较小。计算了使用MDI总分时不同临界值的敏感度和特异度。
本研究结果表明,在基于人群的样本中使用MDI时,应使用临界值而非抑郁诊断算法。必须根据研究目的选择最佳临界值。