Adler Mats, Liberg Benny, Andersson Stig, Isacsson Göran, Hetta Jerker
Affective Disorders Clinic M59, Pyschiatry Southwest, Karolinska University Hospital Huddinge, SE-14186 Stockholm, Sweden.
Nord J Psychiatry. 2008;62(2):130-5. doi: 10.1080/08039480801960354.
Most rating scales for affective disorders measure either depressive or hypomanic/manic symptoms and there are few scales for hypomania/mania in a self-rating format. We wanted to develop and validate a self-rating scale for comprehensive assessment of depressive, manic/hypomanic and mixed affective states. We developed an 18-item self-rating scale starting with the DSM-IV criteria for depression and mania, with subscales for depression and mania. The scale was evaluated on 61 patients with a diagnosis of affective disorder, predominantly bipolar disorder type I, using Montgomery-Asberg Depression Rating Scale (MADRS), Hypomania Interview Guide-Clinical version (HIGH-C) and Clinical Global Impression scale, modified for bipolar patients (CGI-BP) as reference scales. Internal consistency of the scale measured by Cronbach's alpha was 0.89 for the depression subscale and 0.91 for the mania subscale. Spearman's correlation coefficients (two-tailed) between the depression subscale and MADRS was 0.74 (P<0.01) and between mania subscale and HIGH-C 0.80 (P<0.01). A rotated factor analysis of the scale supported the separation of symptoms in the mania and depression subscale. We established that the self-rating scales sensitivity to identify mixed states, with combined cut-offs on the MADRS and HIGH-C as reference, was 0.90 with a specificity of 0.71. The study shows that the Affective Self Rating Scale is highly correlated with ratings of established interview scales for depression and mania and that it may aid the detection of mixed affective states.
大多数情感障碍评定量表测量的是抑郁症状或轻躁狂/躁狂症状，很少有自评形式的轻躁狂/躁狂量表。我们希望开发并验证一种自评量表，用于综合评估抑郁、躁狂/轻躁狂及混合情感状态。我们从抑郁和躁狂的DSM-IV标准出发，开发了一个包含18个条目的自评量表，设有抑郁和躁狂分量表。该量表在61例诊断为情感障碍的患者中进行评估，这些患者主要为I型双相情感障碍，使用蒙哥马利-艾斯伯格抑郁评定量表（MADRS）、轻躁狂访谈指南临床版（HIGH-C）以及为双相情感障碍患者修改的临床总体印象量表（CGI-BP）作为参照量表。通过克朗巴赫α系数测量，该量表抑郁分量表的内部一致性为0.89，躁狂分量表为0.91。抑郁分量表与MADRS之间的斯皮尔曼相关系数（双侧）为0.74（P<0.01），躁狂分量表与HIGH-C之间为0.80（P<0.01）。对该量表进行的旋转因子分析支持了躁狂和抑郁分量表中症状的分离。我们确定，以MADRS和HIGH-C的联合临界值为参照，该自评量表识别混合状态的敏感性为0.90，特异性为0.71。研究表明，情感自评量表与既定的抑郁和躁狂访谈评定量表高度相关，可能有助于检测混合情感状态。
