Center for Health Outcomes Research, United BioSource Corporation, Bethesda, MD 20814, USA.
Int J Methods Psychiatr Res. 2010 Dec;19(4):223-32. doi: 10.1002/mpr.323. Epub 2010 Aug 18.
The aim of the current study was to identify and evaluate cutoffs for mild, moderate, and severe ranges of Hamilton Anxiety Rating Scale (HAM-A) scores. Data were from a four-week randomized trial of treatment for generalized anxiety disorder. Measures included the HAM-A, SF-36, Hospital Anxiety and Depression Scale (HADS), and Clinical Global Impressions of Severity (CGI-S) scale. HAM-A cutoffs were identified based on literature review, expert panel input, and MANOVA models. The optimal cutoff set was evaluated based on association with clinician CGI-S ratings. The sample included 144 patients (56.3% female; 73.6% white; mean age = 35.7 years; mean baseline HAM-A score = 23.7). The optimal HAM-A score ranges were: mild anxiety = 8-14; moderate = 15-23; severe ≥ 24 (scores ≤ 7 were considered to represent no/minimal anxiety). Analysis of variance (ANOVA) models found statistically significant differences among these groups in the SF-36 and HADS. The HAM-A severity ranges closely corresponded to clinicians' CGI-S ratings. The study represents the first step towards developing severity ranges for the HAM-A. These cutoffs should be used with caution and validated in larger samples. If the proposed cutoffs are accepted for general use, they could make results more meaningful and interpretable for researchers, clinicians, and patients.
本研究旨在确定和评估汉密尔顿焦虑量表(HAM-A)评分轻度、中度和重度范围的截断值。数据来自广泛性焦虑障碍四周随机治疗试验。测量包括 HAM-A、SF-36、医院焦虑和抑郁量表(HADS)和临床总体印象严重度量表(CGI-S)。HAM-A 截断值基于文献回顾、专家小组意见和 MANOVA 模型确定。最优截断值集基于与临床医生 CGI-S 评分的关联进行评估。样本包括 144 名患者(56.3%为女性;73.6%为白人;平均年龄为 35.7 岁;基线 HAM-A 平均得分为 23.7)。最优 HAM-A 评分范围为:轻度焦虑=8-14;中度=15-23;重度≥24(得分≤7 被认为代表无/轻度焦虑)。方差分析(ANOVA)模型发现这些组在 SF-36 和 HADS 中的差异具有统计学意义。HAM-A 的严重程度范围与临床医生的 CGI-S 评分密切相关。该研究代表了为 HAM-A 制定严重程度范围的第一步。这些截断值应谨慎使用,并在更大的样本中进行验证。如果接受提议的截断值用于一般用途,它们可以使研究人员、临床医生和患者的结果更有意义和可解释。
Int J Methods Psychiatr Res. 2010-8-18
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