心肌梗死后患者中重度抑郁症的筛查：贝克抑郁自评量表 II 的操作特征。
Screening for major depression in post-myocardial infarction patients: operating characteristics of the Beck Depression Inventory-II.
机构信息
Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Int J Psychiatry Med. 2010;40(2):187-97. doi: 10.2190/PM.40.2.e.
OBJECTIVE
To assess the operating characteristics of the Beck-Depression Inventory-II (BDI-II) and the BDI-II cognitive subscale (BDI-II-cog) in screening for major depression (MDD) in post-myocardial infarction (MI) patients.
METHODS
Between October 2003 and July 2005, 131 post-MI patients admitted to an urban academic medical center completed the BDI-II and a semi-structured interview for depression within 72 hours of symptom onset. Sensitivity, specificity, positive and negative predictive values, overall correct classification, and likelihood ratios for various cutoff values on both scales were evaluated by comparing scores to interview diagnosis of MDD. Receiver-operator curves (ROC) were also calculated and area under the curve (AUC) measured.
RESULTS
The optimal cutoff value for the BDI-II was > or = 16, with a sensitivity of 88.2% and a specificity of 92.1%. Cutoff values of > or = 3 or > or = 4 were both acceptable for the BDI-II-cog (sensitivity = 88.2% and 82.4%, respectively; specificity = 81.6% and 88.6 %, respectively). AUC was 0.96 for the BDI-II and 0.89 for the cognitive subscale.
CONCLUSIONS
Effective depression screening is important in post-MI patients because of depression's independent association with morbidity and mortality following MI. Our results suggest that the BDI-II and its cognitive subscale are effective tools for screening for MDD in post-MI patients.
目的
评估贝克抑郁量表第二版（BDI-II）和 BDI-II 认知分量表（BDI-II-cog）在筛选心肌梗死后（MI）患者中是否存在重度抑郁（MDD）的作用特征。
方法
2003 年 10 月至 2005 年 7 月期间，在城市学术医疗中心就诊的 131 名 MI 后患者在发病后 72 小时内完成了 BDI-II 和半结构化访谈抑郁评估。通过将评分与 MDD 访谈诊断进行比较，评估了两种量表的各种截断值的敏感性、特异性、阳性和阴性预测值、总体正确分类和似然比。还计算了接收者操作特性曲线（ROC）并测量了曲线下面积（AUC）。
结果
BDI-II 的最佳截断值为>或=16，敏感性为 88.2%，特异性为 92.1%。BDI-II-cog 的截断值>或=3 或>或=4 都是可以接受的（敏感性分别为 88.2%和 82.4%，特异性分别为 81.6%和 88.6%）。BDI-II 的 AUC 为 0.96，认知分量表的 AUC 为 0.89。
结论
对 MI 后患者进行有效的抑郁筛查非常重要，因为抑郁与 MI 后发病率和死亡率有独立关系。我们的结果表明，BDI-II 及其认知分量表是 MI 后患者筛查 MDD 的有效工具。
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