Schmidtke Klaus, Metternich Birgitta
Center for Geriatric Medicine and Gerontology Freiburg, University Hospital Freiburg, Germany.
J Psychosom Res. 2009 Sep;67(3):245-51. doi: 10.1016/j.jpsychores.2009.04.005. Epub 2009 Jul 10.
Functional memory disorder (FMD) is an acquired nonorganic condition characterized by significant deficits of memory and concentration that occur in daily living and are thought to be caused by psychosocial burden and distress. FMD is an important differential diagnosis to organic mild cognitive impairment. Although frequent, FMD is under-researched and mostly diagnosed by exclusion rather than by positive diagnostic criteria. Diagnosis can be difficult in patients with borderline cognitive test results.
To aid in the clinical diagnosis and monitoring of FMD, a short 10-item FMD questionnaire and a 22-item FMD rating scale were developed. They asses a range of memory complaints thought to be indicative of FMD. Each of the two inventories was applied and evaluated in a separate study involving FMD patients and control groups. In one study, the natural course of FMD was observed. In the other study, the effect of a therapeutic intervention was assessed. Here, we present the full text of the two FMD inventories and data on test quality characteristics.
Internal consistency and split-half-reliability indices were excellent throughout. At suitable cutoffs, both versions discriminated FMD patients from control subjects with high accuracy. Both also demonstrated discriminant construct validity. Moreover, the long version demonstrated high test-retest reliability and convergent construct validity and proved to be sensitive to change.
The short version of the FMD inventory is a helpful tool in the clinical diagnosis of FMD. The longer version is suitable for monitoring of FMD severity in the context of therapeutic interventions and observational studies. To determine whether the inventories can discriminate FMD from organic mild cognitive impairment, further studies are required.
功能性记忆障碍(FMD)是一种后天性非器质性病症,其特征为日常生活中出现明显的记忆和注意力缺陷,被认为是由心理社会负担和困扰所致。FMD是器质性轻度认知障碍的重要鉴别诊断。尽管FMD很常见,但研究不足,大多通过排除法而非阳性诊断标准进行诊断。对于认知测试结果处于临界值的患者,诊断可能会很困难。
为辅助FMD的临床诊断和监测,开发了一份包含10个条目的简短FMD问卷和一份包含22个条目的FMD评定量表。它们评估了一系列被认为可指示FMD的记忆主诉。这两份量表分别在涉及FMD患者和对照组的单独研究中应用和评估。在一项研究中,观察了FMD的自然病程。在另一项研究中,评估了治疗干预的效果。在此,我们展示这两份FMD量表的全文以及测试质量特征数据。
整体内部一致性和分半信度指标都非常出色。在合适的临界值下,两个版本都能高精度地区分FMD患者和对照受试者。两者还都显示出判别结构效度。此外,较长版本显示出高重测信度和聚合结构效度,并且被证明对变化敏感。
FMD量表的简短版本是FMD临床诊断的有用工具。较长版本适用于在治疗干预和观察性研究中监测FMD的严重程度。要确定这些量表能否区分FMD和器质性轻度认知障碍,还需要进一步研究。