Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan.
Psychiatry Clin Neurosci. 2019 Aug;73(8):448-457. doi: 10.1111/pcn.12842. Epub 2019 Apr 29.
Understanding premorbid personality is important, especially when considering treatment selection. Historically, the premorbid personality of patients with major depression in Japan was described as Shuchaku-kishitsu [similar to Typus melancholicus], as proposed by Shimoda in the 1930s. Since around 2000, there have been increased reports in Japan of young adults with depression who have had premorbid personality differing from the traditional type. In 2005, Tarumi termed this novel condition 'dysthymic-type depression,' and more recently the condition has been called Shin-gata/Gendai-gata Utsu-byo [modern-type depression (MTD)]. We recently developed a semi-structured diagnostic interview to evaluate MTD. Development of a tool that enables understanding of premorbid personality in a short time, especially at the early stage of treatment, is desirable. The object of this study was to develop a self-report scale to evaluate the traits of MTD, and to assess the scale's psychometric properties, diagnostic accuracy, and biological validity.
A sample of 340 participants from clinical and community settings completed measures. Psychometric properties were assessed with factor analysis. Diagnostic accuracy of the MTD traits was compared against a semi-structured interview.
The questionnaire contained 22 items across three subscales, thus we termed it the 22-item Tarumi's Modern-Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self-Esteem (TACS-22). Internal consistency, test-retest reliability, and convergent validity were all satisfactory. Among patients with major depression, the area under the curve was 0.757 (sensitivity of 63.1% and specificity of 82.9%) and the score was positively correlated with plasma tryptophan.
The TACS-22 possessed adequate psychometric properties and diagnostic accuracy in an initial sample of Japanese adults. Additional research on its ability to support clinical assessment of MTD is warranted.
了解病前人格很重要，尤其是在考虑治疗选择时。历史上，日本重度抑郁症患者的病前人格被 Shimoda 在 20 世纪 30 年代描述为 Shuchaku-kishitsu（类似于 Typus melancholicus）。自 2000 年左右以来，日本越来越多的报道称，患有抑郁症的年轻成年人的病前人格与传统类型不同。2005 年，Tarumi 将这种新型病症称为“恶劣心境型抑郁症”，最近又将这种病症称为 Shin-gata/Gendai-gata Utsu-byo（现代型抑郁症（MTD））。我们最近开发了一种半结构化诊断访谈来评估 MTD。开发一种能够在短时间内（尤其是在治疗早期）了解病前人格的工具是可取的。本研究的目的是开发一种评估 MTD 特征的自评量表，并评估该量表的心理测量特性、诊断准确性和生物学有效性。
来自临床和社区环境的 340 名参与者完成了评估。使用因子分析评估心理测量特性。将 MTD 特征的诊断准确性与半结构化访谈进行比较。
问卷包含三个分量表的 22 个项目，因此我们将其命名为 22 项 Tarumi 的现代型抑郁症特征量表：回避社会角色、抱怨和低自尊（TACS-22）。内部一致性、重测信度和聚合效度均令人满意。在重度抑郁症患者中，曲线下面积为 0.757（敏感性为 63.1%，特异性为 82.9%），评分与血浆色氨酸呈正相关。
TACS-22 在日本成年人群体的初始样本中具有足够的心理测量特性和诊断准确性。需要进一步研究其支持 MTD 临床评估的能力。
