Medical School, Universidade de Fortaleza, Fortaleza, CE, Brazil.
Braz J Psychiatry. 2010 Dec;32(4):424-8.
Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population.
A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard').
The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90).
The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).
双相谱系障碍较为普遍,但常常被漏诊和治疗不足。本报告描述了用于双相谱系障碍筛查的心境障碍问卷巴西版本的开发和验证,该问卷是在成年精神科人群中进行的。
共有 114 名连续就诊于门诊精神科的患者完成了心境障碍问卷巴西版本。一位不了解心境障碍问卷结果的研究精神科医生通过 DSM-IV 结构临床访谈的心境模块(“金标准”)对患者进行访谈。
用 Cronbach's alpha 系数评估的心境障碍问卷巴西版本的内部一致性为 0.76(95%置信区间;0.69-0.92)。使用 varimax 旋转的主成分分析表明存在“易怒-思维奔逸”因子和“兴奋-活动”因子,这两个因子解释了 39.1%的变异。根据 SCID,69 名(60.5%)个体被诊断为双相障碍。心境障碍问卷巴西版本筛查评分达到或超过 8 分,其敏感性为 0.91(95%置信区间;0.85-0.98),特异性为 0.70(95%置信区间;0.62-0.75),阳性预测值为 0.82(95%置信区间;0.75-0.88),阴性预测值为 0.84(95%置信区间;0.77-0.90)。
本研究数据表明,心境障碍问卷巴西版本是一种用于筛查双相障碍的有效工具。该工具需要在其他环境(例如,在一般实践中)进行验证。