Osman Naweed, Chow Winnie S, Michel Chantal, Meisenzahl Eva, Schimmelmann Benno G, Schultze-Lutter Frauke
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Early Interv Psychiatry. 2023 Jan;17(1):85-95. doi: 10.1111/eip.13296. Epub 2022 Mar 29.
The Kessler psychological distress scales (K10 and K6) are used as screening tools to assess psychological distress related to the likely presence of a mental disorder. Thus, we studied the psychometric properties of their German versions in a Swiss community sample to evaluate their potential usefulness to screen for mental disorders or relevant mental problems in the community and, relatedly, for low threshold transdiagnostic German-speaking services.
The sample consisted of 829 citizens of the Swiss canton Bern of age 19-43 years. K10/K6 were validated against mini-international neuropsychiatric interview (M.I.N.I.) diagnoses, questionnaires about health status and quality of life. Receiver operating characteristic (ROC) curve analyses were used to test for general discriminative ability and to select optimal cut-offs of the K10 and K6 for non-psychotic full-blown and subthreshold mental disorders.
Cronbach's alphas were 0.81 (K10) and 0.70 (K6). ROC analyses indicated much lower optimal thresholds than earlier suggested; 10 for K10 and 6 for K6. At these thresholds, against M.I.N.I. diagnoses, Cohen's κ (≤0.173) and correspondence rates (≤58.14%) were insufficient throughout. Values were higher at the earlier suggested threshold, yet, at the cost of sensitivity that was below 0.5 in all but three, and below 0.3 in all but six cases.
For the lack of sufficient validity and sensitivity, respectively, our findings suggest that both K10 and K6 would only be of limited use in a low-threshold transdiagnostic mental health service for young adults in Switzerland and likely other German-speaking countries.
凯斯勒心理困扰量表（K10和K6）被用作筛查工具，以评估与可能存在的精神障碍相关的心理困扰。因此，我们在瑞士社区样本中研究了其德文版本的心理测量特性，以评估它们在社区中筛查精神障碍或相关心理问题的潜在效用，以及与低门槛跨诊断德语服务的相关性。
样本包括829名年龄在19至43岁之间的瑞士伯尔尼州公民。K10/K6通过与迷你国际神经精神病学访谈（M.I.N.I.）诊断、关于健康状况和生活质量的问卷进行验证。使用受试者工作特征（ROC）曲线分析来测试一般判别能力，并为非精神病性全面发作和阈下精神障碍选择K10和K6的最佳临界值。
克朗巴赫α系数分别为0.81（K10）和0.70（K6）。ROC分析表明最佳阈值比先前建议的要低得多；K10为10，K6为6。在这些阈值下，与M.I.N.I.诊断相比，科恩κ系数（≤0.173）和符合率（≤58.14%）始终不足。在先前建议的阈值下数值更高，然而，以敏感性为代价，除三例之外所有病例的敏感性均低于0.5，除六例之外所有病例的敏感性均低于0.3。
分别由于缺乏足够的效度和敏感性，我们的研究结果表明，对于瑞士以及可能其他德语国家的低门槛跨诊断心理健康服务中的年轻人而言，K10和K6的用途都将十分有限。
