Chen Xiongying, Feng Zizhao, Li Nanxi, Xiao Le, Chen Xu, Zhu Xuequan
Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, Beijing, China.
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
BMC Psychiatry. 2025 Jan 7;25(1):20. doi: 10.1186/s12888-024-06418-3.
It is important to timely capture the fluctuation of the symptoms related to major depressive disorder (MDD). However, most conventionally used assessment tools for MDD symptoms are not designed for real-time assessment. The Immediate Mood Scaler (IMS) is suitable for the real-time evaluation of the mood of patients with MDD.
The original IMS was translated into Chinese and back-translated. At baseline, data from 368 patients with MDD, including demographic information and scores on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and IMS, were collected. In total, 185 participants completed the retest at Week 2 which included the PHQ-9, GAD-7, and IMS. Internal structural validity, construct validity, and internal consistency were evaluated with the confirmatory factor analysis (CFA), the Pearson correlation, and Cronbach's α, respectively. Responsiveness was anchored by the change of the PHQ-9 total scores from baseline to Week 2 and predictability was tested using the multivariate linear mixed model for repeated measures (MMRM).
Two factors with an eigenvalue greater than 1, corresponding to IMS-Depression and IMS-Anxiety subscales, were identified using CFA. The Cronbach's α that evaluated internal consistency was 0.96, 0.95, and 0.92 for the scores of the IMS, IMS-Depression subscale, and IMS-Anxiety subscale at baseline, respectively. The depression and anxiety subscales at baseline showed high subscale-total correlations (r = 0.96 for the depression subscale; r = 0.89 for the anxiety subscale). The test-retest ICC (0.65, 95%CI: 0.53-0.73) of the IMS at baseline and Week 2 show high reliability. The total score of IMS had significant correlations with that of the PHQ-9 (r = 0.52, P < 0.001) and GAD-7(r = 0.43, P < 0.001), indicating good construct validity. In patients with MDD who showed changes in mood, the changes in total scores of the IMS from baseline to the retest were statistically significant with a mean difference of 13.3 (SD: 20.1), an ES of 0.66, and an SRM of 0.3, showing good responsiveness. Also, the baseline IMS-Depression subscale score could predict the change in the PHQ-9 score over the two weeks (t = 2.19, P = 0.029).
Study findings suggest that the Chinese version of the IMS is a valid and reliable tool for assessing mood symptoms in patients with MDD in China. Further validation studies of the Chinese version IMS in different regions and at various levels of medical institutions are needed to further confirm the current findings.
及时捕捉与重度抑郁症（MDD）相关症状的波动很重要。然而，大多数传统用于评估MDD症状的工具并非为实时评估而设计。即时情绪量表（IMS）适用于对MDD患者的情绪进行实时评估。
将原始的IMS翻译成中文并进行回译。在基线时，收集了368例MDD患者的数据，包括人口统计学信息以及患者健康问卷-9（PHQ-9）、广泛性焦虑障碍-7（GAD-7）和IMS的得分。共有185名参与者在第2周完成了复测，复测内容包括PHQ-9、GAD-7和IMS。分别采用验证性因子分析（CFA）、Pearson相关性分析和Cronbach's α评估内部结构效度、结构效度和内部一致性。以PHQ-9总分从基线到第2周的变化为锚定来评估反应性，并使用重复测量多元线性混合模型（MMRM）测试预测性。
使用CFA确定了两个特征值大于1的因子，分别对应IMS-抑郁和IMS-焦虑子量表。评估内部一致性的Cronbach's α在基线时，IMS得分、IMS-抑郁子量表得分和IMS-焦虑子量表得分分别为0.96、0.95和0.92。基线时的抑郁和焦虑子量表显示出较高的子量表总分相关性（抑郁子量表r = 0.96；焦虑子量表r = 0.89）（此处原文有误，前面说的是总分与其他量表的相关性，这里突然说子量表总分相关性，推测应该是子量表与总分的相关性，若按此推测，此处应为：基线时的抑郁和焦虑子量表显示出较高的子量表与总分相关性（抑郁子量表r = 0.96；焦虑子量表r = 0.89））。基线和第2周时IMS的重测组内相关系数（ICC）（0.65，95%CI：0.53 - 0.73）显示出高可靠性。IMS总分与PHQ-9总分（r = 0.52，P < 0.001）和GAD-7总分（r = 0.43，P < 0.001）有显著相关性，表明具有良好的结构效度。在情绪有变化的MDD患者中，IMS总分从基线到复测的变化具有统计学意义，平均差异为13.3（标准差：20.1），效应量为0.66，标准化反应均值为0.3，显示出良好的反应性。此外，基线时的IMS-抑郁子量表得分可以预测两周内PHQ-9得分的变化（t = 2.19，P = 0.029）。
研究结果表明，中文版IMS是评估中国MDD患者情绪症状的有效且可靠的工具。需要在不同地区和各级医疗机构对中文版IMS进行进一步的验证研究，以进一步证实当前研究结果。
