Jha Manish K, Minhajuddin Abu, Slater Holli, Mayes Taryn L, Blader Joseph, Brown Ryan, Garza Cynthia, Kennard Beth D, Riddle David, Storch Eric A, Shotwell Joseph, Soutullo Cesar A, Wakefield Sarah M, Trivedi Madhukar H
Department of Psychiatry, University of Texas Southwestern Medical Center in Dallas, TX, USA; Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center in Dallas, TX, USA; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Psychiatr Res. 2023 May;161:179-187. doi: 10.1016/j.jpsychires.2023.03.020. Epub 2023 Mar 13.
Symptoms of irritability, anxiety, panic, and insomnia are common in patients with depression, and their worsening after antidepressant treatment initiation is associated with poorer long-term outcomes. The Concise Associated Symptom Tracking (CAST) scale was developed to measure these symptoms in adults with major depressive disorder (MDD). Here, we evaluate the psychometric properties of CAST in an ongoing community-based observational study involving children, adolescents, and young adults. Individuals from the ongoing Texas Youth Depression and Suicide Research Network (TX-YDSRN; N = 952) with CAST data available were included. Fit statistics [Goodness of Fit Index (GFI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA)] from confirmatory factor analyses were used to evaluate the five- and four-domain structure of CAST. Item response theory (IRT) analyses were also used. Individuals were grouped based on age (in years) as youths (8-17) and young adults (18-20). Correlations with other clinical measures were used to inform construct validity. Four-domain (irritability, anxiety, panic, and insomnia) 12-item structure of CAST (CAST-12) was optimal for youths (N = 709, GFI = 0.906, CFI = 0.919, RMSEA = 0.095) and young adults (N = 243, GFI = 0.921, CFI = 0.938, RMSEA = 0.0797) with Cronbach's alpha of 0.87 and 0.88, respectively. Slope of each item exceeded 1.0 on IRT analyses suggesting adequate discrimination for each item. Scores on irritability, anxiety, panic, and insomnia were significantly correlated with similar items on other scales. Together these findings suggest that CAST-12 is a valid self-report measure of irritability, anxiety, insomnia, and panic in youths and young adults.
易激惹、焦虑、惊恐和失眠症状在抑郁症患者中很常见，且在开始抗抑郁治疗后症状恶化与较差的长期预后相关。简明相关症状追踪（CAST）量表旨在测量重度抑郁症（MDD）成人患者的这些症状。在此，我们在一项正在进行的基于社区的观察性研究中评估CAST在儿童、青少年和青年中的心理测量特性，该研究涉及儿童、青少年和青年。纳入了来自正在进行的德克萨斯青少年抑郁与自杀研究网络（TX - YDSRN；N = 952）且有CAST数据的个体。来自验证性因子分析的拟合统计量[拟合优度指数（GFI）、比较拟合指数（CFI）和近似均方根误差（RMSEA）]用于评估CAST的五域和四域结构。还采用了项目反应理论（IRT）分析。个体按年龄（岁）分为青少年（8 - 17岁）和青年（18 - 20岁）。与其他临床测量指标的相关性用于说明结构效度。CAST的四域（易激惹、焦虑、惊恐和失眠）12项结构（CAST - 12）对青少年（N = 709，GFI = 0.906，CFI = 0.919，RMSEA = 0.095）和青年（N = 243，GFI = 0.921，CFI = 0.938，RMSEA = 0.0797）是最优的，克朗巴哈α系数分别为0.87和0.88。IRT分析中每个项目的斜率均超过1.0，表明每个项目具有足够的区分度。易激惹、焦虑、惊恐和失眠得分与其他量表上的类似项目显著相关。这些研究结果共同表明，CAST - 12是青少年和青年中易激惹、焦虑、失眠和惊恐的有效自评测量工具。
