Shahin Islam, Bonnin Caterina Del Mar, Saleh Elsayed, Helmy Khaled, Youssef Usama M, Vieta Eduard
Cairo Mood Center, Cairo, Egypt.
Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Neuropsychiatr Dis Treat. 2020 Sep 28;16:2209-2219. doi: 10.2147/NDT.S259996. eCollection 2020.
The DSM5-defined mixed features in depression do not include psychomotor agitation, irritability or distractibility because they are considered overlapping symptoms. A growing number of modern psychiatrists have expressed dissatisfaction with this and proposed alternative sets of mixed symptoms that are much more common and clinically relevant. Among such alternative criteria were those proposed by Koukopoulos. He utilized the research diagnostic criteria of agitated depression (RDC-A) as a mixed depression subtype, and validated another form of mixed depression, the Koukopoulos criteria for mixed depression (K-DMX).
This study provides psychometric validation for the first self-rated scale designed to measure the most common mixed symptoms in depression as proposed by Koukopoulos.
We conducted a multicenter cross-sectional study of 170 patients with unipolar depression. They completed the Shahin Mixed Depression Scale (SMDS) and underwent expert interviews as a gold standard reference. SMDS' psychometric properties were assessed, including Cronbach's alpha, factor analysis, sensitivity, specificity, predictive value and accuracy.
We found significant association and agreement between mixity according to SMDS and the gold standard (K-DMX and RDC-A according to expert interview) with good internal consistency (Cronbach's alpha=0.87), high sensitivity (=91.4%), specificity (=98.0%), positive predictive value (=96.9%), negative predictive value (= 94.2%) and accuracy (=95.2%). Factor analysis identified one factor for psychomotor agitation and another for mixity without psychomotor agitation.
SMDS was a reliable and valid instrument for assessing the frequently encountered and clinically relevant mixed features in depression.
《精神疾病诊断与统计手册》第五版（DSM5）定义的抑郁症混合特征不包括精神运动性激越、易怒或注意力分散，因为它们被视为重叠症状。越来越多的现代精神科医生对此表示不满，并提出了更常见且与临床相关的混合症状替代组。库科波洛斯提出的标准就是其中之一。他将激越性抑郁症的研究诊断标准（RDC - A）用作混合抑郁症亚型，并验证了另一种混合抑郁症形式，即库科波洛斯混合抑郁症标准（K - DMX）。
本研究为首个旨在测量库科波洛斯提出的抑郁症中最常见混合症状的自评量表提供心理测量学验证。
我们对170例单相抑郁症患者进行了多中心横断面研究。他们完成了沙欣混合抑郁量表（SMDS），并接受专家访谈作为金标准参考。评估了SMDS的心理测量特性，包括克朗巴哈系数、因子分析、敏感性、特异性、预测值和准确性。
我们发现根据SMDS得出的混合性与金标准（根据专家访谈的K - DMX和RDC - A）之间存在显著关联和一致性，具有良好的内部一致性（克朗巴哈系数 = 0.87）、高敏感性（= 91.4%）、特异性（= 98.0%）、阳性预测值（= 96.9%）、阴性预测值（= 94.2%）和准确性（= 95.2%）。因子分析确定了一个精神运动性激越因子和另一个无精神运动性激越的混合性因子。
SMDS是评估抑郁症中常见且与临床相关的混合特征的可靠有效工具。
