Zimmerman Mark, Thompson Justine S, Diehl Joseph M, Balling Caroline, Kiefer Reina
Department of Psychiatry and Human Behavior, Brown Medical School, and the Department of Psychiatry, Rhode Island Hospital, Providence, USA.
Department of Psychiatry and Human Behavior, Brown Medical School, and the Department of Psychiatry, Rhode Island Hospital, Providence, USA.
Psychiatry Res. 2020 Feb 9;286:112859. doi: 10.1016/j.psychres.2020.112859.
DSM-5 includes criteria for an anxious distress specifier for major depressive disorder, and measures have been developed to assess these criteria. The validity of measures of the severity of anxious distress has been established in depressed patients. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined whether a severity measure of anxious distress was as valid as the Hamilton Anxiety Scale (HAMA) as a measure of the severity of anxiety in patients with generalized anxiety disorder (GAD). Eighty-five patients with GAD were interviewed by trained raters who administered the DSM-5 Anxious Distress Specifier Interview (DADSI), HAMA, and Hamilton Depression Rating Scale (HAMD). The patients completed self-report measures of depression, anxiety, and irritability. The DADSI and HAMA were significantly correlated (r 0.52, p < .001). Both the DADSI and HAMA were more highly correlated with measures of anxiety than with measures of the other symptom domains. The HAMD was significantly more highly correlated with the HAMA than with the DADSI. Both measures were significantly correlated with measures of positive mental health, functioning, life satisfaction, and general well-being. Both measures were sensitive to change in response to treatment. Both the DADSI and HAMA were valid measures of anxiety severity in patients with GAD, though the HAMA was more highly confounded with the HAMD than the DADSI. The DADSI is briefer than the HAMA, and thus may be more practical to use in research studies as well as clinical practice.
《精神疾病诊断与统计手册》第五版（DSM - 5）纳入了重度抑郁症的焦虑痛苦特征说明标准，并且已经开发出相关测量方法来评估这些标准。在抑郁症患者中，焦虑痛苦严重程度测量方法的有效性已得到证实。在罗德岛改善诊断评估与服务方法（MIDAS）项目的本报告中，我们研究了焦虑痛苦严重程度测量方法作为广泛性焦虑障碍（GAD）患者焦虑严重程度的一种测量方法，是否与汉密尔顿焦虑量表（HAMA）一样有效。85名广泛性焦虑障碍患者由经过培训的评估者进行访谈，评估者使用DSM - 5焦虑痛苦特征说明访谈（DADSI）、HAMA和汉密尔顿抑郁量表（HAMD）。患者完成了关于抑郁、焦虑和易怒的自我报告测量。DADSI与HAMA显著相关（r = 0.52，p <.001）。DADSI和HAMA与焦虑测量指标的相关性均高于与其他症状领域测量指标的相关性。HAMD与HAMA的相关性显著高于与DADSI的相关性。两种测量方法均与积极心理健康、功能、生活满意度和总体幸福感的测量指标显著相关。两种测量方法对治疗反应的变化均敏感。DADSI和HAMA都是广泛性焦虑障碍患者焦虑严重程度的有效测量方法，不过HAMA与HAMD的混淆程度高于DADSI。DADSI比HAMA更简短，因此在研究以及临床实践中使用可能更具实用性。
