“双相情感障碍认知症状评定量表”（COBRA）在中国双相情感障碍患者中的改编与验证
Adaptation and validation of the "cognitive complaints in bipolar disorder rating assessment" (COBRA) in Chinese bipolar patients.
作者信息
Xiao Lin, Lin Xiaoling, Wang Qingyan, Lu Dali, Tang Siyuan
机构信息
Nursing School of Central South University, Hunan province 410013, China.
Nursing School of Central South University, Hunan province 410013, China.
出版信息
J Affect Disord. 2015 Mar 1;173:226-31. doi: 10.1016/j.jad.2014.11.011. Epub 2014 Nov 18.
BACKGROUND
There is no specific instrument available to measure cognitive deficits as reported by bipolar patients in China. Therefore, if discrepancies between bipolar patients' reports and the results of neuropsychological tests which have been described in other countries existing or not in Chinese bipolar disorder patients have not been known yet. And it is completely blank about the subjective cognition of these Chinese bipolar patients.
OBJECTIVES
The aim of the study is to revise and validate a specific, user-friendly, brief instrument named the "cognitive complaints in bipolar disorder rating assessment" (COBRA) into Chinese version.
METHODS
The total sample (N=255) included 125 bipolar disorder patients and 130 healthy controls. The psychometric properties of the COBRA (e.g. internal consistency, retest reliability, discriminative validity, concurrent validity, content validity, item analysis, confirmatory factor analysis, ROC curve and feasibility) were analyzed.
RESULTS
The Chinese version of the COBRA had very high internal consistency (Cronbach's alpha=0.905) and retest reliability (ICC=0.902). Confirmatory factor analysis validated the one-factor model and the cut-off value to discriminate the patients and controls was 11.Bipolar patients experienced greater cognitive complaints compared to control group suggesting a discriminative validity of the instrument. No significant correlation was found between the COBRA and the total Montreal Cognitive Assessment Scale (MoCA), except for single measures related to executive function (phonemic fluency, p=0.045), verbal memory (delayed recall, p=0.004).
LIMITATIONS
Cross-sectional design, no specific or unspecific but reliable instrument in Chinese to assess subjective cognitive difficulties in mental disorders for criterion validity or convergent validity analysis.
CONCLUSIONS
The Chinese version of the COBRA showed to be a simple and reliable instrument to assess subjective cognitive complaints in Chinese bipolar patients.
背景
在中国，尚无专门用于测量双相情感障碍患者所报告的认知缺陷的工具。因此，双相情感障碍患者的报告与其他国家所描述的神经心理学测试结果之间是否存在差异，在中国双相情感障碍患者中尚不清楚。而且，对于这些中国双相情感障碍患者的主观认知情况完全空白。
目的
本研究旨在将一种名为“双相情感障碍认知主诉评定量表”（COBRA）的特定、易用、简短工具修订并验证为中文版。
方法
总样本（N = 255）包括125名双相情感障碍患者和130名健康对照者。分析了COBRA的心理测量学特性（如内部一致性、重测信度、区分效度、同时效度、内容效度、项目分析、验证性因素分析、ROC曲线和可行性）。
结果
COBRA中文版具有非常高的内部一致性（Cronbach's α = 0.905）和重测信度（ICC = 0.902）。验证性因素分析验证了单因素模型，区分患者和对照的临界值为11。与对照组相比，双相情感障碍患者经历了更多的认知主诉，表明该工具具有区分效度。除了与执行功能相关的单一测量（语音流畅性，p = 0.045）、言语记忆（延迟回忆，p = 0.004）外，COBRA与蒙特利尔认知评估量表（MoCA）总分之间未发现显著相关性。
局限性
横断面设计，在中国没有用于评估精神障碍主观认知困难的特定或非特定但可靠的工具进行效标效度或聚合效度分析。
结论
COBRA中文版显示是一种评估中国双相情感障碍患者主观认知主诉的简单可靠工具。
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