Langerak Wendy, Langeland Willie, van Balkom Anton, Draisma Stasja, Terluin Berend, Draijer Nel
Department of Review and Appeal, The Dutch Institute for Employee Benefit Schemes, Utrecht, The Netherlands.
Work. 2012;43(3):369-80. doi: 10.3233/WOR-2012-1393.
This study aimed to evaluate the criterion validity and the diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) regarding the identification of depressive and anxiety disorders in an insurance medicine setting.
Our sample consisted of 230 individuals who applied for a work disability benefit due to mental health problems.
Depressive and anxiety disorders were assessed using the 4DSQ and the Composite International Diagnostic Interview (CIDI). Internal consistency was determined by calculating Cronbach's alpha values. Criterion validity was evaluated by regression techniques. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate diagnostic accuracy.
Of the 230 participants 109 (47.4%) had a current DSM-IV depressive disorder and 146 (63.5%) an anxiety disorder. The 4DSQ scales showed an excellent internal consistency. The depression scale of the 4DSQ had specific sensitivity for major depressive disorder. The anxiety scale was also sensitive for the anxiety disorders. The area under the ROC curve (AUC) indicated good diagnostic accuracy of the 4DSQ for assessing depressive and/or anxiety disorders: AUC-value 0.81 for both depression and anxiety.
Although the 4DSQ shows good criterion validity and diagnostic accuracy with respect to depressive and anxiety disorders in applicants for a work disability benefit due to mental health problems, the feasibility of the 4DSQ as a screening measure for depressive and anxiety disorders is limited due to the high prevalence of depressive and anxiety disorders.
本研究旨在评估四维症状问卷（4DSQ）在保险医学环境中识别抑郁和焦虑障碍方面的标准效度和诊断准确性。
我们的样本包括230名因心理健康问题申请工作残疾福利的个体。
使用4DSQ和复合国际诊断访谈（CIDI）评估抑郁和焦虑障碍。通过计算克朗巴哈系数值来确定内部一致性。通过回归技术评估标准效度。进行受试者工作特征（ROC）分析以评估诊断准确性。
在230名参与者中，109名（47.4%）患有当前的DSM-IV抑郁障碍，146名（63.5%）患有焦虑障碍。4DSQ量表显示出出色的内部一致性。4DSQ的抑郁量表对重度抑郁障碍具有特定的敏感性。焦虑量表对焦虑障碍也很敏感。ROC曲线下面积（AUC）表明4DSQ在评估抑郁和/或焦虑障碍方面具有良好的诊断准确性：抑郁和焦虑的AUC值均为0.81。
尽管4DSQ在因心理健康问题申请工作残疾福利的申请人中，在抑郁和焦虑障碍方面显示出良好的标准效度和诊断准确性，但由于抑郁和焦虑障碍的高患病率，4DSQ作为抑郁和焦虑障碍筛查措施的可行性有限。
