Weintraub Daniel, Oehlberg Katherine A, Katz Ira R, Stern Matthew B
Department of Psychiatry, University of Pennsylvania, and the Parkinson's Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center 19104, USA.
Am J Geriatr Psychiatry. 2006 Feb;14(2):169-75. doi: 10.1097/01.JGP.0000192488.66049.4b.
The objective of this study was to compare the sensitivity, specificity, and diagnostic accuracy of the 15-item Geriatric Depression Scale (GDS-15) and the Hamilton Depression Rating Scale (HDRS) in patients with Parkinson disease (PD).
A convenience sample of 148 outpatients with idiopathic PD receiving specialty care completed the GDS-15 and were administered the HDRS and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID) depression module by a research psychiatrist or trained research assistant. Receiver-operating characteristic (ROC) curves were plotted for the GDS-15 and HDRS scores with a SCID diagnosis of a depressive disorder as the state variable.
Thirty-two subjects (22%) were diagnosed with a depressive disorder. The discriminant validity of the GDS-15 and HDRS were both high (ROC area under the curve: 0.92 and 0.91, respectively), with greatest dichotomization for the GDS-15 at a cutoff of 4/5 (87% accuracy, 88% sensitivity, 85% specificity) and the HDRS at a cutoff of 9/10 (83% accuracy, 88% sensitivity, 78% specificity).
The GDS-15 performs well as a screening instrument and in distinguishing depressed from nondepressed patients in PD. Its test characteristics are comparable to the HDRS. Because it is a brief instrument and can be self-administered, it is an excellent depression screening tool in this population.
本研究旨在比较15项老年抑郁量表(GDS - 15)和汉密尔顿抑郁量表(HDRS)在帕金森病(PD)患者中的敏感性、特异性和诊断准确性。
选取148名接受专科护理的特发性PD门诊患者作为便利样本,他们完成了GDS - 15量表,并由研究精神科医生或经过培训的研究助理对其进行HDRS量表测评以及《精神疾病诊断与统计手册》第四版(SCID)抑郁模块的结构化临床访谈。以SCID诊断的抑郁障碍作为状态变量,绘制GDS - 15和HDRS得分的受试者工作特征(ROC)曲线。
32名受试者(22%)被诊断为抑郁障碍。GDS - 15和HDRS的判别效度均较高(曲线下面积分别为0.92和0.91),GDS - 15在临界值为4/5时二分法效果最佳(准确率87%,敏感性88%,特异性85%),HDRS在临界值为9/10时二分法效果最佳(准确率83%,敏感性88%,特异性78%)。
GDS - 15作为一种筛查工具,在区分PD患者是否抑郁方面表现良好。其测试特征与HDRS相当。由于它是一种简短的工具且可自行施测,因此是该人群中优秀的抑郁筛查工具。