1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
2 College of Social Work, Florida State University, Tallahassee, FL, USA.
J Psychopharmacol. 2019 Feb;33(2):185-193. doi: 10.1177/0269881118817156. Epub 2019 Jan 17.
BACKGROUND/AIMS: While substantial prior research has evaluated the psychometric properties of the 12-item Concise Health Risk Tracking-Self Report (CHRT-SR), a measure of suicide propensity and suicidal thoughts, no prior research has investigated its factor structure, sensitivity to change over time, and other psychometric properties in a placebo-controlled trial of antidepressant medication, nor determined whether symptoms change throughout treatment.
Participants in the multi-site Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study ( n=278) provided data to evaluate the factor structure and sensitivity to change over time of the CHRT-SR through eight weeks of a clinical trial in which participants received either placebo or antidepressant medication (sertraline).
RESULTS/OUTCOMES: Factor analysis confirmed two factors: propensity (comprised of first-order factors including pessimism, helplessness, social support, and despair) and suicidal thoughts. Internal consistency (α's ranged from 0.69-0.92) and external validity were both acceptable, with the total score and propensity factor scores significantly correlated with total scores and single-item suicidal-thoughts scores on the self-report Quick Inventory of Depressive Symptoms and the clinician-rated 17-item Hamilton Rating Scale for Depression. Through analyzing CHRT-SR changes over eight treatment weeks, the total score and both the factors decreased regardless of baseline suicidal thoughts. Change in clinician-rated suicidal thoughts was reflected by change in both the total score and propensity factor score.
CONCLUSIONS/INTERPRETATION: These results confirm the reliability, validity, and applicability of the CHRT-SR to a placebo-controlled clinical trial of depressed outpatients receiving antidepressant medication.
背景/目的：虽然大量先前的研究已经评估了 12 项简明健康风险追踪自我报告（CHRT-SR）的心理测量特性，该量表用于衡量自杀倾向和自杀念头，但在抗抑郁药物的安慰剂对照试验中，没有研究调查其因子结构、随时间变化的敏感性以及其他心理测量特性，也没有确定症状在整个治疗过程中是否会发生变化。
多地点建立抗抑郁反应的调节因子和生物标志物的临床护理研究（EMBARC）的参与者（n=278）提供数据，通过为期八周的临床试验评估 CHRT-SR 的因子结构和随时间变化的敏感性，参与者接受安慰剂或抗抑郁药物（舍曲林）治疗。
结果/结果：因子分析证实了两个因素：倾向（由包括悲观、无助、社会支持和绝望在内的一阶因素组成）和自杀念头。内部一致性（α 值范围为 0.69-0.92）和外部有效性均可接受，总分和倾向因子得分与自我报告的抑郁快速清单的总分和单一自杀念头得分以及临床医生评定的 17 项汉密尔顿抑郁评定量表显著相关。通过分析八周治疗期间 CHRT-SR 的变化，总分和两个因素都有所下降，无论基线自杀念头如何。临床医生评定的自杀念头变化反映在总分和倾向因子得分的变化上。
结论/解释：这些结果证实了 CHRT-SR 在接受抗抑郁药物治疗的门诊抑郁症患者的安慰剂对照临床试验中的可靠性、有效性和适用性。
