Shinzato Hotaka, Zamami Yu, Kondo Tsuyoshi
Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
Brain Sci. 2020 Sep 27;10(10):678. doi: 10.3390/brainsci10100678.
For simultaneous screening of mixed features (MF) by DSM-5 and mixed depression (MD) by Benazzi, useful symptoms were extracted from our 12-item dimensional scale for depressive mixed state (DMX-12). Subjects were 190 consecutive cases with major depressive episode (MDE) who visited our clinic. Associations between symptomatological combinations of the DMX-12 and MF or MD were analyzed using receiver operating characteristic (ROC). The rate of MF was 4.2% while that of MD was 22.6%. Eight symptoms (overreactivity, inner tension, racing/crowded thought, impulsivity, irritability, aggression, risk-taking behavior, and dysphoria) with their AUC > 0.6 for ROC curves were specially focused on distinguishing patients with MF or MD from non-mixed patients. By using these 8 symptoms, 40.5% of the overall patients were screened as positive at the same cut-off value (≥13) for both MD and MF. The AUC of ROC curve and sensitivity/specificity were well balanced together with sufficient negative predictive values. The abovementioned 8 symptoms seem to be helpful for primary screening and negative check of DMX with considerable severity during MDE.
为了同时筛查DSM-5定义的混合特征（MF）和贝纳齐定义的混合性抑郁（MD），我们从12项抑郁混合状态维度量表（DMX-12）中提取了有用的症状。研究对象为连续190例到我们诊所就诊的重度抑郁发作（MDE）患者。使用受试者工作特征（ROC）分析DMX-12症状组合与MF或MD之间的关联。MF的发生率为4.2%，而MD的发生率为22.6%。特别关注ROC曲线下面积（AUC）>0.6的八个症状（反应过度、内心紧张、思维奔逸/杂乱、冲动、易怒、攻击性、冒险行为和烦躁不安），以区分MF或MD患者与非混合患者。使用这8个症状，在MD和MF相同的临界值（≥13）下，40.5%的总体患者被筛查为阳性。ROC曲线的AUC以及敏感性/特异性得到了很好的平衡，同时具有足够的阴性预测值。上述8个症状似乎有助于在MDE期间对具有相当严重程度的DMX进行初步筛查和阴性检查。
