Fok Marcella Lei-Yee, Seegobin Seth, Frissa Souci, Hatch Stephani L, Hotopf Matthew, Hayes Richard D, Moran Paul
Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Personal Ment Health. 2015 Nov;9(4):250-7. doi: 10.1002/pmh.1307. Epub 2015 Aug 27.
Personality disorder (PD) is associated with important health outcomes in the general population. However, the length of diagnostic interviews poses a significant barrier to obtaining large scale, population-based data on PD. A brief screen for the identification of people at high risk of PD in the general population could be extremely valuable for both clinicians and researchers.
We set out to validate the Standardised Assessment of Personality - Abbreviated Scale (SAPAS), in a general population sample, using the Structured Clinical Interviews for DSM-IV Personality Disorders (SCID-II) as a gold standard.
One hundred and ten randomly selected, community-dwelling adults were administered the SAPAS screening interview. The SCID-II was subsequently administered by a clinical interviewer blind to the initial SAPAS score. Receiver operating characteristic analysis was used to assess the discriminatory performance of the SAPAS, relative to the SCID-II.
Area under the curve for the SAPAS was 0.70 (95% CI = 0.60 to 0.80; p < 0.001), indicating moderate overall discriminatory accuracy. A cut point score of 4 on the SAPAS correctly classified 58% of participants. At this cut point, the sensitivity and specificity were 0.69 and 0.53 respectively.
The SAPAS operates less efficiently as a screen in general population samples and is probably most usefully applied in clinical populations.
人格障碍（PD）与普通人群的重要健康结局相关。然而，诊断访谈的时长对获取基于大规模人群的PD数据构成了重大障碍。在普通人群中进行简短筛查以识别PD高危人群，对临床医生和研究人员都可能极有价值。
我们着手在普通人群样本中验证人格标准化评估简表（SAPAS），将《精神疾病诊断与统计手册》第四版人格障碍的结构化临床访谈（SCID-II）作为金标准。
对110名随机选取的社区成年居民进行了SAPAS筛查访谈。随后由一名对初始SAPAS评分不知情的临床访谈者进行SCID-II访谈。采用受试者工作特征分析来评估SAPAS相对于SCID-II的鉴别性能。
SAPAS的曲线下面积为0.70（95%置信区间 = 0.60至0.80；p < 0.001），表明总体鉴别准确性中等。SAPAS上的切点分数为4时，正确分类了58%的参与者。在此切点时，敏感性和特异性分别为0.69和0.53。
在普通人群样本中，SAPAS作为筛查工具的效率较低，可能最适用于临床人群。
