Pôle Rééducation-Réadaptation, CHU Dijon, Université de Bourgogne, 23 rue Gaffarel, Dijon, France.
Clin Rehabil. 2010 Mar;24(3):251-7. doi: 10.1177/0269215509346087. Epub 2010 Jan 22.
To assess the sensitivity to change of two depression scales for stroke patients: the Aphasic Depression Rating Scale (ADRS), which is a 9-item external assessment, and the Visual Analog Mood Scale (VAMS), which is a visual self-assessment scale.
Forty-nine stroke patients admitted to two rehabilitation units.
Symptoms of depression were assessed twice at a one-month interval (D0-D30) using the ADRS, the VAMS, and by a trained psychologist (PSY). Sensitivity to change was assessed by effect size and standardized response mean. A one-way ANOVA on ranks was performed to determine if the scales distinguished between deteriorated, stable and improved patient status. Spearman's correlation coefficient (r) was used to assess the relationship between changes in PSY and changes in the ADRS and the VAMS between D0 and D30.
Mean depression scores at D0 and D30 were 2.6 +/- 1.8 and 2.4 +/- 1.7 (ADRS/10), 3.1 +/- 2.9 and 3.0 +/- 3.2 (VAMS/10), 2.9 +/- 2.3 and 2.4 +/- 2.4 (PSY/10). Percentages of deteriorated, stable and improved patient status were 22%, 45% and 33% (ADRS); 41%, 22% and 37% (VAMS); and 20%, 41% and 39% (PSY). Changes in PSY correlated with the ADRS (r = 0.72, P<10( -6)) and the VAMS (r = 0.41, P<10(- 2)). The ADRS was better than the VAMS in terms of effect size, standardized response mean and ability to discriminate between deteriorated, stable and improved patient status. This result was partly due to the difficulty encountered by nine (19%) patients in understanding directions to complete the VAMS.
The ADRS is more sensitive than the VAMS for detecting changes in post-stroke depression. The VAMS is less appropriate in very cognitively impaired stroke patients.
评估两种用于脑卒中患者的抑郁量表的变化敏感性：失语性抑郁评定量表（ADRS），这是一个 9 项外部评估，以及视觉模拟情绪量表（VAMS），这是一个视觉自我评估量表。
49 名入住两个康复病房的脑卒中患者。
在一个月的间隔内（D0-D30）使用 ADRS、VAMS 和经过培训的心理学家（PSY）两次评估抑郁症状。通过效应大小和标准化反应均值来评估变化的敏感性。对等级进行单向方差分析，以确定量表是否能区分病情恶化、稳定和改善的患者。使用斯皮尔曼等级相关系数（r）评估 PSY 与 D0 至 D30 期间 ADRS 和 VAMS 的变化之间的关系。
D0 和 D30 时的平均抑郁评分分别为 2.6 +/- 1.8 和 2.4 +/- 1.7（ADRS/10）、3.1 +/- 2.9 和 3.0 +/- 3.2（VAMS/10）、2.9 +/- 2.3 和 2.4 +/- 2.4（PSY/10）。病情恶化、稳定和改善的患者比例分别为 22%、45%和 33%（ADRS）；41%、22%和 37%（VAMS）；20%、41%和 39%（PSY）。PSY 的变化与 ADRS（r = 0.72，P<10(-6)）和 VAMS（r = 0.41，P<10(-2)）相关。在效应大小、标准化反应均值和区分病情恶化、稳定和改善患者状态的能力方面，ADRS 优于 VAMS。这一结果部分归因于 9 名（19%）患者在理解完成 VAMS 指导方面遇到的困难。
ADRS 比 VAMS 更能检测脑卒中后抑郁的变化。VAMS 在认知功能严重受损的脑卒中患者中不太合适。
