泰国老年人中测量重度抑郁症时自评工具与临床医生评定工具之间的一致性水平：作为泰国衰老与痴呆研究（THAISAD）一部分的1年评估
Level of agreement between self-rated and clinician-rated instruments when measuring major depressive disorder in the Thai elderly: a 1-year assessment as part of the THAISAD study.
作者信息
Wongpakaran Nahathai, Wongpakaran Tinakon, Wannarit Kamonporn, Saisavoey Nattha, Pinyopornpanish Manee, Lueboonthavatchai Peeraphon, Apisiridej Nattaporn, Srichan Thawanrat, Ruktrakul Ruk, Satthapisit Sirina, Nakawiro Daochompu, Hiranyatheb Thanita, Temboonkiat Anakevich, Tubtimtong Namtip, Rakkhajeekul Sukanya, Wongtanoi Boonsanong, Tanchakvaranont Sitthinant, Bookkamana Putipong, Srisutasanavong Usaree, Nivataphand Raviwan, Petchsuwan Donruedee
机构信息
Faculty of Medicine, Chiang Mai University, Chiang Mai, Kingdom of Thailand.
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Kingdom of Thailand.
出版信息
Clin Interv Aging. 2014 Feb 25;9:377-82. doi: 10.2147/CIA.S56683. eCollection 2014.
PURPOSE
Whether self-reporting and clinician-rated depression scales correlate well with one another when applied to older adults has not been well studied, particularly among Asian samples. This study aimed to compare the level of agreement among measurements used in assessing major depressive disorder (MDD) among the Thai elderly and the factors associated with the differences found.
PATIENTS AND METHODS
This was a prospective, follow-up study of elderly patients diagnosed with MDD and receiving treatment in Thailand. The Mini International Neuropsychiatric Inventory (MINI), 17-item Hamilton Depression Rating Scale (HAMD-17), 30-item Geriatric Depression Scale (GDS-30), 32-item Inventory of Interpersonal Problems scale, Revised Experience of Close Relationships scale, ten-item Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support were used. Follow-up assessments were conducted after 3, 6, 9, and 12 months.
RESULTS
Among the 74 patients, the mean age was 68±6.02 years, and 86% had MDD. Regarding the level of agreement found between GDS-30 and MINI, Kappa ranged between 0.17 and 0.55, while for Gwet's AC1 the range was 0.49 to 0.91. The level of agreement was found to be lowest at baseline, and increased during follow-up visits. The correlation between HAMD-17 and GDS-30 scores was 0.17 (P=0.16) at baseline, then 0.36 to 0.41 in later visits (P<0.01). The PSS-10 score was found to be positively correlated with GDS-30 at baseline, and predicted the level of disagreement found between the clinicians and patients when reporting on MDD.
CONCLUSION
The level of agreement between the GDS, MINI, and HAMD was found to be different at baseline when compared to later assessments. Patients who produced a low GDS score were given a high rating by the clinicians. An additional self-reporting tool such as the PSS-10 could, therefore, be used in such under-reporting circumstances.
目的
自我报告和临床医生评定的抑郁量表应用于老年人时，二者之间的相关性如何，尚未得到充分研究，尤其是在亚洲样本中。本研究旨在比较泰国老年人中用于评估重度抑郁症（MDD）的测量方法之间的一致性水平以及与所发现差异相关的因素。
患者与方法
这是一项对在泰国被诊断为MDD并接受治疗的老年患者进行的前瞻性随访研究。使用了迷你国际神经精神访谈量表（MINI）、17项汉密尔顿抑郁量表（HAMD - 17）、30项老年抑郁量表（GDS - 30）、32项人际问题量表、亲密关系修订体验量表、10项感知压力量表（PSS - 10）以及多维感知社会支持量表。在3、6、9和12个月后进行随访评估。
结果
74例患者中，平均年龄为68±6.02岁，86%患有MDD。关于GDS - 30与MINI之间的一致性水平，kappa值在0.17至0.55之间，而Gwet's AC1的范围为0.49至0.91。一致性水平在基线时最低，在随访期间升高。HAMD - 17与GDS - 30评分在基线时的相关性为0.17（P = 0.16），在后续随访中为0.36至0.41（P < 0.01）。发现PSS - 10评分在基线时与GDS - 30呈正相关，并预测了临床医生和患者在报告MDD时发现的不一致水平。
结论
与后期评估相比，GDS、MINI和HAMD在基线时的一致性水平有所不同。GDS评分低的患者被临床医生给予了较高评分。因此，在这种报告不足的情况下，可以使用额外的自我报告工具，如PSS - 10。
Zotero 插件