Perini Sarah J, Slade Tim, Andrews Gavin
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, Australia.
J Affect Disord. 2006 Feb;90(2-3):123-30. doi: 10.1016/j.jad.2005.10.011. Epub 2005 Dec 7.
The purpose of this study was to compare a newly developed screening measure of disability, the WHODAS II, to three established generic effectiveness measures in terms of its sensitivity to symptom change in people with anxiety disorders.
Patients who had undergone treatment for social phobia or panic disorder/agoraphobia at an anxiety disorders clinic were administered generic effectiveness measures and symptom measures before and after treatment. The design was naturalistic and observational. Data analysis included correlations between generic effectiveness and symptom measures; and effect size calculations regarding the ability of each generic effectiveness measure to discriminate between patients whose symptoms improved and patients whose symptoms did not improve over the course of treatment.
The WHODAS II was consistently the most sensitive generic effectiveness measure in its capacity to detect symptom changes in patients with social phobia. The SF-12 and K-10 also showed moderate sensitivity to symptom change. In the sample of patients with panic disorder/agoraphobia, the SF-12 was the most sensitive measure overall, closely followed by the K-10 and WHODAS II. The NCS Disability Days were the least sensitive to symptom change in both samples.
The WHODAS II is at least as sensitive as other generic effectiveness measures to anxiety symptom changes, and is particularly sensitive to changes in social anxiety symptoms. It may prove to be a valuable measurement tool for informing public health policy in relation to anxiety disorders.
本研究旨在比较一种新开发的残疾筛查工具——世界卫生组织残疾评定量表第二版(WHODAS II)与三种既定的通用疗效测量工具,看其对焦虑症患者症状变化的敏感性。
在一家焦虑症诊所接受社交恐惧症或惊恐障碍/场所恐惧症治疗的患者,在治疗前后接受通用疗效测量工具和症状测量工具的评估。研究设计为自然观察性研究。数据分析包括通用疗效测量工具与症状测量工具之间的相关性;以及计算每种通用疗效测量工具区分治疗过程中症状改善患者和症状未改善患者的能力的效应量。
在检测社交恐惧症患者症状变化的能力方面,WHODAS II始终是最敏感的通用疗效测量工具。简明健康调查量表(SF-12)和10项心理痛苦量表(K-10)对症状变化也表现出中等敏感性。在惊恐障碍/场所恐惧症患者样本中,SF-12总体上是最敏感的测量工具,紧随其后的是K-10和WHODAS II。国家疾病伤残调查残疾天数在两个样本中对症状变化最不敏感。
WHODAS II对焦虑症状变化的敏感性至少与其他通用疗效测量工具相同,对社交焦虑症状变化尤为敏感。它可能被证明是一种有价值的测量工具,可为焦虑症相关的公共卫生政策提供参考。