Queen's University, Ontario, Canada.
Department of Psychiatry, University of Toronto, Ontario, Canada.
Semin Arthritis Rheum. 2019 Oct;49(2):260-266. doi: 10.1016/j.semarthrit.2019.03.004. Epub 2019 Mar 9.
This study aimed to: 1) determine the prevalence of depression and anxiety in SLE patients using the Center for Epidemiological Studies-Depression Scale [CES-D], Hospital Anxiety and Depression Scale [HADS], and Beck Anxiety Inventory [BAI] questionnaires; 2) study the criterion validity, interpretability, and test-retest reliability of CES-D, HADS and BAI; and 3) evaluate their diagnostic accuracy when compared to the assessment of an independent psychiatric assessment using the Mini-International Neuropsychiatric Interview (MINI).
159 consecutive SLE participants were screened for depression and anxiety using the CES-D, HADS, and BAI, and underwent the MINI. Sensitivity and specificity were evaluated against the MINI. Test-retest reliability was studied. Receiver operator characteristic (ROC) curves were utilized to determine the cut-off scores for CES-D, HADS and BAI.
The prevalence of depression ranged from 29% (HADS-D) to 52% (CES-D) and the prevalence of anxiety ranged from 45% (BAI) to 50% (HADS-A). ROC showed similar performance for CES-D and HADS-D. The diagnostic accuracy of HADS-A outperformed BAI. Furthermore, these self-reported questionnaires demonstrated good to excellent test-retest reliability. Analyses exhibited optimal cut-offs for CES-D (26), BAI (19), HADS-A (6), and HADS-D (8) that optimized their sensitivity and specificity as screening metrics for depression and anxiety in SLE patients.
Anxiety and depression are highly prevalent in patients with SLE. Patient-reported outcome questionnaires such as the CES-D, HADS, and BAI may be useful tools to screen for depression and anxiety in SLE. Our results suggest that SLE-specific cut-offs may improve diagnostic accuracy of current screening metrics in patients with lupus.
本研究旨在：1）使用流行病学研究中心抑郁量表[CES-D]、医院焦虑抑郁量表[HADS]和贝克焦虑量表[BAI]评估 SLE 患者的抑郁和焦虑患病率；2）研究 CES-D、HADS 和 BAI 的准则效度、可解释性和重测信度；3）并将其与使用迷你国际神经精神访谈（MINI）进行的独立精神科评估进行比较，评估其诊断准确性。
对 159 例连续的 SLE 患者进行抑郁和焦虑的 CES-D、HADS 和 BAI 筛查，并进行 MINI 评估。评估 MINI 评估的敏感性和特异性。研究重测信度。利用受试者工作特征（ROC）曲线确定 CES-D、HADS 和 BAI 的截断值。
抑郁的患病率范围为 29%（HADS-D）至 52%（CES-D），焦虑的患病率范围为 45%（BAI）至 50%（HADS-A）。ROC 显示 CES-D 和 HADS-D 具有相似的性能。HADS-A 的诊断准确性优于 BAI。此外，这些自我报告问卷表现出良好到极好的重测信度。分析显示 CES-D（26）、BAI（19）、HADS-A（6）和 HADS-D（8）的最佳截断值，这些截断值可优化其在 SLE 患者中筛查抑郁和焦虑的敏感性和特异性。
SLE 患者中焦虑和抑郁的患病率很高。患者报告的结果问卷，如 CES-D、HADS 和 BAI，可能是筛查 SLE 患者抑郁和焦虑的有用工具。我们的研究结果表明，SLE 特异性截断值可能会提高当前筛查指标在狼疮患者中的诊断准确性。
