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使用《惊恐障碍严重程度量表-自评》中的两个项目开发一种用于检测和测量惊恐障碍的极简短量表。

Development of a very brief scale for detecting and measuring panic disorder using two items from the Panic Disorder Severity Scale-Self Report.

机构信息

Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden.

Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden.

出版信息

J Affect Disord. 2019 Oct 1;257:615-622. doi: 10.1016/j.jad.2019.07.057. Epub 2019 Jul 5.

Abstract

OBJECTIVE

To minimize the burden in detecting and monitoring Panic Disorder and Agoraphobia by developing a very brief scale with selected items from the Panic Disorder Severity Scale-Self Report (PDSS-SR), and to investigate the proposed scale's psychometric properties in a comorbid sample.

METHODS

A sample of 5103 patients from the Internet Psychiatry Clinic in Sweden, diagnosed and treated with Internet-based cognitive behavioral therapy for panic disorder (n = 1390), social anxiety disorder (n = 1313) or depression (n = 2400), responded to the PDSS-SR. Six criteria related to factor structure, sensitivity to change and clinical representativeness were used to select items. Psychometric analyses for the selected very brief scale were performed.

RESULTS

Items 2 (distress during panic attacks) and 4 (agoraphobic avoidance), were selected to create the very brief PDSS-SR version. Correlations with the full scale were high at screening, pre and post, and for change (0.87-0.93). Categorical Omega was ⍵ = 0.74. With a cut-off of 3 points, the scale could detect panic disorder in a psychiatric sample with a sensitivity of 85% and a specificity of 66%.

LIMITATIONS

Limitations include lack of healthy controls and lack of blinding on secondary outcome measures.

CONCLUSION

The proposed 2-item PDSS-SR version is a good candidate for a very brief panic disorder questionnaire, both for detecting cases and for measuring change. This is especially useful in clinical settings when measuring more than one condition at a time.

摘要

目的

通过从惊恐障碍严重程度自评量表(PDSS-SR)中选择精选项目来开发一个非常简短的量表,从而最大限度地减少惊恐障碍和广场恐惧症的检测和监测负担,并在共病样本中研究该量表的心理测量特性。

方法

从瑞典互联网精神病学诊所的 5103 名患者中抽取样本,这些患者被诊断并接受基于互联网的认知行为疗法治疗惊恐障碍(n=1390)、社交焦虑障碍(n=1313)或抑郁症(n=2400),他们对 PDSS-SR 做出了回应。使用与因子结构、对变化的敏感性和临床代表性相关的六项标准来选择项目。对所选非常简短量表进行心理测量分析。

结果

选择项目 2(惊恐发作时的痛苦)和 4(广场恐惧症回避)来创建非常简短的 PDSS-SR 版本。在筛查、治疗前和治疗后以及变化时,与完整量表的相关性很高(0.87-0.93)。分类 Omega 为 ⍵=0.74。当以 3 分为截断值时,该量表可在精神病学样本中以 85%的灵敏度和 66%的特异性检测出惊恐障碍。

局限性

局限性包括缺乏健康对照者和缺乏对次要结局测量的盲法。

结论

提出的 2 项 PDSS-SR 版本是一个非常简短的惊恐障碍问卷的良好候选者,既可以用于检测病例,也可以用于衡量变化。当同时测量多种情况时,这在临床环境中特别有用。

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