Research and Development, Epworth HealthCare, Richmond, Victoria, Australia; Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Research and Development, Epworth HealthCare, Richmond, Victoria, Australia; Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
J Affect Disord. 2018 Aug 15;236:164-171. doi: 10.1016/j.jad.2018.04.092. Epub 2018 Apr 21.
Anxiety and depression are common problems following traumatic brain injury (TBI), warranting routine screening. Self-report rating scales including the Hospital Anxiety and Depression Scale (HADS) are associated with depression and anxiety diagnoses in individuals with TBI. The relationship between individual HADS symptoms and structured clinical interview methods (SCID) requires further investigation, particularly in regard to identifying a small number of key items that can potentially be recognised by clinicians and carers of individuals with TBI.
138 individuals sustaining a complicated-mild to severe TBI completed the HADS, and the Structured Clinical Interview for DSM-IV, Research Version (SCID) at 12-months post-injury. The associations between individual HADS items, separately and in combination, as well as overall depression and anxiety subscale scores, and SCID-diagnosed depressive and anxiety disorders were analysed.
CART (Classification and Regression Tree) analysis found HADS depression item 2 "I still enjoy the things I used to enjoy" and a combination of two anxiety items, 3 "I get a sort of frightened feeling as if something awful is about to happen" and 5 "worrying thoughts go through my mind", performed similarly to total depression and anxiety subscales in terms of their association with depressive and anxiety disorders respectively, at 12-months post-injury.
Patients were predominantly injured in motor vehicle accidents and received comprehensive care within a no-fault accident compensation system and so may not be representative of the wider TBI population.
Although validation is required, a small number of self-report items are highly associated with 12-month post-injury diagnoses.
焦虑和抑郁是创伤性脑损伤（TBI）后的常见问题，需要进行常规筛查。包括医院焦虑和抑郁量表（HADS）在内的自评量表与 TBI 患者的抑郁和焦虑诊断相关。HADS 单项症状与结构化临床访谈方法（SCID）之间的关系需要进一步研究，特别是在确定少数可能被 TBI 患者的临床医生和护理人员识别的关键项目方面。
138 名复杂轻度至重度 TBI 患者在损伤后 12 个月完成了 HADS 和 DSM-IV 研究版结构化临床访谈（SCID）。分析了 HADS 单项、组合项以及整体抑郁和焦虑子量表评分与 SCID 诊断的抑郁和焦虑障碍之间的关联。
CART（分类和回归树）分析发现 HADS 抑郁量表第 2 项“我仍然享受我以前喜欢的事情”和焦虑量表第 3 项“我有一种可怕的感觉，好像有可怕的事情要发生”和第 5 项“忧虑的想法在我脑海中闪过”的组合，与损伤后 12 个月的抑郁和焦虑障碍分别具有相似的相关性。
患者主要因机动车事故受伤，并在无过错事故赔偿系统内接受全面护理，因此可能无法代表更广泛的 TBI 人群。
尽管需要验证，但少数自我报告项目与损伤后 12 个月的诊断高度相关。
