Wells K B, Burnam M A, Leake B, Robins L N
Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute and School of Medicine 90024.
J Psychiatr Res. 1988;22(3):207-20. doi: 10.1016/0022-3956(88)90006-4.
To increase the feasibility of identifying persons with depressive disorders in a large-scale health policy study, we tested the concordance between face-to-face and telephone-administered versions of the depression section of the NIMH Diagnostic Interview Schedule (DIS). This section was administered over the telephone to 230 English-speaking participants of the Los Angeles site of the NIMH Epidemiologic Catchment Area Program (ECA) after their completion of a face-to-face interview (Wave II) with the full DIS. Time lag between interviews was 3 months, on the average. Persons with depressive symptoms were oversampled. Using the face-to-face version as the criterion measure, the sensitivity, specificity, and positive predictive value of the telephone version for identifying the presence or absence of any lifetime unipolar depressive disorder were 71, 89, and 63 percent, respectively; the kappa statistic was 0.57, and agreement was unbiased. The comparable figures for concordance between two face-to-face interviews administered one year apart to the same subjects were 54, 89, and 60 percent and 0.45 (kappa), respectively. Thus, disagreement was due primarily to test-retest unreliability of the DIS rather than the method of administration.
为提高在大规模健康政策研究中识别抑郁症患者的可行性,我们测试了美国国立精神卫生研究所诊断访谈表(DIS)抑郁症部分面对面访谈版和电话访谈版之间的一致性。在国立精神卫生研究所流行病学集水区项目(ECA)洛杉矶站点的230名说英语的参与者完成了与完整DIS的面对面访谈(第二波)后,通过电话对这部分内容进行了访谈。两次访谈之间的时间间隔平均为3个月。有抑郁症状的人被过度抽样。以面对面访谈版作为标准测量方法,电话访谈版识别任何终生单相抑郁症存在与否的敏感性、特异性和阳性预测值分别为71%、89%和63%;kappa统计量为0.57,一致性无偏差。对同一受试者相隔一年进行的两次面对面访谈之间一致性的可比数字分别为54%、89%和60%以及0.45(kappa)。因此,不一致主要是由于DIS的重测不可靠性,而非访谈方式。