Department of Psychiatry, Sleep Assessment Unit, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong.
Sleep Med. 2010 Jan;11(1):43-8. doi: 10.1016/j.sleep.2009.06.008. Epub 2009 Nov 30.
There are limited screening instruments for diagnosis of REM sleep behavior disorder (RBD) and none for quantifying the severity of disease. We aimed to validate a 13-item self-reported RBD questionnaire (RBDQ-HK) for diagnostic and monitoring purposes.
Based on ICSD-II and our previous clinical and empirical work, the RBDQ-HK questionnaire was designed and administered in patients attending university-affiliated sleep clinic and psychiatric out-patient clinic, and subjects from the general population. ROC curve and exploratory factor analysis were employed to evaluate the scale, which had a score ranging from 0 to 100.
One hundred and seven RBD patients [mean age 62.6 (15.5) years; male 70.1%] and 107 control subjects [mean age 55.3 (9.0) years, male 57.9%] completed the questionnaire. The diagnoses of all the study subjects were independently ascertained by clinical interview and PSG. RBD patients had a significantly higher total RBDQ-HK score [mean (s.d.): 32.1 (16.1), range 3-71] than the control group [9.5 (10.2), range 0-55] (p<0.005). The RBDQ-HK demonstrated robust psychometric properties with moderate sensitivity (82.2%), specificity (86.9%), positive predictive value (PPV; 86.3%), and negative predictive value (NPV; 83.0%), high internal consistency and test-retest reliability. Exploratory factor analysis revealed two components (dream-related and behavioral factors) that corresponded to the essential clinical features of RBD. The best cut-off for total score (range 0-100) was at 18/19 and the best cut-off for factor 2 (behavioral factors including sleep talking, shouting, limb movements and sleep-related injuries, range 0-70) was at 7/8.
The RBDQ-HK has satisfactory validity and reliability as a measure of clinical RBD symptoms and severity. It may serve as an effective tool for diagnosis and evaluation of the disease course to facilitate future clinical and research studies.
目前用于 REM 睡眠行为障碍（RBD）诊断的筛查工具有限，且尚无用于量化疾病严重程度的工具。本研究旨在验证一种用于诊断和监测目的的 13 项自评 RBD 问卷（RBDQ-HK）。
基于 ICSD-II 以及我们之前的临床和实证工作，设计了 RBDQ-HK 问卷，并在参加大学附属睡眠诊所和精神科门诊的患者以及普通人群中进行了调查。采用 ROC 曲线和探索性因子分析来评估该量表，量表评分范围为 0 至 100。
107 例 RBD 患者[平均年龄 62.6（15.5）岁；男性占 70.1%]和 107 例对照者[平均年龄 55.3（9.0）岁，男性占 57.9%]完成了问卷。所有研究对象的诊断均通过临床访谈和 PSG 独立确定。与对照组相比，RBD 患者的总 RBDQ-HK 评分[平均值（标准差）：32.1（16.1），范围 3-71]明显更高（p<0.005）。RBDQ-HK 具有良好的心理测量学特性，具有中等的灵敏度（82.2%）、特异性（86.9%）、阳性预测值（86.3%）和阴性预测值（83.0%），具有较高的内部一致性和重测信度。探索性因子分析显示，两个分量（与梦境相关和行为因素）与 RBD 的基本临床特征相对应。总分（范围 0-100）的最佳截断值为 18/19，因子 2（包括说梦话、大喊大叫、肢体运动和与睡眠相关的损伤等行为因素）的最佳截断值为 7/8。
RBDQ-HK 作为一种评估 RBD 临床症状和严重程度的工具，具有良好的有效性和可靠性。它可能成为诊断和评估疾病过程的有效工具，以促进未来的临床和研究。
