Ertan F S, Ertan T, Kiziltan G, Uyguçgil H
Department of Neurology, Istanbul University Cerrahpaşa Medical School, Aksaray 34303 Istanbul, Turkey.
J Neurol Neurosurg Psychiatry. 2005 Oct;76(10):1445-7. doi: 10.1136/jnnp.2004.057984.
The objective of this study was to investigate reliability and validity of the self rated 30 item Geriatric Depression Scale (GDS) in screening and diagnosis of depression in Parkinson's disease (PD). The study sample comprised 109 non-demented patients with PD admitted to the movement disorders outpatient unit. The reference diagnosis of depression was made according to DSM-IV criteria. Discriminant validity and internal consistency of the total scale were studied. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated for different cutoff scores. Receiver operating characteristics (ROC) analysis was also carried out. The sample comprised 56 patients with and 53 without depression. In the discriminant validity analysis, the mean total GDS score of subjects with depression was significantly higher compared with those without depression. The Cronbach's alpha score was 0.92 and the split half correlation coefficient 0.91. The cutoff score of 13/14 provided the highest sum of sensitivity and specificity level. The sensitivity of this cutoff score was 0.78 and specificity 0.85, while PPV was 0.84 and NPV 0.79. The area under the curve value in the ROC analysis was 0.891. Sensitivity and specificity analysis showed that cutoff scores of 8/9 or 9/10 could be useful for screening and 14/15 or 15/16 for diagnostic purposes. This study showed that the 30 item GDS, with its high discriminant validity, internal consistency, and reasonably clear cutoff scores, could be a useful screening or diagnostic self rated depression scale in patients with PD.
本研究的目的是调查30项老年抑郁量表(GDS)自评版本在帕金森病(PD)抑郁筛查和诊断中的可靠性和有效性。研究样本包括109名因运动障碍入住门诊的非痴呆型PD患者。根据《精神疾病诊断与统计手册》第四版(DSM-IV)标准进行抑郁的参考诊断。研究了总量表的判别效度和内部一致性。计算了不同临界值的敏感性、特异性、阳性和阴性预测值(PPV和NPV)。还进行了受试者工作特征(ROC)分析。样本包括56名有抑郁症状的患者和53名无抑郁症状的患者。在判别效度分析中,有抑郁症状的受试者的GDS总分均值显著高于无抑郁症状的受试者。克朗巴哈系数(Cronbach's alpha)为0.92,分半相关系数为0.91。临界值13/14的敏感性和特异性之和最高。该临界值的敏感性为0.78,特异性为0.85,PPV为0.84,NPV为0.79。ROC分析中的曲线下面积值为0.891。敏感性和特异性分析表明,临界值8/9或9/10可用于筛查,14/15或15/16可用于诊断。本研究表明,30项GDS具有较高的判别效度、内部一致性和合理明确的临界值,可作为PD患者有用的自评抑郁筛查或诊断量表。