Torres Soler C, Olofsdotter S, Vadlin S, Ramklint M, Nilsson K W, Sonnby K
a Center for Clinical Research , Västmanlands County Hospital, Uppsala University , Västerås , Sweden.
b Department of Neuroscience , Akademiska Sjukhuset, Uppsala University , Uppsala , Sweden.
Nord J Psychiatry. 2018 Apr;72(3):184-190. doi: 10.1080/08039488.2017.1414873. Epub 2017 Dec 19.
The diagnostic accuracy of the parent report of the Montgomery-Åsberg Depression Rating Scale (MADRS-P) for the screening of major depressive disorder (MDD) in adolescents has not been evaluated.
The aim was to explore the psychometric properties and diagnostic accuracy of the MADRS-P in general child and adolescent psychiatric outpatient services in Sweden.
The study was a validation and a diagnostic accuracy study. Consecutive adolescent psychiatric patients (n = 101, 45 males, mean age 15 years) were assessed with a diagnostic interview, the Kiddie Schedule of Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL), as a reference test. Thereafter, their parents reported on the MADRS-P. Both categorical MDD diagnoses and dimensional MDD symptom severity scores were obtained from the K-SADS-PL.
The internal consistency of the MADRS-P, measured with Cronbach's alpha, was 0.846. The concurrent validity, assessed by Spearman's rho as a correlation between the K-SADS MDD symptom severity score and the MADRS-P score, was 0.580. The area under the curve in a receiver operating characteristic analysis for all participants was 0.786 (95% confidence interval 0.694-0.877, p < .001). At a cut-off of 10, sensitivity was 0.86, specificity 0.54, positive predictive value 0.59 and negative predictive value 0.84.
The parent-rated MADRS-P showed similar psychometric properties as previously shown for the self-rated MADRS-S in adults. Although the MADRS-P has acceptable diagnostic accuracy for screening for MDD in adolescents in a general psychiatric setting, it cannot be used alone for diagnosing MDD.
蒙哥马利-奥斯伯格抑郁评定量表家长报告版（MADRS-P）用于筛查青少年重度抑郁症（MDD）的诊断准确性尚未得到评估。
旨在探讨MADRS-P在瑞典普通儿童和青少年精神科门诊服务中的心理测量特性及诊断准确性。
本研究为效度验证及诊断准确性研究。对连续就诊的青少年精神科患者（n = 101，男性45名，平均年龄15岁）进行诊断性访谈，以学龄儿童情感障碍和精神分裂症量表目前及终生版（K-SADS-PL）作为参照测试。之后，由其家长报告MADRS-P的评分。从K-SADS-PL获得MDD的分类诊断及MDD症状严重程度的维度评分。
用Cronbach's alpha系数测得MADRS-P的内部一致性为0.846。通过Spearman相关系数评估的同时效度，即K-SADS的MDD症状严重程度评分与MADRS-P评分之间的相关性为0.580。所有参与者的受试者工作特征分析曲线下面积为0.786（95%置信区间0.694 - 0.877，p <.001）。截断值为10时，灵敏度为0.86，特异度为0.54，阳性预测值为0.对值为0.84。
家长评定的MADRS-P显示出与之前成人自评的MADRS-S相似的心理测量特性。尽管MADRS-P在普通精神科环境中筛查青少年MDD时具有可接受的诊断准确性，但不能单独用于诊断MDD。
