Lerdal Anners, Kottorp Anders, Gay Caryl L, Grov Ellen K, Lee Kathryn A
Lovisenberg Diakonale Hospital, Lovisenberggata 17, NO-0440 Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, Oslo, Norway.
Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
J Affect Disord. 2014 Apr;158:48-52. doi: 10.1016/j.jad.2014.01.013. Epub 2014 Feb 5.
The Beck Depression Inventory-II (BDI-II) is often used to assess depressive symptoms among stroke patients, but more evidence is needed regarding its psychometric properties in this population. The purpose of this study was to assess the BDI-II׳s psychometric properties using a Rasch model application in a sample of patients 6 months after a first clinical stroke.
Data were collected prospectively from patient medical records and from questionnaires (with assistance if needed) as a part of a longitudinal study of poststroke fatigue. Data from the 6-month follow-up were used in this analysis. The sample consisted of 106 patients with first-ever stroke recruited from two Norwegian hospitals between 2007 and 2008. Depressive symptoms were measured with the BDI-II. Rasch analysis was used to assess the BDI-II׳s psychometric properties in this sample.
Five BDI-II items did not demonstrate acceptable goodness-of-fit to the Rasch model: items 10 (crying), 16 (changes in sleep), 17 (irritability), 18 (changes in appetite), and 21 (loss of interest in sex). If these 5 items were removed, the resulting 16-item version not only had fewer items, it also had better internal scale validity, person-response validity, and person-separation reliability than the original 21-item version in this sample of stroke survivors.
The study did not include a clinical evaluation of depression.
A 16-item version of the BDI-II, omitting items 10, 16, 17, 18 and 21, may be more appropriate than the original 21-item BDI-II for use as a unidimensional measure of depression in patients following first-ever stroke.
贝克抑郁量表第二版（BDI-II）常被用于评估中风患者的抑郁症状，但对于该量表在此类人群中的心理测量学特性，仍需更多证据。本研究的目的是在首次临床中风6个月后的患者样本中，运用拉施模型评估BDI-II的心理测量学特性。
作为中风后疲劳纵向研究的一部分，前瞻性地从患者病历和问卷中收集数据（必要时给予协助）。本分析使用了6个月随访的数据。样本包括2007年至2008年从两家挪威医院招募的106例首次中风患者。使用BDI-II测量抑郁症状。运用拉施分析评估该样本中BDI-II的心理测量学特性。
BDI-II的5个项目未显示出与拉施模型可接受的拟合优度：项目10（哭泣）、16（睡眠变化）、17（易怒）、18（食欲变化）和21（对性失去兴趣）。如果去除这5个项目，由此产生的16项版本不仅项目数量更少，而且在这个中风幸存者样本中，其内部量表效度、个人反应效度和个人区分信度均优于原始的21项版本。
该研究未包括对抑郁症的临床评估。
对于首次中风后的患者，作为抑郁症的单维测量工具，删除项目10、16、17、18和21的16项版本BDI-II可能比原始的21项BDI-II更合适。
