Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark; Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Feb 2;81:131-137. doi: 10.1016/j.pnpbp.2017.10.024. Epub 2017 Nov 1.
Although psychiatric comorbidity in Parkinson's Disease (PD) has often been studied, the individual psychiatric symptoms have rarely been evaluated from a clinimetric point of view in an attempt to measure how much the symptoms have been bothering or distressing the PD patients. The current study is therefore aimed at evaluating from a clinimetric viewpoint the severity of psychiatric symptoms affecting PD patients by using the Hopkins Symptom Checklist (SCL-90-R) to show its measurement-driven construct validity (scalability). The conventional nine SCL-90-R subscales (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideas, and psychoticism), as well as the clinical most valid subscales from the SCL-28 version (depression, anxiety, interpersonal sensitivity, and neurasthenia) were analysed according to a clinimetric approach by comparing PD patients with a control group from a general population study. Scalability was tested by the non-parametric item response theory model by use of a Mokken analysis. Among the various SCL-90-R or SCL-28 subscales we identified from the clinimetric analysis that the somatization, anxiety, phobic anxiety, psychoticism, and neurasthenia (apathy), as well as the SCL-90-R GSI, were the most impaired psychiatric syndromes reaching a clinically significant effect size above 0.80, whereas the total SCL-28 GSI obtained an effect size of just 0.80. Our clinimetric analysis has shown that patients with PD not only are bothered with diverse somatic symptoms, but also with specific secondary psychiatric comorbidities which are clinically severe markers of impairment in the day-to-day function implying a negative cooping approach.
尽管帕金森病 (PD) 中的精神共病经常被研究，但从临床角度评估个别精神症状的情况很少见，目的是尝试衡量这些症状对 PD 患者造成了多大困扰或痛苦。因此，本研究旨在通过使用 Hopkins 症状清单 (SCL-90-R) 从临床角度评估影响 PD 患者的精神症状的严重程度，以展示其具有测量驱动的结构有效性（可扩展性）。根据临床角度，对传统的 SCL-90-R 的九个子量表（躯体化、强迫观念、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执观念和精神病性），以及 SCL-28 版本中最有效的临床子量表（抑郁、焦虑、人际关系敏感和神经衰弱）进行分析。通过使用 Mokken 分析的非参数项目反应理论模型来测试可扩展性。在我们从临床角度分析的各种 SCL-90-R 或 SCL-28 子量表中，我们发现躯体化、焦虑、恐怖、精神病性和神经衰弱（冷漠）以及 SCL-90-R GSI 是受损最严重的精神综合征，达到了临床意义上的 0.80 以上的效应量，而 SCL-28 GSI 的效应量仅为 0.80。我们的临床分析表明，PD 患者不仅受多种躯体症状困扰，还患有特定的二级精神共病，这些共病是日常功能受损的严重临床标志物，暗示了一种消极的应对方式。
