Fava G A, Pilowsky I, Pierfederici A, Bernardi M, Pathak D
Psychother Psychosom. 1982;38(1):141-53. doi: 10.1159/000287622.
Occurrence and characteristics of depression and illness behavior were studied in 325 inpatients of a general hospital in the northern part of Italy. Patients were surveyed in six separate wards (medicine, surgery, dermatology, obstetrics and gynecology, orthopedics and ophthalmology) and represented about 90% of their actual population during a 1-week period. Two self-report scales were used for screening: the CES-D for measuring depression developed by the NIMH and the Illness Behavior Questionnaire (IBQ) developed by Pilowsky and Spence. Both scales were administered in their validated Italian translations. Applying the generally used cut-off point of 16 in the CES-D score, about 58% of the patients were classified as depressed. This cut-off was derived from community studies in the US. Applying a rather more conservative cut-off point of 23 (derived from the scores of psychiatrically depressed patients in Italy), still 33.5% of the patients emerged as depressed. The IBQ scores of the depressed patients showed significantly (p less than 0.001) higher levels of general hypochondriasis, disease conviction, dysphoria and irritability than the nondepressed patients. There were no relevant differences between wards in the amount of depression and IBQ scores even when differences were adjusted for age, sex, marital status and social class. Implications for psychosomatic research (sociodemographic characteristics of depression and illness behavior, bias in comparing hospital patients and controls in the general population, etc.) and treatment (consultation-liaison psychiatry) are discussed.
在意大利北部一家综合医院的325名住院患者中，对抑郁症和疾病行为的发生情况及特征进行了研究。在六个不同科室（内科、外科、皮肤科、妇产科、骨科和眼科）对患者进行了调查，这些患者代表了一周内其实际住院人数的约90%。使用了两种自我报告量表进行筛查：美国国立精神卫生研究所开发的用于测量抑郁症的流调中心用抑郁量表（CES-D），以及皮洛斯基和斯彭斯开发的疾病行为问卷（IBQ）。两种量表均采用经验证的意大利语翻译版本进行施测。将CES-D得分中普遍使用的临界值16应用于此研究，约58%的患者被归类为抑郁。这个临界值源自美国的社区研究。应用一个更为保守的临界值23（源自意大利精神病性抑郁患者的得分），仍有33.5%的患者被判定为抑郁。抑郁患者的IBQ得分显示，与非抑郁患者相比，在一般疑病、疾病确信、烦躁不安和易怒等方面的水平显著更高（p<0.001）。即使在对年龄、性别、婚姻状况和社会阶层进行差异调整后，各科室之间在抑郁程度和IBQ得分方面也没有显著差异。文中讨论了该研究对心身医学研究（抑郁症和疾病行为的社会人口学特征、在比较医院患者和普通人群中的对照组时存在的偏差等）和治疗（会诊-联络精神病学）的意义。
