University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, USA.
The Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, USA.
J Affect Disord. 2015 Mar 15;174:589-93. doi: 10.1016/j.jad.2014.11.021. Epub 2014 Nov 24.
The identification of predictors of treatment response holds tremendous potential for the improvement of clinical outcomes in bipolar disorder (BP). The goal of this project is to evaluate the test-retest reliability of a new clinical tool, the Lithium Questionnaire (LQ), for the retrospective assessment of long-term lithium use in research participants with BP.
Twenty-nine individuals with BP-I (n=27), major depression (n=1), or schizoaffective disorder (n=1) were recruited for participation. The LQ was administered to all participants at two time-points, spaced 17 months apart on average, and used to determine each subject׳s score on the Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder Scale, or the Alda Scale. Scores were confirmed through a best-estimate procedure, and test-retest reliability (intra-class correlation coefficient [ICC]) of the LQ was calculated.
The correlation between the total Alda Scale scores at the two time-points was in the moderate range (ICC=0.60). Relevant clinical factors such as age or presence of Axis I psychiatric comorbidity did not influence the reliability.
The validity of the LQ was not examined. Inclusion of two participants with non-BP diagnoses may have affected the LQ׳s reliability, but re-analysis of our data after exclusion of these participants did not influence the reliability. The absence of measures of mood and cognition at time of LQ may be a limitation of this work.
The LQ holds promise for the standardization of the retrospective assessment of long-term treatment in BP.
识别治疗反应的预测因子对于改善双相情感障碍(BP)的临床结局具有巨大的潜力。本项目的目的是评估一种新的临床工具——锂问卷(LQ)的测试-再测试可靠性,用于回顾性评估 BP 研究参与者的长期锂治疗。
招募了 29 名 BP-I 患者(n=27)、单相重性抑郁(n=1)或分裂情感障碍(n=1)患者参与。在平均间隔 17 个月的两个时间点,向所有参与者施测 LQ,并使用该问卷确定每位受试者在双相障碍研究受试者长期治疗反应回顾性标准(Alda 量表)上的得分。通过最佳估计程序确认得分,并计算 LQ 的测试-再测试可靠性(组内相关系数[ICC])。
两次测试之间的总 Alda 量表得分的相关性处于中等范围(ICC=0.60)。年龄或是否存在轴 I 精神共病等相关临床因素并未影响可靠性。
LQ 的有效性尚未检验。纳入两名非 BP 诊断的参与者可能影响了 LQ 的可靠性,但排除这些参与者后重新分析我们的数据并未影响可靠性。LQ 时没有情绪和认知的测量可能是这项工作的一个局限性。
LQ 有望实现 BP 长期治疗回顾性评估的标准化。