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更快筛查,更快行动:一项使用贝克抑郁量表快速筛查法对帕金森病伴轻度认知障碍患者进行抑郁症状筛查的试点研究。

Screen Fast, Screen Faster: A Pilot Study to Screen for Depressive Symptoms Using the Beck Depression Inventory Fast Screen in Parkinson's Disease With Mild Cognitive Impairment.

作者信息

Elben Saskia, Dimenshteyn Karina, Trenado Carlos, Folkerts Ann-Kristin, Ophey Anja, Sulzer Patricia, Becker Sara, Schmidt Nele, Tödt Inken, Witt Karsten, Liepelt-Scarfone Inga, Yilmaz Rezzak, Kalbe Elke, Wojtecki Lars

机构信息

Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.

Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.

出版信息

Front Neurol. 2021 Mar 8;12:640137. doi: 10.3389/fneur.2021.640137. eCollection 2021.

Abstract

Depressive symptoms have a high prevalence in patients with Parkinson's disease (PD) and are associated with cognitive dysfunction. Especially in PD with mild cognitive impairment (MCI), a time-efficient and valid instrument for the assessment of depression primarily focusing on psychological symptoms and disregarding confounding somatic symptoms is needed. We performed an examination of the psychometric properties of the Beck Depression Inventory II (BDI-II) and the Beck Depression Inventory Fast Screen (BDI-FS). The sample consisted of 64 patients [22 females and 42 males, mean age: 67.27 years ( = 7.32)]. Depressive symptoms were measured in a cohort of PD patients with MCI. For the BDI-II and BDI-FS the psychometric concepts of internal consistency, convergent validity and diagnostic agreement were assessed. Patients gave higher ratings on test items addressing somatic symptoms than those addressing non-somatic ones. The correlation between the absolute total scores of the BDI-II and the BDI-FS was significant ( = 0.91, < 0.001), which indicated convergent validity. The Cronbach's alpha values indicated adequate internal consistencies for both measures (BDI-II: 0.84; BDI-FS: 0.78). There was a higher than chance level agreement of diagnoses of the two questionnaires, measured by Cohen's kappa (0.58, < 0.001). The agreements between previous diagnosis of depression and the diagnoses of the BDI-II/BDI-FS were also significantly higher than chance level (BDI-II: 0.34, = 0.007, BDI-FS: 0.39, = 0.002). Additional AUC analysis across different cutoffs showed that performance of BDI-FS was better than BDI-II, supporting the observation of an equivalent or better performance of BDI-FS than BDI-II. Importantly, AUC analysis confirmed that a cutoff = 4 for BDI-FS was suitable in the considered sample of patients with PD-MCI. In a cohort of PD-MCI, the BDI-FS demonstrates adequate psychometric properties in comparison to the BDI-II and can be used as a screening measure for assessing depression in cognitively impaired PD patients, focusing solely on psychological symptoms. Still, further research is needed to validate this instrument.

摘要

帕金森病(PD)患者中抑郁症状的患病率很高,且与认知功能障碍有关。特别是在轻度认知障碍(MCI)的帕金森病患者中,需要一种高效且有效的工具来评估抑郁症,该工具主要关注心理症状而忽略混杂的躯体症状。我们对贝克抑郁量表第二版(BDI-II)和贝克抑郁量表快速筛查版(BDI-FS)的心理测量特性进行了检验。样本包括64名患者[22名女性和42名男性,平均年龄:67.27岁(标准差=7.32)]。在一组患有MCI的帕金森病患者中测量抑郁症状。对于BDI-II和BDI-FS,评估了内部一致性、收敛效度和诊断一致性的心理测量概念。患者对涉及躯体症状的测试项目的评分高于涉及非躯体症状的项目。BDI-II和BDI-FS的绝对总分之间的相关性显著(r=0.91,P<0.001),这表明具有收敛效度。克朗巴赫α值表明这两种测量方法都具有足够的内部一致性(BDI-II:0.84;BDI-FS:0.78)。用科恩kappa系数测量,两份问卷诊断的一致性高于随机水平(0.58,P<0.001)。先前抑郁症诊断与BDI-II/BDI-FS诊断之间的一致性也显著高于随机水平(BDI-II:0.34,P=0.007,BDI-FS:0.39,P=0.002)。不同临界值的额外AUC分析表明,BDI-FS的表现优于BDI-II,支持BDI-FS表现等同于或优于BDI-II的观察结果。重要的是,AUC分析证实,在考虑的帕金森病合并MCI患者样本中,BDI-FS的临界值=4是合适的。在一组帕金森病合并MCI患者中,与BDI-II相比,BDI-FS表现出足够的心理测量特性,可作为评估认知受损帕金森病患者抑郁症的筛查工具,仅关注心理症状。不过,仍需要进一步研究来验证该工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3976/7982682/2cde56eb83dd/fneur-12-640137-g0001.jpg

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