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抑郁症状快速问卷临床医生版(VQIDS-C)和自评版(VQIDS-SR)的心理测量与临床评估

Psychometric and Clinical Evaluation of the Clinician (VQIDS-C) and Self-Report (VQIDS-SR) Versions of the Very Quick Inventory of Depressive Symptoms.

作者信息

Rush A John, Madia Nancy D, Carmody Thomas, Trivedi Madhukar H

机构信息

Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA.

Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.

出版信息

Neuropsychiatr Dis Treat. 2022 Feb 17;18:289-302. doi: 10.2147/NDT.S342457. eCollection 2022.

Abstract

PURPOSE

Evaluate the psychometric properties of the 5-item Very Quick Inventory of Depressive Symptomatology self-report and clinician-rated versions (VQIDS-SR/VQIDS-C), compare their relative performance, create crosswalks between their total scores and other accepted depressive symptom ratings, and define clinically relevant depressive symptom severity thresholds and categorical outcomes for both versions.

PATIENTS AND METHODS

The Sequenced Treatment Alternatives to Relieve Depression trial obtained baseline and exit 17-item Hamilton Rating Scale for Depression (HRSD) and 30-item Inventory of Depressive Symptomatology - Clinician-rated scores, and baseline and visit-wise QIDS-SR and QIDS-C ratings from the first treatment step (citalopram). The VQIDS-C and the VQIDS-SR items (sad mood, self-outlook, involvement, fatigue, psychomotor slowing) (each rated 0-3), extracted from the corresponding 16-item ratings, were selected to best reflect the 6-item HRSD (HRSD) (exclusive of anxiety). Classical Test Theory (CTT) and Item-Response Theory (IRT) analyses assessed psychometric features. IRT analyses produced total score crosswalks between the VQIDS, QIDS-C, QIDS-SR and HRSD. Clinically relevant VQIDS symptom severity thresholds and treatment outcomes were estimated based on cross-walks from the parent QIDS ratings.

RESULTS

Both VQIDS versions were unifactorial with acceptable internal consistencies (Cronbach's alphas >0.80), item-total correlations (0.57-0.74) by CCT, and strong IRT item performance. Based on QIDS severity thresholds (none 0-5; mild 6-10; moderate 11-15; severe 16-20; and very severe 21-27), comparable thresholds were 0-2; 3-5; 6-9; 9-12; and >12 for VQIDS-C, and 0-2; 2-5; 6-8; 9-12; and >12 for VQIDS-SR. Kappa values were acceptable in comparing categories of outcomes (eg, no benefit, remission, etc) based on VQIDS and corresponding QIDS categories.

CONCLUSION

The VQIDS-C and VQIDS-SR assess selected core depressive symptoms with psychometrically acceptable properties. Theelf-report and clinician-rated versions provide virtually identical information, symptom severity thresholds and symptom change categories. Both are as sensitive to change as the corresponding QIDS, making them suitable for use in busy practices.

摘要

目的

评估5项抑郁症状快速自评量表(VQIDS-SR)和临床医生评定量表(VQIDS-C)的心理测量特性,比较它们的相对表现,建立两者总分与其他公认的抑郁症状评定之间的对照表,并确定两个版本在临床上具有相关性的抑郁症状严重程度阈值和分类结果。

患者与方法

缓解抑郁的序贯治疗替代方案试验获取了基线和结束时的17项汉密尔顿抑郁评定量表(HRSD)评分、30项抑郁症状量表临床医生评定得分,以及第一个治疗步骤(西酞普兰)的基线和各访视点的QIDS-SR及QIDS-C评分。从相应的16项评分中提取出VQIDS-C和VQIDS-SR的项目(悲伤情绪、自我认知、参与度、疲劳、精神运动迟缓)(每项评分为0-3分),以最佳反映6项HRSD(不包括焦虑)。采用经典测验理论(CTT)和项目反应理论(IRT)分析评估心理测量特征。IRT分析得出了VQIDS、QIDS-C、QIDS-SR和HRSD之间的总分对照表。基于母体QIDS评分的对照表估计了临床上具有相关性的VQIDS症状严重程度阈值和治疗结果。

结果

两个VQIDS版本均为单因素量表,具有可接受的内部一致性(Cronbach's α>0.80),CTT得出的项目与总分相关性为0.57-0.74,IRT项目表现良好。根据QIDS严重程度阈值(无:0-5;轻度:6-10;中度:11-15;重度:16-20;极重度:21-27),VQIDS-C的可比阈值分别为0-2;3-5;6-9;9-12;>12,VQIDS-SR的可比阈值分别为0-2;2-5;6-8;9-12;>12。基于VQIDS和相应QIDS类别比较结果类别(如无改善、缓解等)时,kappa值可接受。

结论

VQIDS-C和VQIDS-SR评估选定的核心抑郁症状,具有可接受的心理测量特性。自评量表和临床医生评定量表提供了几乎相同的信息、症状严重程度阈值和症状变化类别。两者对变化的敏感性与相应的QIDS相同,适用于繁忙的临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3df/8860726/f5520bf46a6b/NDT-18-289-g0001.jpg

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