Svensson Martin, Nilsson Thomas, Johansson Håkan, Viborg Gardar, Perrin Sean, Sandell Rolf
a Department of Psychology , Lund University , Lund , SE , Sweden.
Nord J Psychiatry. 2019 Jan;73(1):58-63. doi: 10.1080/08039488.2018.1554699. Epub 2019 Jan 14.
Panic disorder, with or without agoraphobia (PDA or PD, respectively), is a major public health problem. After having established a PD diagnosis based on the DSM or the ICD systems, the Panic Disorder Severity Scale (PDSS) is the most widely used interview-based instrument for assessing disorder severity. There is also a self-report version of the instrument (PDSS-SR); both exist in a Swedish translation but their psychometric properties remain untested.
We studied 221 patients with PD/PDA recruited to a randomized controlled preference trial of cognitive-behavioral and brief panic-focused psychodynamic psychotherapy. In addition to PDSS and PDSS-SR the participants completed self-reports including the Clinical Outcome in Routine Evaluation - Outcome Measure, Montgomery Åsberg Depression Rating Scale, Sheehan Disability Scale, Bodily Sensations Questionnaire and the Mobility Inventory for Agoraphobia.
PDSS and PDSS-SR possessed excellent psychometric properties (internal consistency, test-retest reliability) and convergent validity. A single factor structure for both versions was not confirmed. In terms of clinical utility, the PDSS had very high inter-rater reliability and correspondence with PD assessed via structured diagnostic interview. Both versions were sensitive to the effects of PD-focused treatment, although subjects scored systematically lower on the self-report version.
The study confirmed the reliability and validity of the Swedish versions of PDSS and PDSS-SR. Both versions were highly sensitive to the effects of two PD-focused treatments and can be used both in clinical and research settings. However, further investigation of the factor structures of both the PDSS and PDSS-SR is warranted.
ClinicalTrials.gov identifier: NCT01606592.
惊恐障碍，伴或不伴广场恐惧症（分别为PDA或PD），是一个重大的公共卫生问题。在基于DSM或ICD系统确立惊恐障碍诊断后，惊恐障碍严重程度量表（PDSS）是最广泛使用的基于访谈的评估障碍严重程度的工具。该工具也有自我报告版本（PDSS-SR）；两者均有瑞典语翻译版本，但它们的心理测量特性尚未经过测试。
我们研究了221名招募到认知行为疗法和简短的聚焦惊恐的心理动力心理治疗随机对照偏好试验中的PD/PDA患者。除了PDSS和PDSS-SR，参与者还完成了自我报告，包括常规评估中的临床结局-结局测量、蒙哥马利-阿斯伯格抑郁评定量表、希恩残疾量表、身体感觉问卷和广场恐惧症行动量表。
PDSS和PDSS-SR具有出色的心理测量特性（内部一致性、重测信度）和收敛效度。两个版本的单一因素结构均未得到证实。在临床效用方面，PDSS具有非常高的评分者间信度，且与通过结构化诊断访谈评估的PD具有一致性。两个版本对聚焦惊恐障碍治疗的效果均敏感，尽管受试者在自我报告版本上的得分系统性地更低。
该研究证实了瑞典语版本的PDSS和PDSS-SR的信度和效度。两个版本对两种聚焦惊恐障碍治疗的效果均高度敏感，可用于临床和研究环境。然而，有必要对PDSS和PDSS-SR的因素结构进行进一步研究。
ClinicalTrials.gov标识符：NCT01606592。
