National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
J Psychosom Res. 2013 May;74(5):414-9. doi: 10.1016/j.jpsychores.2013.02.009. Epub 2013 Mar 19.
Anxiety is a common non-motor symptom in Parkinson's disease (PD). This study analyzed the measurement properties of three frequently used anxiety scales in PD: the Beck Anxiety Inventory (BAI), the Hamilton Anxiety Rating Scale (HARS), and the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A).
The Rasch model was applied to a multicenter international cohort of 342 patients and assessed the following aspects: fit to the Rasch model, unidimensionality, reliability, response category ordering, item local independence, differential item functioning, and scale targeting.
In their original form, the BAI, HARS, and HADS-A, did not fit the Rasch model. A good fit to the Rasch model was only found after significant modifications, including rescoring some items and deleting those failing to fit the model. For the BAI and HADS-A, these adjustments resulted in unidimensionality. The HARS was not unidimensional and separate analyses were performed for its psychic and somatic subscales. Whereas the somatic anxiety subscale fit the Rasch model, this was achieved for the psychic anxiety subscale after modifications.
None of the currently used anxiety scales display satisfactory measurement properties for assessing anxiety in PD. The results suggest the need to develop a new disease-specific scale for measuring anxiety in PD.
焦虑是帕金森病（PD）的常见非运动症状。本研究分析了三种常用于 PD 的焦虑量表的测量特性：贝克焦虑量表（BAI）、汉密尔顿焦虑量表（HARS）和医院焦虑抑郁量表-焦虑分量表（HADS-A）。
Rasch 模型应用于一个由 342 名患者组成的多中心国际队列，评估了以下方面：适合 Rasch 模型、单维性、可靠性、反应类别排序、项目局部独立性、差异项目功能和目标范围。
BAI、HARS 和 HADS-A 最初的形式不符合 Rasch 模型。只有经过重大修改后，才能很好地符合 Rasch 模型，包括重新评分一些项目和删除不符合模型的项目。对于 BAI 和 HADS-A，这些调整导致了单维性。HARS 不是单维的，对其心理和躯体分量表分别进行了分析。躯体焦虑分量表符合 Rasch 模型，而心理焦虑分量表则在修改后符合模型。
目前使用的焦虑量表在评估 PD 中的焦虑方面均显示出不理想的测量特性。结果表明需要开发一种新的用于测量 PD 中焦虑的疾病特异性量表。
