西班牙初级卫生保健中抑郁症的测量：HSCL-5和HSCL-10的心理测量特性及诊断准确性
Measuring depression in Primary Health Care in Spain: Psychometric properties and diagnostic accuracy of HSCL-5 and HSCL-10.
作者信息
Rodríguez-Barragán María, Fernández-San-Martín María Isabel, Clavería Ana, Le Reste Jean Yves, Nabbe Patrice, Motrico Emma, Gómez-Gómez Irene, Peguero-Rodríguez Eva
机构信息
Primary Health Centre La Mina, Gerència Territorial d'Atenció Primària de Barcelona, Institut Català de la Salut, Sant Adrià de Besòs, Barcelona, Spain.
Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
出版信息
Front Med (Lausanne). 2023 Jan 9;9:1014340. doi: 10.3389/fmed.2022.1014340. eCollection 2022.
BACKGROUND
Depression has a high prevalence among European countries. Several instruments have been designed to assess its symptoms in different populations. The Hopkins Symptom Checklist 25 (HSCL-25) scale has been identified as valid, reproducible, effective, and easy to use. There are short versions of this scale that could be useful in Primary Care (PC) settings, but their psychometric properties are unknown.
AIM
To assess in PC patients the psychometric properties and diagnostic accuracy of the Spanish version of the HSCL-10 and the HSCL-5 consisting of 10 and 5 items, respectively.
METHODS
A multicenter, cross-sectional study was carried out at six PC centers in Spain. The HSCL-25 was administered to outpatients aged 45-75 who also participated in the structured Composite International Diagnostic Interview (CIDI). HSCL-10 and HSCL-5 were assessed and compared to HSCL-25 regarding total score correlation, internal consistency, and criterion validity against the gold-standard CIDI. This is a methodological study from a secondary data analysis and the primary data has been previously published.
RESULTS
Out of 790 patients, 767 completed the HSCL-25 and 736 the CIDI interview (96.0%). Cronbach's Alpha was 0.84 for HSCL-10 and 0.77 for HSCL-5. The known-group method and confirmatory factor analysis were acceptable for the establishment of construct validity. Sensitivity was 79.7% (CI95%, 67.7-88.0%) for HSCL-10, and 78.0% (CI95%, 65.9-86.6%) for HSCL-5, whereas specificity was 83% (CI95%, 80.0-85.7%) for HSCL-10, and 72.8% (CI95%, 69.3-76.0%) for HSCL-5. Area under the curve against CIDI was 0.88 (CI95%, 0.84-0.92%) for HSCL-10, and 0.85 (CI95%, 0.81-0.89%) for HSCL-5. Optimum cutoff point calculated with Youden Index was 1.90 for the HSCL-10 and 1.80 for the HSCL-5.
CONCLUSION
HSCL-10 and HSCL-5 are reliable and valid tools to detect depression symptoms and can be used in PC settings.
背景
抑郁症在欧洲国家中具有较高的患病率。已经设计了多种工具来评估不同人群中的抑郁症状。霍普金斯症状清单25项（HSCL - 25）量表已被确定为有效、可重复、高效且易于使用。该量表有简短版本，可能在初级保健（PC）环境中有用，但它们的心理测量特性尚不清楚。
目的
评估西班牙文版的分别包含10项和5项的HSCL - 10和HSCL - 5在初级保健患者中的心理测量特性和诊断准确性。
方法
在西班牙的六个初级保健中心开展了一项多中心横断面研究。对年龄在45 - 75岁的门诊患者进行HSCL - 25量表测评，这些患者同时还参与了结构化的复合国际诊断访谈（CIDI）。对HSCL - 10和HSCL - 5进行评估，并在总分相关性、内部一致性以及相对于金标准CIDI的标准效度方面与HSCL - 25进行比较。这是一项基于二次数据分析的方法学研究，原始数据此前已发表。
结果
在790名患者中，767人完成了HSCL - 25量表测评，736人完成了CIDI访谈（96.0%）。HSCL - 10的克朗巴哈系数为0.84，HSCL - 5的克朗巴哈系数为0.77。已知组方法和验证性因素分析对于构建效度的建立是可接受的。HSCL - 10的敏感性为79.7%（95%置信区间，67.7 - 88.0%），HSCL - 5的敏感性为78.0%（95%置信区间，65.9 - 86.6%）；而HSCL - 10的特异性为83%（95%置信区间，80.0 - 85.7%），HSCL - 5的特异性为72.8%（95%置信区间，69.3 - 76.0%）。相对于CIDI的曲线下面积，HSCL - 10为0.88（95%置信区间，0.84 - 0.92%），HSCL - 5为0.85（95%置信区间，0.81 - 0.89%）。使用约登指数计算的最佳截断点，HSCL - 10为1.90，HSCL - 这5为1.80。
结论
HSCL - 10和HSCL - 5是检测抑郁症状的可靠且有效的工具，可用于初级保健环境。
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