相对压力量表得分较高，这是痴呆症患者家庭照料者可能存在精神障碍的一个指标。

High score on the Relative Stress Scale, a marker of possible psychiatric disorder in family carers of patients with dementia.

作者信息

Ulstein Ingun, Wyller Torgeir Bruun, Engedal Knut

机构信息

Norwegian Centre for Dementia Research, Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway.

出版信息

Int J Geriatr Psychiatry. 2007 Mar;22(3):195-202. doi: 10.1002/gps.1660.

DOI:10.1002/gps.1660

PMID:17044130

Abstract

OBJECTIVE

To compare the scores on the Relative Stress Scale (RSS) with those on the General Health Questionnaire (GHQ) and the Geriatric Depression Scale (GDS), and to establish a cut-off score for RSS in order to distinguish carers with symptoms of psychiatric disorders from those without.

METHODS

One hundred and ninety-four carers of 194 patients suffering from dementia according to ICD-10 were included in the study. Burden of care was assessed by the 15-items RSS, and psychiatric symptoms by means of the GHQ-30 and the 30-items GDS. A case score above 5 on GHQ and above 13 on GDS were used to define carers with probable psychiatric morbidity. Sensitivity (SS), specificity (SP), accuracy and likelihood ratio for a positive test (LR+) were calculated for different cut-points of the RSS.

RESULTS

Fifty-six percent of the carers had a GHQ score above 5, and 22% had a GDS score above 13. A two-step cluster analysis using 192 of the 194 carers, identified three groups of carers; a low risk group for psychiatric morbidity (LRG), 82 carers with GHQ < or = 5 and GDS < or = 13; a medium risk group (MRG), 69 carers with GHQ > 5 and GDS < or = 13; and a high-risk group (HRG), 40 carers with GHQ > 5 and GDS > 13. The optimal RSS cut-off to distinguish between the LRG and the others was > 23 (SS 0.72, SP 0.82, accuracy 0.76, LR + 4.0), whereas the optimal cut-off to separate the HRG from the others was >30 (SS 0.74, SP 0.87, accuracy 0.84, LR + 5.7).

CONCLUSION

The RSS is a useful instrument to stratify carers according to their risk of psychiatric morbidity.

摘要

目的

比较相对压力量表（RSS）得分与一般健康问卷（GHQ）及老年抑郁量表（GDS）得分，并确定RSS的临界值，以区分有精神障碍症状的照料者和无精神障碍症状的照料者。

方法

根据国际疾病分类第10版（ICD - 10），194名痴呆患者的194名照料者纳入本研究。采用15项RSS评估照料负担，通过GHQ - 30和30项GDS评估精神症状。GHQ得分高于5分且GDS得分高于13分被用来定义可能存在精神疾病的照料者。针对RSS的不同切点计算敏感度（SS）、特异度（SP）、准确率和阳性试验似然比（LR +）。

结果

56%的照料者GHQ得分高于5分，22%的照料者GDS得分高于13分。对194名照料者中的192名进行两步聚类分析，确定了三组照料者；精神疾病低风险组（LRG），82名照料者GHQ≤5且GDS≤13；中度风险组（MRG），69名照料者GHQ＞5且GDS≤13；高风险组（HRG），40名照料者GHQ＞5且GDS＞13。区分LRG与其他组的最佳RSS临界值＞23（SS 0.72，SP 0.82，准确率0.76，LR + 4.0），而将HRG与其他组区分开的最佳临界值＞30（SS 0.74，SP 0.87，准确率0.84，LR + 5.7）。