Roberts R E, Lewinsohn P M, Seeley J R
Social Psychiatry Research Group, University of Texas Health Science Center, Houston 77225.
J Am Acad Child Adolesc Psychiatry. 1991 Jan;30(1):58-66. doi: 10.1097/00004583-199101000-00009.
The ability of two depression scales, the Center for Epidemiologic Studies Depression Scale (CES-D) and the Beck Depression Inventory (BDI), to identify cases of DSM-III-R major depression and dysthymia was investigated in a large, community sample of high school students. Receiver operating characteristics analyses indicated that different caseness criteria should be used for boys and girls for both the CES-D and the BDI. Internal consistency-reliability and sensitivity and specificity for detecting current episodes of current depression and dysthymia were adequate and comparable to those found with adult samples, but both the CES-D and the BDI generated many false positives. Multiple screening using the "serial" strategy increased positive predictive power substantially for both the CES-D and the BDI, whereas using the "parallel" strategy had very little effect on the efficacy of the two screeners. The results indicate that neither the BDI nor the CES-D should be used by themselves as methods for case ascertainment in either epidemiological or experimental studies, although the BDI does function somewhat better than the CES-D as a screener.
在一个规模庞大的高中生社区样本中，对两种抑郁量表——流行病学研究中心抑郁量表（CES-D）和贝克抑郁量表（BDI）——识别《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中重度抑郁症和恶劣心境病例的能力进行了调查。受试者工作特征分析表明，对于CES-D和BDI，男孩和女孩应使用不同的病例判定标准。检测当前抑郁症和恶劣心境发作的内部一致性信度以及敏感性和特异性是足够的，并且与在成人样本中发现的情况相当，但CES-D和BDI都产生了许多假阳性结果。使用“串联”策略进行多次筛查，显著提高了CES-D和BDI的阳性预测能力，而使用“并联”策略对这两种筛查工具的效能几乎没有影响。结果表明，在流行病学或实验研究中，BDI和CES-D都不应该单独用作病例确诊方法，尽管BDI作为筛查工具的功能比CES-D稍好一些。
