Meuldijk Denise, Giltay Erik J, Carlier Ingrid Ve, van Vliet Irene M, van Hemert Albert M, Zitman Frans G
School of Psychology, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands.
JMIR Ment Health. 2017 Aug 29;4(3):e35. doi: 10.2196/mental.5453.
There is a need for brief screening methods for psychiatric disorders in clinical practice. This study assesses the validity and accuracy of a brief self-report screening questionnaire, the Web Screening Questionnaire (WSQ), in detecting psychiatric disorders in a study group comprising the general population and psychiatric outpatients aged 18 years and older.
The aim of this study was to investigate whether the WSQ is an adequate test to screen for the presence of depressive and anxiety disorders in clinical practice.
Participants were 1292 adults (1117 subjects from the general population and 175 psychiatric outpatients), aged 18 to 65 years. The discriminant characteristics of the WSQ were examined in relation to the ("gold standard") Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) disorders, by means of sensitivity, specificity, area under the curve (AUC), and positive and negative predictive values (PPVs, NPVs).
The specificity of the WSQ to individually detect depressive disorders, anxiety disorders, and alcohol abuse or dependence ranged from 0.89 to 0.97 for most disorders, with the exception of post-traumatic stress disorder (0.52) and specific phobia (0.73). The sensitivity values ranged from 0.67 to 1.00, with the exception of depressive disorder (0.56) and alcohol abuse or dependence (0.56). Given the low prevalence of separate disorders in the general population sample, NPVs were extremely high across disorders (≥0.97), whereas PPVs were of poor strength (range 0.02-0.33).
In this study group, the WSQ was a relatively good screening tool to identify individuals without a depressive or anxiety disorder, as it accurately identified those unlikely to suffer from these disorders (except for post-traumatic stress disorders and specific phobias). However, in case of a positive WSQ screening result, further diagnostic procedures are required.
临床实践中需要针对精神障碍的简短筛查方法。本研究评估了一种简短的自我报告筛查问卷——网络筛查问卷（WSQ）在检测包括18岁及以上普通人群和精神科门诊患者的研究组中精神障碍的有效性和准确性。
本研究的目的是调查WSQ是否是临床实践中筛查抑郁和焦虑障碍的充分测试工具。
参与者为1292名18至65岁的成年人（1117名来自普通人群，175名精神科门诊患者）。通过敏感性、特异性、曲线下面积（AUC）以及阳性和阴性预测值（PPV、NPV），研究了WSQ相对于（“金标准”）迷你国际神经精神病学访谈升级版（MINI-Plus）障碍的判别特征。
WSQ单独检测抑郁症、焦虑症以及酒精滥用或依赖的特异性，大多数障碍范围为0.89至0.97，但创伤后应激障碍（0.52）和特定恐惧症（0.73）除外。敏感性值范围为0.67至1.00，但抑郁症（0.56）和酒精滥用或依赖（0.56）除外。鉴于普通人群样本中单一障碍的患病率较低，各障碍的NPV极高（≥0.97），而PPV强度较差（范围为0.02 - 0.33）。
在该研究组中，WSQ是识别无抑郁或焦虑障碍个体的相对较好的筛查工具，因为它能准确识别那些不太可能患有这些障碍的个体（创伤后应激障碍和特定恐惧症除外）。然而，如果WSQ筛查结果为阳性，则需要进一步的诊断程序。
