Brooks W B, Jordan J S, Divine G W, Smith K S, Neelon F A
Department of Medicine, Duke University Medical Center, Durham, NC 27710.
Med Care. 1990 Sep;28(9):793-804. doi: 10.1097/00005650-199009000-00009.
In this study the relationship between four psychologic health constructs (depression, anxiety, patient response bias, and hostility) and the Sickness Impact Profile (SIP) measurement of functional status was evaluated. The SIP, Carroll Depression Rating Scale (CDRS); and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 332 patients hospitalized for treatment of combined medical and psychiatric problems. Pearson's product-moment correlation was high between CDRS and SIP Total score (r = 0.67) and between CDRS and SIP Psychosocial subscale (r = 0.72); correlation was lower between CDRS and SIP Physical subscale (r = 0.44). Six MMPI scales (depression, anxiety, psychasthenia, lie, K, hostility) correlated with SIP Total score (r = 0.18 to 0.50), with SIP Psychosocial score (r = 0.28 to 0.65) and less well with SIP Physical subscale (r = 0.07 to 0.25). Factor analysis of the SIP categories showed two factors with eigenvalues greater than 1. Promax factor rotation showed all SIP Psychosocial categories and all measured psychologic variables loaded most heavily on factor 1. SIP Physical categories loaded most heavily on factor 2. Stepwise multiple regression analysis showed that psychologic variables account for 49% of the SIP total variance, 62% of SIP Psychosocial subscale variance, but only 19% of SIP Physical subscale variance. The CDRS accounts for the major portion of the explained variance with only minor additional contributions from the MMPI scales. We conclude that 1) the SIP discriminates psychosocial and physical dysfunction even in medical patients with extensive psychiatric comorbidity; 2) the SIP measures at least two dimensions of health, one of which is strongly related to depression; and 3) constructs measured by MMPI scales do not have substantial independent contribution to SIP variance.
在本研究中，评估了四种心理健康指标（抑郁、焦虑、患者反应偏差和敌意）与功能状态的疾病影响量表（SIP）测量值之间的关系。对332名因内科和精神科合并问题住院治疗的患者施测了SIP、卡罗尔抑郁评定量表（CDRS）和明尼苏达多相人格调查表（MMPI）。CDRS与SIP总分之间（r = 0.67）以及CDRS与SIP心理社会分量表之间（r = 0.72）的皮尔逊积差相关系数较高；CDRS与SIP身体分量表之间的相关性较低（r = 0.44）。六个MMPI量表（抑郁、焦虑、神经衰弱、说谎、K、敌意）与SIP总分相关（r = 0.18至0.50），与SIP心理社会得分相关（r = 0.28至0.65），与SIP身体分量表的相关性较差（r = 0.07至0.25）。SIP类别的因子分析显示有两个特征值大于1的因子。斜交因子旋转显示，所有SIP心理社会类别和所有测量的心理变量在因子1上的负荷最重。SIP身体类别在因子2上的负荷最重。逐步多元回归分析表明，心理变量占SIP总方差的49%，占SIP心理社会分量表方差的62%，但仅占SIP身体分量表方差的19%。CDRS占解释方差的主要部分，MMPI量表的额外贡献较小。我们得出结论：1）即使在患有广泛精神疾病合并症的内科患者中，SIP也能区分心理社会功能障碍和身体功能障碍；2）SIP测量至少两个健康维度，其中一个与抑郁密切相关；3）MMPI量表测量的指标对SIP方差没有实质性的独立贡献。
