主要抑郁症的初级保健患者的残疾和感知压力。

Disability and perceived stress in primary care patients with major depression.

机构信息

Universidad Europea de Valencia.

出版信息

Psicothema. 2020 May;32(2):167-175. doi: 10.7334/psicothema2019.319.

DOI:10.7334/psicothema2019.319

PMID:32249741

Abstract

BACKGROUND

Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9).

METHOD

A total of 1,704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9. We evaluated the factor structure, measurement invariance across gender, internal consistency, and the discriminative and predictive validity.

RESULTS

Confirmatory factor analyses revealed a unifactorial model of the SDS containing 4 items (SDS-4) with the best model fit (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). This model contained the three life domain items (work, family, and social life) plus perceived stress (PS) with significant loadings. The internal consistency of the SDS-4 was acceptable in patients with or without MDD, regardless of symptom severity. The SDS-4 also showed good discriminative capacity and acceptable predictive validity in all subsamples.

CONCLUSIONS

These findings support the use of the SDS-4 to assess depression-related disability in patients at Spanish primary care centres.

摘要

背景

重度抑郁症（MDD）在西班牙初级保健（PC）环境中患病率很高，是西班牙残疾的主要原因。本研究旨在使用患者健康问卷-9（PHQ-9）评估 MDD 患者和不同严重程度症状患者的 Sheehan 残疾量表（SDS）的几个关键心理测量特性。

方法

共有 1704 名参与 PsicAP 临床试验的 PC 患者完成了 SDS 和 PHQ-9。我们评估了因子结构、性别间的测量不变性、内部一致性以及判别和预测效度。

结果

验证性因子分析显示 SDS 的单因素模型包含 4 个项目（SDS-4），具有最佳的模型拟合度（CFI：.99；GFI：.99；TLI：96；RMSEA：.10）。该模型包含三个生活领域项目（工作、家庭和社会生活）加上感知压力（PS），具有显著的负荷。无论是否患有 MDD，无论症状严重程度如何，SDS-4 的内部一致性在患者中都是可以接受的。SDS-4 在所有亚组中也表现出良好的判别能力和可接受的预测效度。