Neitzer Andrea, Sun Sumi, Doss Sheila, Moran John, Schiller Brigitte
Satellite Healthcare, San Jose, California 95128, USA.
Hemodial Int. 2012 Apr;16(2):207-13. doi: 10.1111/j.1542-4758.2012.00663.x.
Depression is common in patients suffering from end-stage renal disease (ESRD). Various screening tools for depression in ESRD patients are available. This study aimed to validate the Beck Depression Inventory-Fast Screen (BDI-FS) with the Beck Depression Inventory-II (BDI-II) as depression screening tool in conventional hemodialysis (CHD) patients. One hundred sixty two CHD patients were studied with both screening questionnaires. We used the Pearson Correlation Coefficient to measure the agreement between BDI-II and BDI-FS scores from 134 patients who responded to both questionnaires. Receiver operating characteristics curve and area under the curve were constructed to determine a valid BDI-FS cutoff score to identify ESRD patients at risk for depression. BDI-II and BDI-FS scores strongly correlated (Pearson r = 0.85, p < 0.0001). At a BDI-II cutoff ≥16, receiver operating characteristics showed the best balance between sensitivity and specificity for the BDI-FS cutoff value of ≥4 with a sensitivity of 97.2% (95% confidence interval [CI]: 85.5%, 99.9%) and a specificity of 91.8% (95% CI: 84.5%, 96.4%). When applying the above cutoff scores, prevalence of depressive symptoms in all completed questionnaires was found to be 28.7% (BDI-II) and 30.1% (BDI-FS), respectively. The BDI-FS was found to be an efficient and effective tool for depression screening in ESRD patients which can be easily implemented in routine dialysis care.
抑郁症在终末期肾病(ESRD)患者中很常见。有多种针对ESRD患者抑郁症的筛查工具。本研究旨在验证贝克抑郁量表快速筛查版(BDI-FS)与贝克抑郁量表第二版(BDI-II)作为常规血液透析(CHD)患者抑郁症筛查工具的有效性。对162例CHD患者使用这两种筛查问卷进行研究。我们用皮尔逊相关系数来衡量134例对两种问卷都有回应的患者的BDI-II和BDI-FS得分之间的一致性。构建受试者工作特征曲线及曲线下面积以确定有效的BDI-FS临界值,用于识别有抑郁症风险的ESRD患者。BDI-II和BDI-FS得分高度相关(皮尔逊r = 0.85,p < 0.0001)。当BDI-II临界值≥16时,受试者工作特征显示,对于BDI-FS临界值≥4,敏感性和特异性之间达到最佳平衡,敏感性为97.2%(95%置信区间[CI]:85.5%,99.9%),特异性为91.8%(95%CI:84.5%,96.4%)。应用上述临界值时,在所有完成的问卷中,抑郁症状的患病率分别为28.7%(BDI-II)和30.1%(BDI-FS)。BDI-FS被发现是一种用于ESRD患者抑郁症筛查的高效工具,可在常规透析护理中轻松实施。