Department of Mental Health, School of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Psychiatry Clin Neurosci. 2011 Aug;65(5):434-41. doi: 10.1111/j.1440-1819.2011.02236.x.
This study aimed to establish the screening performance and optimal cut-off points for the Japanese version of Kessler (K)6, K10 and the Depression and Suicide Screen (DSS).
A self-report questionnaire including K6, K10 and DSS, as well as the Center for Epidemiologic Studies - Depression Scale (CES-D), was administered to a random sample of community residents in Japan (non-cases, n = 147) and psychiatric outpatients diagnosed with mood or anxiety disorders according to DSM-IV (cases, n = 17). A receiver-operator characteristics (ROC) curve was drawn to estimate the area under the curve (AUC), the sensitivity, and specificity with the optimal cut-off points for K6, K10, and DSS, which were then compared with those of CES-D. The community sample was also asked to rate each measure on a scale from 'very easy' to 'very hard' to use.
K6 and K10 showed a high AUC (0.93-0.94), which was comparable to that of CES-D (0.95), but DSS showed a significantly smaller AUC (0.89) than CES-D (P < 0.05). The optimal cut-off points were estimated as 4/5 for K6, 9/10 for K10, and 1/2 for DSS. The sensitivity of these three scales was similar, but the specificity was lower for DSS than for the other two. K6, K10 and DSS were rated as being 'very easy' or 'easy to use' significantly more than CES-D (P < 0.01).
The screening performance of the Japanese versions of K6 and K10 was comparable with that of CES-D, and better than that of DDS. K6/K10, particularly K6, might have an advantage, even over the CES-D, because of its similar screening performance and better acceptability.
本研究旨在建立日本版 Kessler（K）6、K10 和抑郁与自杀筛查（DSS）的筛查性能和最佳截断值。
向日本社区居民（非病例，n=147）和根据 DSM-IV 诊断为心境或焦虑障碍的精神科门诊患者（病例，n=17）随机发放一份包含 K6、K10 和 DSS 以及流行病学研究中心抑郁量表（CES-D）的自报问卷。绘制受试者工作特征（ROC）曲线，以估算 K6、K10 和 DSS 的曲线下面积（AUC）、灵敏度和特异性，以及最佳截断值，并与 CES-D 进行比较。社区样本还被要求在“非常容易”到“非常困难”的量表上对每个测量指标进行评分。
K6 和 K10 的 AUC 值较高（0.93-0.94），与 CES-D（0.95）相当，但 DSS 的 AUC 值显著小于 CES-D（P<0.05）。最佳截断值估计为 K6 为 4/5，K10 为 9/10，DSS 为 1/2。这三个量表的灵敏度相似，但 DSS 的特异性低于其他两个量表。K6、K10 和 DSS 被评为“非常容易”或“容易使用”的比例明显高于 CES-D（P<0.01）。
日本版 K6 和 K10 的筛查性能与 CES-D 相当，优于 DDS。K6/K10，特别是 K6，由于其相似的筛查性能和更好的可接受性，可能具有优势，甚至超过 CES-D。
