Kvaal Kari, Ulstein Ingun, Nordhus Inger Hilde, Engedal Knut
Postgraduate Education in Psychiatry and Mental Health, Oslo University College, Norway.
Int J Geriatr Psychiatry. 2005 Jul;20(7):629-34. doi: 10.1002/gps.1330.
In geriatric psychiatry assessment scales are often used in clinical praxis in the diagnostic work-up of mental disorders.
To assess whether the state part of the STAI is useful as a case-finding instrument of mental disorders.
Data came from 70 non demented geriatric in-patients in stable clinical condition. Mean age was 83.3 years (range 64-96), and 74.3% were women. The 20-item STAI state instrument was used to measure current anxiety symptoms. Without knowledge of the score on STAI state a psychiatrist examined all patients and set diagnosis according to DSM-IV-TR criteria, but hierarchical rules were not used. Sensitivity, specificity, Likelihood ratio and accuracy were calculated for different cut-points of the mean sumscore on the STAI state.
15.7% of the participants suffered from a mental disorder: GAD = 1, mixed anxiety-depression = 5, depression = 1, dysthymic = 1, adjustment disorder (mixed anxiety-depression) = 1, and personality disorder = 1. The mean STAI sumscore in this group was 56.3 compared with 39.2 in the 59 patients without any psychiatric diagnosis. The optimal cut-off score on the STAI mean sumscore corresponding to the highest accuracy of 0.87 was 55/54 with sensitivity 0.82, specificity 0.88, and LR + 6.8.
The STAI state scale is a useful instrument for detecting a variety of mental disorders in older people. Further studies should be carried out in different populations.
在老年精神病学中，评估量表常用于精神障碍诊断检查的临床实践。
评估状态特质焦虑问卷（STAI）的状态分量表是否可用作精神障碍的病例筛查工具。
数据来自70名临床状况稳定的非痴呆老年住院患者。平均年龄为83.3岁（范围64 - 96岁），女性占74.3%。使用包含20个条目的STAI状态量表来测量当前的焦虑症状。在不知道STAI状态得分的情况下，一名精神科医生对所有患者进行检查，并根据《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）标准进行诊断，但未使用分层规则。针对STAI状态量表平均总分的不同切点，计算敏感性、特异性、似然比和准确性。
15.7%的参与者患有精神障碍：广泛性焦虑障碍（GAD）=1例，混合性焦虑抑郁障碍=5例，抑郁症=1例，恶劣心境=1例，适应性障碍（混合性焦虑抑郁）=1例，人格障碍=1例。该组的STAI平均总分是56.3，而59名无任何精神疾病诊断的患者的平均总分为39.2。对应最高准确性0.87的STAI平均总分最佳切点为55/54，敏感性为0.82，特异性为0.88，阳性似然比为6.8。
STAI状态量表是检测老年人各种精神障碍的有用工具。应在不同人群中开展进一步研究。
