Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
Department of Psychology, Fordham University, Bronx, NY.
Palliat Support Care. 2021 Jun;19(3):312-321. doi: 10.1017/S1478951520001169.
Inflammation may contribute to the high prevalence of depressive symptoms seen in lung cancer. "Sickness behavior" is a cluster of symptoms induced by inflammation that are similar but distinct from depressive symptoms. The Sickness Behavior Inventory-Revised (SBI-R) was developed to measure sickness behavior. We hypothesized that the SBI-R would demonstrate adequate psychometric properties in association with inflammation.
Participants with stage IV lung cancer (n = 92) were evaluated for sickness behavior using the SBI-R. Concomitant assessments were made of depression (Patient Hospital Questionniare-9, Hospital Anxiety and Depression Scale) and inflammation [C-reactive protein (CRP)]. Classical test theory (CTT) was applied and multivariate models were created to explain SBI-R associations with depression and inflammation. Factor Analysis was also used to identify the underlying factor structure of the hypothesized construct of sickness behavior. A longitudinal analysis was conducted for a subset of participants.
The sample mean for the 12-item SBI-R was 8.3 (6.7) with a range from 0 to 33. The SBI-R demonstrated adequate internal consistency with a Cronbach's coefficient of 0.85, which did not increase by more than 0.01 with any single-item removal. This analysis examined factor loadings onto a single factor extracted using the principle components method. Eleven items had factor loadings that exceeded 0.40. SBI-R total scores were significantly correlated with depressive symptoms (r = 0.78, p < 0.001) and CRP (r = 0.47, p < 0.001). Multivariate analyses revealed that inflammation and depressive symptoms explained 67% of SBI-R variance.
The SBI-R demonstrated adequate reliability and construct validity in this patient population with metastatic lung cancer. The observed findings suggest that the SBI-R can meaningfully capture the presence of sickness behavior and may facilitate a greater understanding of inflammatory depression.
炎症可能导致肺癌患者中抑郁症状的高发。“疾病行为”是一组由炎症引起的症状，与抑郁症状相似但又不同。修订后的疾病行为量表（SBI-R）是用来测量疾病行为的。我们假设 SBI-R 与炎症相关时会表现出足够的心理测量学特性。
使用 SBI-R 对患有 IV 期肺癌的患者（n = 92）进行疾病行为评估。同时评估抑郁（患者医院问卷-9、医院焦虑和抑郁量表）和炎症[C 反应蛋白（CRP）]。应用经典测试理论（CTT），建立多元模型来解释 SBI-R 与抑郁和炎症的关系。还进行了因子分析，以确定疾病行为假设结构的潜在因子结构。对一部分参与者进行了纵向分析。
12 项 SBI-R 的样本平均值为 8.3（6.7），范围为 0 至 33。SBI-R 具有足够的内部一致性，克朗巴赫系数为 0.85，任何单项删除后增加不超过 0.01。本分析考察了使用主成分法提取的单一因子上的因子负荷。11 个项目的因子负荷超过 0.40。SBI-R 总分与抑郁症状（r = 0.78，p < 0.001）和 CRP（r = 0.47，p < 0.001）显著相关。多元分析显示，炎症和抑郁症状解释了 SBI-R 变异的 67%。
SBI-R 在患有转移性肺癌的患者群体中表现出足够的可靠性和结构有效性。观察到的结果表明，SBI-R 可以有意义地捕捉疾病行为的存在，并可能有助于更好地理解炎症性抑郁。
