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基层医疗中用于识别老年期广泛性焦虑症的自我报告测量方法的比较

Comparison of self-report measures for identifying late-life generalized anxiety in primary care.

作者信息

Webb Sarah A, Diefenbach Gretchen, Wagener Paula, Novy Diane M, Kunik Mark, Rhoades Howard M, Stanley Melinda A

机构信息

Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 200 Holcombe Boulevard, Houston, TX 77030, USA.

出版信息

J Geriatr Psychiatry Neurol. 2008 Dec;21(4):223-31. doi: 10.1177/0891988708324936.

Abstract

This study evaluated the Penn State Worry Questionnaire, Penn State Worry Questionnaire-Abbreviated, and the Generalized Anxiety Disorder Questionnaire-IV for identifying generalized anxiety disorder in older medical patients. Participants were 191 of 281 patients screened for a clinical trial evaluating cognitive-behavior treatment, n = 110 with generalized anxiety disorder, 81 without. Participants completed the Penn State Worry Questionnaire and Generalized Anxiety Disorder Questionnaire-IV at pretreatment. Kappa coefficients estimated agreement with the Structured Clinical Interview for Diagnosis. Receiver operating characteristic curves compared sensitivity and specificity of self-report measures. The Penn State Worry Questionnaire (cutoff = 50) provided the strongest prediction of generalized anxiety disorder (sensitivity, 76%; specificity, 73%; 75% correctly classified; kappa = .49. Item 2 of the Generalized Anxiety Disorder Questionnaire-IV demonstrated comparable accuracy. The Penn State Worry Questionnaire, Generalized Anxiety Disorder Questionnaire-IV, and briefer versions of these measures may be useful in identifying late-life generalized anxiety disorder in medical settings.

摘要

本研究评估了宾夕法尼亚州立大学忧虑问卷、宾夕法尼亚州立大学忧虑问卷简版以及广泛性焦虑障碍问卷第四版在识别老年内科患者广泛性焦虑障碍方面的作用。在一项评估认知行为治疗的临床试验中,从281名筛查患者中选取了191名参与者,其中110名患有广泛性焦虑障碍,81名未患。参与者在治疗前完成了宾夕法尼亚州立大学忧虑问卷和广泛性焦虑障碍问卷第四版。kappa系数用于评估与《结构化临床诊断访谈》的一致性。通过绘制受试者工作特征曲线来比较自我报告量表的敏感性和特异性。宾夕法尼亚州立大学忧虑问卷(临界值 = 50)对广泛性焦虑障碍的预测能力最强(敏感性为76%;特异性为73%;75%分类正确;kappa = 0.49)。广泛性焦虑障碍问卷第四版的第2项显示出相当的准确性。宾夕法尼亚州立大学忧虑问卷、广泛性焦虑障碍问卷第四版以及这些量表的简短版本可能有助于在医疗环境中识别老年期广泛性焦虑障碍。

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