Sanchez-Villegas Almudena, Schlatter Javier, Ortuno Felipe, Lahortiga Francisca, Pla Jorge, Benito Silvia, Martinez-Gonzalez Miguel A
Department of Clinical Sciencies, University of Las Palmas de Gran Canaria, Spain.
BMC Psychiatry. 2008 Jun 17;8:43. doi: 10.1186/1471-244X-8-43.
Depression assessment in population studies is usually based on depressive symptoms scales. However, the use of scales could lead to the choice of an arbitrary cut-off point depending on the sample characteristics and on the patient diagnosis. Thus, the use of a medical diagnosis of depression could be a more appropriate approach.
To validate a self-reported physician diagnosis of depression using the Structured Clinical Interview for DSM-IV (SCID-I) as Gold Standard and to assess the factors associated to a valid self-reported diagnosis.
The SUN Project is a cohort study based on university graduates followed-up through postal questionnaires. The response to the question included in the questionnaire: Have you ever been diagnosed of depression by a physician? was compared to that obtained through the SCID-I applied by a psychiatrist or a clinical psychologist. The percentages of confirmed depression and non-depression were assessed for the overall sample and according to several characteristics. Logistic regression models were fitted to ascertain the association between different factors and a correct classification regarding depression status.
The percentage of confirmed depression was 74.2%; 95% confidence interval (95% CI) = 63.3-85.1. Out of 42 participants who did not report a depression diagnosis in the questionnaire, 34 were free of the disease (%confirmed non-depression = 81.1%; 95% CI = 69.1-92.9). The probability of being a true positive was higher among ex-smokers and non-smokers and among those overweight or obese but the differences were not statistically significant.
The validity of a self-reported diagnosis of depression in the SUN cohort is adequate. Thus, this question about depression diagnosis could be used in further investigations regarding this disease in this graduate cohort study.
在人群研究中，抑郁症评估通常基于抑郁症状量表。然而，量表的使用可能会导致根据样本特征和患者诊断选择任意的截断点。因此，使用抑郁症的医学诊断可能是一种更合适的方法。
以《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈（SCID-I）作为金标准，验证自我报告的医生抑郁症诊断，并评估与有效自我报告诊断相关的因素。
SUN项目是一项基于大学毕业生的队列研究，通过邮寄问卷进行随访。将问卷中“您是否曾被医生诊断为抑郁症？”这一问题的回答与精神科医生或临床心理学家应用SCID-I获得的回答进行比较。评估整个样本以及根据几个特征确定的确诊抑郁症和未患抑郁症的百分比。拟合逻辑回归模型以确定不同因素与抑郁症状态正确分类之间的关联。
确诊抑郁症的百分比为74.2%；95%置信区间（95%CI）=63.3-85.1。在问卷中未报告抑郁症诊断的42名参与者中，34人未患该病（确诊未患抑郁症的百分比=81.1%；95%CI=69.1-92.9）。前吸烟者和非吸烟者以及超重或肥胖者中真正阳性的概率较高，但差异无统计学意义。
SUN队列中自我报告的抑郁症诊断有效性足够。因此，关于抑郁症诊断的这个问题可用于该研究生队列研究中关于这种疾病的进一步调查。
