Department of Clinical Psychology, EMGO Institute, VU University Amsterdam, The Netherlands.
Psychiatry Res. 2010 Mar 30;176(1):45-50. doi: 10.1016/j.psychres.2009.01.012. Epub 2010 Jan 13.
The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10, extended with five additional questions focusing on core anxiety symptoms, and were evaluated with the WHO Composite International Diagnostic Interview (CIDI lifetime version 2.1) to assess DSM-IV disorders (major depressive disorder, dysthymia, generalized anxiety disorder, social phobia, panic disorder, agoraphobia). Reliability (Cronbach's alpha) of the Dutch K10 was 0.94. Based on Receiver Operating Characteristics (ROC) analysis, the area under the curve (AUC) for the K10 for any depressive and/or anxiety disorder was found to be 0.87. The extended questions on the EK10 significantly improved the detection of anxiety disorders in particular. With a cut-off point of 20, the K10 reached a sensitivity of 0.80 and a specificity of 0.81 for any depressive and/or anxiety disorder. For the EK10, a cut-off point of 20 and/or at least one positive answer on the additional questions provided a sensitivity of 0.90 and a specificity of 0.75 for detecting any depressive and/or anxiety disorder. The Dutch version of the K10 is appropriate for screening depressive disorders in primary care, while the EK10 is preferred in screening for both depressive and anxiety disorders.
本研究旨在验证荷兰版 Kessler-10（K10）及其扩展版（EK10）在初级保健中筛查抑郁和焦虑障碍的有效性。数据来自荷兰抑郁和焦虑研究（NESDA）的 1607 名参与者（18 至 65 岁，68.8%为女性），他们从 65 名全科医生中招募而来。参与者完成了 K10，并扩展了五个额外的问题，重点关注核心焦虑症状，并用世界卫生组织复合国际诊断访谈（CIDI 终身版 2.1）进行评估，以评估 DSM-IV 障碍（重性抑郁障碍、心境恶劣、广泛性焦虑障碍、社交恐惧症、惊恐障碍、广场恐怖症）。荷兰版 K10 的可靠性（Cronbach's alpha）为 0.94。基于受试者工作特征（ROC）分析，K10 对任何抑郁和/或焦虑障碍的曲线下面积（AUC）为 0.87。EK10 上的扩展问题特别提高了焦虑障碍的检测能力。K10 的截断值为 20 时，对任何抑郁和/或焦虑障碍的敏感性为 0.80，特异性为 0.81。对于 EK10，截断值为 20 和/或附加问题上至少有一个阳性答案可提供对任何抑郁和/或焦虑障碍的检测敏感性为 0.90，特异性为 0.75。荷兰版 K10 适合在初级保健中筛查抑郁障碍，而 EK10 更适合筛查抑郁和焦虑障碍。
