Bennett H E, Thomas S A, Austen R, Morris A M S, Lincoln N B
School of Psychology, University of Nottingham, UK.
Br J Clin Psychol. 2006 Sep;45(Pt 3):367-76. doi: 10.1348/014466505x58277.
There are few validated measures to assess mood in stroke patients and even fewer suitable for all stroke patients, including those with communication problems. The aim of this study was to compare the Stroke Aphasic Depression Questionnaire Hospital version (SADQ-H), Signs of Depression Scale (SODS), Visual Analogue Mood Scale (VAMS) and Visual Analogue Self-esteem Scale (VASES) in screening for mood problems after stroke.
Fifty healthy older adults and 100 stroke patients in hospital completed the VAMS and VASES. A nurse completed the SADQ-H and SODS in relation to the stroke patients. A relative/carer completed the SADQ-H and SODS in relation to the healthy older adults. Those without communication problems also completed the Hospital Anxiety and Depression Scale (HADS).
The internal consistency of the scales was low in healthy older adults. In stroke patients the internal consistency of the SADQ-H, VAMS, and VASES was high (alpha = .71-.84) but that of the SODS was low (alpha = .53). In healthy older adults, correlations between the HADS and the VAMS and VASES were high but low between the HADS and SADQ-H and SODS. In stroke patients, the HADS depression scale correlated significantly with all the scales (0.35-0.55) but only the SADQ-H 10, VAMS, and VASES were significantly correlated with the HADS anxiety scale (0.40-0.52). Appropriate cut-offs were found for the SADQ-H (17/18), SADQ-H 10 (5/6), SODS (1/2), and VAMS 'sad' item (22/23) in comparison to depression on the HADS. No appropriate cut-offs were identified in comparison to anxiety on the HADS.
The SADQ-H, SADQ-H10 and SODS were all appropriate for screening for possible depression after stroke but not for screening for possible anxiety. The SADQ-H 10 had greater internal consistency and higher sensitivity and specificity than the SODS and is shorter than the SADQ-H. It was also significantly correlated with both the anxiety and depression scales of the HADS. The SADQ-H 10 was therefore recommended as the most appropriate for screening purposes. The VAMS and VASES provided no clear cut-offs for use in screening but scores were highly correlated with the HADS. They are therefore more suitable for assessing severity of low mood rather than for screening purposes. The cut-offs identified need further validation in an independent sample of stroke patients, including a higher proportion with low mood.
用于评估卒中患者情绪的有效测量方法很少，适用于所有卒中患者（包括存在沟通问题的患者）的测量方法更少。本研究的目的是比较卒中失语抑郁问卷医院版（SADQ-H）、抑郁症状量表（SODS）、视觉模拟情绪量表（VAMS）和视觉模拟自尊量表（VASES）在筛查卒中后情绪问题方面的效果。
50名健康老年人和100名住院卒中患者完成了VAMS和VASES。一名护士针对卒中患者完成了SADQ-H和SODS。一名亲属/照料者针对健康老年人完成了SADQ-H和SODS。没有沟通问题的患者还完成了医院焦虑抑郁量表（HADS）。
健康老年人中这些量表的内部一致性较低。在卒中患者中，SADQ-H、VAMS和VASES的内部一致性较高（α = 0.71 - 0.84），但SODS的内部一致性较低（α = 0.53）。在健康老年人中，HADS与VAMS和VASES之间的相关性较高，但HADS与SADQ-H和SODS之间的相关性较低。在卒中患者中，HADS抑郁量表与所有量表均显著相关（0.35 - 0.55），但只有SADQ-H 10、VAMS和VASES与HADS焦虑量表显著相关（0.40 - 0.52）。与HADS上的抑郁相比，发现了SADQ-H（17/18）、SADQ-H 10（5/6）、SODS（1/2）和VAMS“悲伤”项目（22/23）的合适临界值。与HADS上的焦虑相比，未确定合适的临界值。
SADQ-H、SADQ-H10和SODS均适用于筛查卒中后可能的抑郁，但不适用于筛查可能的焦虑。SADQ-H 10比SODS具有更高的内部一致性、更高的敏感性和特异性，且比SADQ-H更短。它还与HADS的焦虑和抑郁量表均显著相关。因此，推荐SADQ-H 10作为最适合筛查目的的量表。VAMS和VASES在筛查中未提供明确的临界值，但得分与HADS高度相关。因此，它们更适合评估情绪低落的严重程度而非用于筛查目的。所确定的临界值需要在一个独立的卒中患者样本中进一步验证，包括情绪低落比例更高的样本。
