Mental Health Unit, Centre of Epidemiology, Surveillance and Health Promotion, Italian National Institute of Health, Rome, Italy.
J Eur Acad Dermatol Venereol. 2012 Feb;26(2):165-71. doi: 10.1111/j.1468-3083.2011.04022.x. Epub 2011 Mar 14.
The prevalence of depressive disorders is high among patients with skin disease. The PC-SAD is a 37-item self-administered depression screening questionnaire that has been validated in dermatological patients.
The aim of this study was to develop and validate a brief depression severity instrument derived from the PC-SAD that can be used to assess severity and monitor ongoing clinical course.
Two patient samples participated in the study: 72 adult dermatological inpatients and 73 adults attending six primary care practices. Psychiatric assessment included the Structured Clinical Interview for DSM-IV and an 18-item version of the PC-SAD; moreover, dermatological patients completed the Patient Health Questionnaire depression scale (PHQ-9), while primary care patients were administered the Montgomery-Asberg Depression Rating Scale (MADRS). A subset of five PC-SAD items showing the best psychometric properties were selected, and the reliability and validity of the resulting instrument (PC-SAD5) were examined.
The PC-SAD5 showed satisfactory internal consistency in both samples. There was a high correlation between PC-SAD5 and PHQ-9 and MADRS scores. Multiple regression analysis revealed a gradient of PC-SAD5 scores from patients with no mental disorder, those with milder forms of depression, to those with Major Depressive Disorder. Similar results were observed for the 18-item version of the PC-SAD.
The availability of valid and reliable continuous measures of depression severity derived from the PC-SAD extends its field of application from depression screening to use as a follow-up measure of depression severity in routine clinical practice. A validated very short instrument such as the PC-SAD5 may have substantial clinical value.
皮肤病患者中抑郁障碍的患病率很高。PC-SAD 是一种 37 项自评抑郁筛查问卷，已在皮肤科患者中得到验证。
本研究旨在开发和验证一种源自 PC-SAD 的简短抑郁严重程度工具，用于评估严重程度和监测正在进行的临床过程。
两个患者样本参与了这项研究：72 名成年皮肤科住院患者和 73 名在 6 个初级保健机构就诊的成年人。精神病学评估包括 DSM-IV 结构化临床访谈和 18 项 PC-SAD 版本；此外，皮肤科患者完成了患者健康问卷抑郁量表（PHQ-9），而初级保健患者则接受了蒙哥马利-阿斯伯格抑郁评定量表（MADRS）。选择了五个具有最佳心理测量特性的 PC-SAD 项目，检验了由此产生的工具（PC-SAD5）的可靠性和有效性。
PC-SAD5 在两个样本中均显示出令人满意的内部一致性。PC-SAD5 与 PHQ-9 和 MADRS 评分高度相关。多元回归分析显示，PC-SAD5 评分存在从无精神障碍患者、轻度抑郁患者到重度抑郁症患者的梯度。PC-SAD 的 18 项版本也观察到了类似的结果。
源自 PC-SAD 的有效且可靠的抑郁严重程度连续测量工具的可用性扩展了其从抑郁筛查到常规临床实践中作为抑郁严重程度随访测量的应用范围。一种经过验证的非常简短的工具，如 PC-SAD5，可能具有重要的临床价值。
