Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
J Head Trauma Rehabil. 2010 Jan-Feb;25(1):23-30. doi: 10.1097/HTR.0b013e3181b4b6ab.
To compare spontaneous, interview-based, postconcussion symptom reporting to endorsement of symptoms on a standardized questionnaire.
Sixty-one patients referred to a concussion clinic following mild traumatic brain injury.
Patients recalled their current symptoms and problems via open-ended interview and then completed a structured postconcussion checklist.
Open-ended interview and the British Columbia Postconcussion Symptom Inventory (BC-PSI).
On average, patients endorsed 3.3 symptoms (SD = 1.9) during open-ended interview and 9.1 symptoms (SD = 3.2) on the BC-PSI (P < .001). Approximately 44% endorsed 4 or more symptoms during interview compared with 92% on the BC-PSI. The percentage of patients endorsing items on the BC-PSI compared with interview was significantly greater on all 13 items. It was common for patients to endorse symptoms as moderate-severe on the BC-PSI, despite not spontaneously reporting those symptoms during the interview.
Clinicians need to be cautious when interpreting questionnaires and be aware of the possibility of nonspecific symptom endorsement, symptom overendorsement, symptom expectations influencing symptom endorsement, and the nocebo effect.
比较自发的、基于访谈的、脑震荡后症状报告与在标准化问卷上对症状的认可。
61 名因轻度创伤性脑损伤而被转介到脑震荡诊所的患者。
患者通过开放式访谈回忆他们当前的症状和问题，然后完成一份结构化的脑震荡后检查表。
开放式访谈和不列颠哥伦比亚省脑震荡后症状清单（BC-PSI）。
平均而言，患者在开放式访谈中认可 3.3 种症状（SD = 1.9），在 BC-PSI 上认可 9.1 种症状（SD = 3.2）（P <.001）。在访谈中，约有 44%的患者认可 4 种或更多症状，而在 BC-PSI 上则有 92%的患者认可。与访谈相比，患者在 BC-PSI 上认可项目的百分比在所有 13 项上均显著更高。患者在 BC-PSI 上认可症状为中度-重度，尽管在访谈中并未自发报告这些症状，这种情况很常见。
临床医生在解释问卷时需要谨慎，并意识到可能存在非特异性症状认可、症状过度认可、症状期望影响症状认可以及反安慰剂效应的可能性。
