Donker Tara, van Straten Annemieke, Marks Isaac, Cuijpers Pim
Department of Clinical Psychology,VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
J Med Internet Res. 2009 Jul 24;11(3):e19. doi: 10.2196/jmir.1134.
The advent of Internet-based self-help systems for common mental disorders has generated a need for quick ways to triage would-be users to systems appropriate for their disorders. This need can be met by using brief online screening questionnaires, which can also be quickly used to screen patients prior to consultation with a GP.
To test and enhance the validity of the Web Screening Questionnaire (WSQ) to screen for: depressive disorder, alcohol abuse/dependence, GAD, PTSD, social phobia, panic disorder, agoraphobia, specific phobia, and OCD.
A total of 502 subjects (aged 18 - 80) answered the WSQ and 9 other questionnaires on the Internet. Of these 502, 157 were assessed for DSM-IV-disorders by phone in a WHO Composite International Diagnostic Interview with a CIDI-trained interviewer.
Positive WSQ "diagnosis" had significantly (P < .001) higher means on the corresponding validating questionnaire than negative WSQ "diagnosis". WSQ sensitivity was 0.72 - 1.00 and specificity was 0.44 - 0.77 after replacing three items (GAD, OCD, and panic) and adding one question for specific phobia. The Areas Under the Curve (AUCs) of the WSQ's items with scaled responses were comparable to AUCs of longer questionnaires.
The WSQ screens appropriately for common mental disorders. While the WSQ screens out negatives well, it also yields a high number of false positives.
基于互联网的常见精神障碍自助系统的出现,使得需要快速将潜在用户分流到适合其疾病的系统中。使用简短的在线筛查问卷可以满足这一需求,这些问卷也可在患者与全科医生会诊前快速用于筛查。
测试并提高网络筛查问卷(WSQ)对抑郁症、酒精滥用/依赖、广泛性焦虑症、创伤后应激障碍、社交恐惧症、惊恐障碍、广场恐惧症、特定恐惧症和强迫症的筛查效度。
共有502名年龄在18至80岁之间的受试者在互联网上回答了WSQ和其他9份问卷。在这502名受试者中,157人通过电话接受了由经过CIDI培训的访谈员进行的世界卫生组织综合国际诊断访谈,以评估其DSM-IV疾病。
与WSQ“诊断”为阴性相比,WSQ“诊断”为阳性在相应的效度验证问卷上的平均分显著更高(P <.001)。在替换三个项目(广泛性焦虑症、强迫症和惊恐障碍)并添加一个关于特定恐惧症的问题后,WSQ的敏感性为0.72 - 1.00,特异性为0.44 - 0.77。具有量表反应的WSQ项目的曲线下面积(AUC)与较长问卷的AUC相当。
WSQ能对常见精神障碍进行适当筛查。虽然WSQ能很好地筛出阴性,但也会产生大量假阳性结果。