Jeyabalan S, Kuruvilla A, Prasad J, Abraham S, Jacob K S
Christian Medical College, Vellore, India.
Aust Fam Physician. 2007 Nov;36(11):969-72.
Depression is a common mental health problem often seen in primary care. This study sought to determine the accuracy of five screening questions for diagnosing common mental disorders in a general practice clinic and to develop a risk score.
Three hundred and fifty patients not taking psychotropic drugs were evaluated using a combination of screening and confirmatory questions, a total symptom score, and a points system (employing multivariate statistical models) to quantify the ability of each question to detect a common mental disorder.
Different screening and confirmatory strategies resulted in different sensitivities and specificities. There was good agreement between the risk estimate produced by the point system and that produced directly by the multivariate models.
The point system developed to diagnose depression in the primary care setting is an alternative approach to currently available screening methods. It is easy to use but requires changes to the physician's approach to diagnostic certainty. The study needs to be replicated and the approach refined.
抑郁症是基层医疗中常见的心理健康问题。本研究旨在确定一般诊疗诊所中用于诊断常见精神障碍的五个筛查问题的准确性，并制定一个风险评分。
对350名未服用精神药物的患者进行评估，采用筛查和确诊问题相结合的方法、总症状评分以及积分系统（采用多变量统计模型）来量化每个问题检测常见精神障碍的能力。
不同的筛查和确诊策略导致了不同的敏感性和特异性。积分系统产生的风险估计值与多变量模型直接产生的风险估计值之间具有良好的一致性。
为基层医疗环境中诊断抑郁症而开发的积分系统是目前可用筛查方法的一种替代方法。它易于使用，但需要改变医生对诊断确定性的处理方式。该研究需要重复进行，方法也需要完善。
