Wang Jian, Guo Wan-Jun, Zhang Lan, Deng Wei, Wang Hui-Yao, Yu Jian-Ying, Luo Shan-Xia, Huang Ming-Jin, Dong Zai-Quan, Li Da-Jiang, Song Jin-Ping, Jiang Yu, Cheng Nan-Sheng, Liu Xie-He, Li Tao
Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China; Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China.
Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
Compr Psychiatry. 2017 Jul;76:87-97. doi: 10.1016/j.comppsych.2017.04.001. Epub 2017 Apr 6.
Depression and anxiety among general hospital patients are common and under-recognized in China. This study aimed toward developing a short questionnaire for screening depression and anxiety in non-psychiatric clinical settings, and to test its reliability and validity.
The item pool which included 35 questions about emotional distress was drafted through a comprehensive literature review. An expert panel review and the first clinical test with 288 general hospital patients were conducted for the primary item selection. The second clinical test was performed to select the final item in 637 non-psychiatric patients. The reliability and validity of the final questionnaire were tested in 763 non-psychiatric patients, in which 211 subjects were interviewed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). Multiple data analysis methods including principal components analysis (PCA), item response theory (IRT), and receiver operating characteristic (ROC) curve were used to select items and validate the final questionnaire.
The series selection of items resulted in a 9-item questionnaire, namely Huaxi Emotional-distress Index (HEI). The Cronbach's α coefficient of HEI was 0.90. The PCA results showed a unidimensional construct. The area under the ROC curve (AUC) was 0.88 when compared with MINI interview. Using the optimal cut-off score of HEI (≥11), the sensitivity and specificity were 0.880 and 0.766, respectively.
The HEI is considered as a reliable and valid instrument for screening depression and anxiety, which may have substantial clinical value to detect patients' emotional disturbances especially in the busy non-psychiatric clinical settings in China.
综合医院患者中的抑郁和焦虑很常见，在中国却未得到充分认识。本研究旨在开发一种简短问卷，用于在非精神科临床环境中筛查抑郁和焦虑，并测试其信效度。
通过全面的文献综述起草了包含35个关于情绪困扰问题的项目池。进行了专家小组评审和对288名综合医院患者的首次临床试验以进行初步项目筛选。在637名非精神科患者中进行了第二次临床试验以选择最终项目。在763名非精神科患者中测试了最终问卷的信效度，其中211名受试者由精神科医生使用迷你国际神经精神访谈量表（MINI）进行访谈。使用包括主成分分析（PCA）、项目反应理论（IRT）和受试者工作特征（ROC）曲线在内的多种数据分析方法来选择项目并验证最终问卷。
项目的系列筛选产生了一个9项问卷，即华西情绪困扰指数（HEI）。HEI的克朗巴哈α系数为0.90。PCA结果显示为单维结构。与MINI访谈相比，ROC曲线下面积（AUC）为0.88。使用HEI的最佳截断分数（≥11）时，敏感性和特异性分别为0.880和0.766。
HEI被认为是一种可靠且有效的抑郁和焦虑筛查工具，对于在中国繁忙的非精神科临床环境中检测患者的情绪障碍可能具有重要的临床价值。
