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测量精神病性抑郁症。

Measuring psychotic depression.

作者信息

Østergaard S D, Meyers B S, Flint A J, Mulsant B H, Whyte E M, Ulbricht C M, Bech P, Rothschild A J

机构信息

Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University hospital, Aalborg, Denmark; Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Acta Psychiatr Scand. 2014 Mar;129(3):211-20. doi: 10.1111/acps.12165. Epub 2013 Jun 25.

DOI:10.1111/acps.12165
PMID:23799875
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3819398/
Abstract

OBJECTIVE

Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD.

METHOD

The psychometric properties of the rating scales were evaluated based on data from the Study of Pharmacotherapy of Psychotic Depression.

RESULTS

A rating scale consisting of the 6-item Hamilton melancholia subscale (HAM-D6 ) plus five items from the Brief Psychiatric Rating Scale (BPRS), named the HAMD-BPRS11 , displayed clinical validity (Spearman's correlation coefficient between HAMD-BPRS11 and Clinical Global Impression - Severity (CGI-S) scores = 0.79-0.84), responsiveness (Spearman's correlation coefficient between change in HAMD-BPRS11 and Clinical Global Impression - Improvement (CGI-I) scores = -0.74--0.78) and unidimensionality (Loevinger's coefficient of homogeneity = 0.41) in the evaluation of PD. The HAM-D6 fulfilled the same criteria, whereas the full 17-item Hamilton Depression Scale failed to meet criteria for unidimensionality.

CONCLUSION

Our results suggest that the HAMD-BPRS11 is a more valid measure than pure depression scales for evaluating the severity of PD.

摘要

目的

精神病性抑郁（PD）是一种严重致残的疾病，需要密切监测。然而，目前尚无用于评估PD严重程度的既定评定量表。本分析的目的是评估既定抑郁评定量表以及一些涵盖抑郁和精神病性症状的新综合评定量表与PD相关的心理测量特性。

方法

基于精神病性抑郁药物治疗研究的数据评估评定量表的心理测量特性。

结果

一个由6项汉密尔顿抑郁量表的忧郁症分量表（HAM-D6）加上简明精神病评定量表（BPRS）中的5个项目组成的评定量表，命名为HAMD-BPRS11，在评估PD时显示出临床效度（HAMD-BPRS11与临床总体印象-严重程度（CGI-S）评分之间的斯皮尔曼相关系数=0.79-0.84）、反应性（HAMD-BPRS11的变化与临床总体印象-改善（CGI-I）评分之间的斯皮尔曼相关系数=-0.74--0.78）和单维性（洛温杰同质性系数=0.41）。HAM-D6符合相同标准，而完整的17项汉密尔顿抑郁量表未达到单维性标准。

结论

我们的结果表明，对于评估PD的严重程度，HAMD-BPRS11比单纯的抑郁量表是一种更有效的测量工具。