Thombs Brett D, Hudson Marie, Schieir Orit, Taillefer Suzanne S, Baron Murray
Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
Arthritis Rheum. 2008 Mar 15;59(3):438-43. doi: 10.1002/art.23329.
Reported rates of depressive symptoms in patients with systemic sclerosis (SSc) are high. No depression assessment tools, however, have been validated for patients with SSc. Our objective was to assess the internal consistency reliability, convergent validity, and structural/construct validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in patients with SSc.
We conducted a cross-sectional, multicenter study of 470 SSc patients. Internal consistency reliability was assessed with Cronbach's alpha and structural/construct validity with confirmatory factor analysis.
Internal consistency reliability was good for the overall CES-D scale (alpha = 0.88) and for its 4 factors (alpha = 0.67-0.88). Correlations of the CES-D total score were -0.73 with mental health, -0.36 with physical health, 0.41 with disability, and 0.44 with pain. The 4-factor model originally found in the general population and validated for patients with rheumatoid arthritis (depressed affect, somatic/vegetative, [lack of] positive affect, and interpersonal factors) fit the data well, as did a second-order version of the same model with an overarching depression factor that loaded onto each of the 4 first-order factors. The 4-factor model fit the SSc data better than alternative models.
Internal consistency reliability and convergent validity were good, the 4-factor structure reported in the general population was replicated, and a second-order model with an overarching depression factor fit well. These findings indicate that the CES-D is a valid and reliable measure of depressive symptoms for patients with SSc.
系统性硬化症（SSc）患者中报告的抑郁症状发生率较高。然而，尚无针对SSc患者的抑郁评估工具得到验证。我们的目的是评估流行病学研究中心抑郁量表（CES-D）在SSc患者中的内部一致性信度、收敛效度以及结构/构想效度。
我们对470例SSc患者进行了一项横断面、多中心研究。用Cronbach's α评估内部一致性信度，用验证性因子分析评估结构/构想效度。
CES-D总量表（α = 0.88）及其4个因子（α = 0.67 - 0.88）的内部一致性信度良好。CES-D总分与心理健康的相关性为 -0.73，与身体健康的相关性为 -0.36，与残疾的相关性为0.41，与疼痛的相关性为0.44。最初在普通人群中发现并在类风湿关节炎患者中得到验证的4因子模型（抑郁情绪、躯体/植物神经症状、[缺乏]积极情绪和人际因素）与数据拟合良好，具有一个总体抑郁因子并加载到4个一阶因子中的同一模型的二阶版本也是如此。4因子模型比其他模型更适合SSc数据。
内部一致性信度和收敛效度良好，复制了普通人群中报告的4因子结构，且具有总体抑郁因子的二阶模型拟合良好。这些发现表明，CES-D是一种用于评估SSc患者抑郁症状的有效且可靠的测量工具。
