Vaccarino Anthony L, Black Sandra E, Gilbert Evans Susan, Frey Benicio N, Javadi Mojib, Kennedy Sidney H, Lam Benjamin, Lam Raymond W, Lasalandra Bianca, Martens Emily, Masellis Mario, Milev Roumen, Mitchell Sara, Munoz Douglas P, Sparks Alana, Swartz Richard H, Tan Brian, Uher Rudolf, Evans Kenneth R
Indoc Research, Toronto, ON, Canada.
Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.
Front Psychiatry. 2023 Jun 2;14:1154519. doi: 10.3389/fpsyt.2023.1154519. eCollection 2023.
Symptoms of depression are present in neurodegenerative disorders (ND). It is important that depression-related symptoms be adequately screened and monitored in persons living with ND. The Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) is a widely-used self-report measure to assess and monitor depressive severity across different patient populations. However, the measurement properties of the QIDS-SR have not been assessed in ND.
To use Rasch Measurement Theory to assess the measurement properties of the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) in ND and in comparison to major depressive disorder (MDD).
De-identified data from the Ontario Neurodegenerative Disease Research Initiative (NCT04104373) and Canadian Biomarker Integration Network in Depression (NCT01655706) were used in the analyses. Five hundred and twenty participants with ND (Alzheimer's disease or mild cognitive impairment, amyotrophic lateral sclerosis, cerebrovascular disease, frontotemporal dementia and Parkinson's disease) and 117 participants with major depressive disorder (MDD) were administered the QIDS-SR. Rasch Measurement Theory was used to assess measurement properties of the QIDS-SR, including unidimensionality and item-level fit, category ordering, item targeting, person separation index and reliability and differential item functioning.
The QIDS-SR fit well to the Rasch model in ND and MDD, including unidimensionality, satisfactory category ordering and goodness-of-fit. Item-person measures (Wright maps) showed gaps in item difficulties, suggesting poor precision for persons falling between those severity levels. Differences between mean person and item measures in the ND cohort logits suggest that QIDS-SR items target more severe depression than experienced by the ND cohort. Some items showed differential item functioning between cohorts.
The present study supports the use of the QIDS-SR in MDD and suggest that the QIDS-SR can be also used to screen for depressive symptoms in persons with ND. However, gaps in item targeting were noted that suggests that the QIDS-SR cannot differentiate participants falling within certain severity levels. Future studies would benefit from examination in a more severely depressed ND cohort, including those with diagnosed clinical depression.
神经退行性疾病（ND）患者存在抑郁症状。对ND患者的抑郁相关症状进行充分筛查和监测非常重要。抑郁症状快速自评量表（QIDS-SR）是一种广泛使用的自评工具，用于评估和监测不同患者群体的抑郁严重程度。然而，QIDS-SR在ND中的测量特性尚未得到评估。
运用拉施测量理论评估抑郁症状快速自评量表（QIDS-SR）在ND中的测量特性，并与重度抑郁症（MDD）进行比较。
分析来自安大略神经退行性疾病研究倡议（NCT04104373）和加拿大抑郁症生物标志物整合网络（NCT01655706）的匿名数据。对520名ND患者（阿尔茨海默病或轻度认知障碍、肌萎缩侧索硬化症、脑血管疾病、额颞叶痴呆和帕金森病）和117名重度抑郁症（MDD）患者进行QIDS-SR测评。运用拉施测量理论评估QIDS-SR的测量特性，包括单维度性和项目水平拟合、类别排序、项目靶向、人员分离指数以及信度和项目功能差异。
QIDS-SR在ND和MDD中与拉施模型拟合良好，包括单维度性、令人满意的类别排序和拟合优度。项目-人员测量（赖特图）显示项目难度存在差距，表明处于这些严重程度水平之间的人员精度较差。ND队列对数几率中平均人员测量和项目测量之间的差异表明，QIDS-SR项目针对的是比ND队列所经历的更严重的抑郁症。一些项目在不同队列之间显示出项目功能差异。
本研究支持在MDD中使用QIDS-SR，并表明QIDS-SR也可用于筛查ND患者的抑郁症状。然而，注意到项目靶向存在差距，这表明QIDS-SR无法区分处于特定严重程度水平的参与者。未来的研究将受益于在更严重抑郁的ND队列中进行检查，包括那些被诊断为临床抑郁症的患者。
