1University Psychiatric Hospital Duffel,Duffel,Belgium.
3General Hospital Sint Jan Brugge-Oostende AV,Brugge,Belgium.
Acta Neuropsychiatr. 2018 Aug;30(4):203-208. doi: 10.1017/neu.2018.2. Epub 2018 Mar 4.
According to a recent study, ratings on the Psychotic Depression Assessment Scale (PDAS) obtained via a dedicated semi-structured interview are valid measures of the severity of psychotic depression. This study aimed to further test the validity, scalability and responsiveness of the PDAS in older adults using independent ratings on the Clinical Global Impression Scale - Severity (CGI-S) and the Montgomery-Asberg Depression Rating Scale (MADRS) as references.
Ratings were performed at admission and discharge at two old age psychiatric wards in Flanders, Belgium. In total, 62 older adults (mean age: 74.3 years) with psychotic depression were included. The PDAS was rated by trained nurses using the semi-structured PDAS interview. Senior psychiatrists scored the participants on the CGI-S. Psychologists or experienced nurses rated participants on the MADRS. Clinical validity was assessed by correlating the PDAS total scores with CGI-S ratings and MADRS total scores. Mokken analysis was performed to assess the scalability of the PDAS. Responsiveness was assessed by comparing the proportion of participants in remission (PDAS total score <8 at study baseline and endpoint).
The Spearman correlation coefficients were 0.76 and 0.79 for the PDAS versus CGI-S and PDAS versus MADRS, respectively. The Mokken analysis yielded a Loevinger coefficient of 0.46, which is indicative of scalability. At admission, no participants met the PDAS remission criterion. At discharge, 54% (95% confidence interval: 47%-60%) of the patients met this criterion.
The PDAS appears to be a clinically valid, scalable and responsive measure of the severity of psychotic depression in older adults.
根据最近的一项研究，通过专门的半结构化访谈获得的精神病性抑郁评估量表（PDAS）评分是精神病性抑郁严重程度的有效衡量标准。本研究旨在使用独立的临床总体印象严重程度量表（CGI-S）和蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评分作为参考，进一步测试 PDAS 在老年患者中的有效性、可扩展性和反应度。
在比利时佛兰德斯的两个老年精神病病房进行入院和出院时的评估。共有 62 名患有精神病性抑郁的老年患者（平均年龄：74.3 岁）入组。PDAS 由经过培训的护士使用 PDAS 半结构化访谈进行评定。资深精神科医生对患者进行 CGI-S 评分。心理学家或经验丰富的护士对患者进行 MADRS 评分。通过将 PDAS 总分与 CGI-S 评分和 MADRS 总分进行相关性分析来评估临床有效性。Mokken 分析用于评估 PDAS 的可扩展性。通过比较研究基线和终点时处于缓解状态（PDAS 总分<8）的患者比例来评估反应度。
PDAS 与 CGI-S 和 PDAS 与 MADRS 的 Spearman 相关系数分别为 0.76 和 0.79。Mokken 分析得出的 Loevinger 系数为 0.46，表明具有可扩展性。入院时，没有患者符合 PDAS 缓解标准。出院时，54%（95%置信区间：47%-60%）的患者符合该标准。
PDAS 似乎是一种在老年精神病性抑郁患者中具有临床有效性、可扩展性和反应度的有效衡量工具。
