Gardner William, Lucas Amanda, Kolko David J, Campo John V
Drs. Gardner and Campo and Ms. Lucas are with the Center for Innovation in Pediatric Practice, Columbus Children's Research Institute and the Departments of Pediatrics and Psychiatry at The Ohio State University; and Dr. Kolko is with the Department of Psychiatry at the University of Pittsburgh Medical Center.
Drs. Gardner and Campo and Ms. Lucas are with the Center for Innovation in Pediatric Practice, Columbus Children's Research Institute and the Departments of Pediatrics and Psychiatry at The Ohio State University; and Dr. Kolko is with the Department of Psychiatry at the University of Pittsburgh Medical Center.
J Am Acad Child Adolesc Psychiatry. 2007 May;46(5):611-618. doi: 10.1097/chi.0b013e318032384b.
To validate the 17-item version of the Pediatric Symptom Checklist (PSC-17) as a screen for common pediatric mental disorders in primary care.
Patients were 269 children and adolescents (8-15 years old) whose parents completed the PSC-17 in primary care waiting rooms. Children were later assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL). The PSC-17's subscales were compared with K-SADS-PL diagnoses and measures of anxiety, depression, general psychopathology, functioning, and impairment.
In receiver operating characteristics analyses, the PSC-17 subscales performed as well as competing screens (Child Depression Inventory, the parent and child Screens for Child Anxiety-Related Disorders) and Child Behavior Checklist subscales (Aggressive, Anxious-Depressed, Attention, Externalizing, Internalizing, and Total) in predicting diagnoses of attention-deficit/hyperactivity disorder, externalizing disorders, and depression (area under the curve > or =0.80). The instrument was less successful with anxiety (area under the curve = 0.68). None of the screens were highly sensitive, many were insensitive, and all would have low positive predictive value in low-risk primary care populations.
The PSC-17 and its subscales are briefer than alternative questionnaires, but performed as well as those instruments in detecting common mental disorders in primary care. Continued research is needed to develop brief yet sensitive assessment instruments appropriate for primary care.
验证17项版儿童症状清单(PSC - 17)作为基层医疗中常见儿童精神障碍筛查工具的有效性。
研究对象为269名儿童和青少年(8 - 15岁),其父母在基层医疗候诊室完成了PSC - 17的填写。随后使用学龄儿童情感障碍和精神分裂症评定量表(目前和终生版,K - SADS - PL)对这些儿童进行评估。将PSC - 17的分量表与K - SADS - PL诊断结果以及焦虑、抑郁、一般精神病理学、功能和损害的测量结果进行比较。
在接受者操作特征分析中,PSC - 17分量表在预测注意缺陷/多动障碍、外化障碍和抑郁诊断方面的表现与其他竞争筛查工具(儿童抑郁量表、儿童焦虑相关障碍父母和儿童筛查量表)以及儿童行为检查表分量表(攻击性行为、焦虑抑郁、注意力、外化、内化和总分)相当(曲线下面积≥0.80)。该工具在焦虑方面的表现较差(曲线下面积 = 0.68)。所有筛查工具的敏感性均不高,许多工具不敏感,并且在低风险基层医疗人群中所有工具的阳性预测值都较低。
PSC - 17及其分量表比其他问卷更简短,但在基层医疗中检测常见精神障碍方面的表现与那些工具相当。需要继续开展研究以开发适合基层医疗的简短且敏感的评估工具。