Assouly-Besse F, Dollfus S, Petit M
Service de Psychiatrie, Centre hospitalier René Dubos, Pontoise.
Encephale. 1995 Jul-Aug;21(4):273-84.
Whereas Chapman's social and physical scales are the most used instruments for the assessment of anhedonia in schizophrenia, no French translation has been still validated by the authors. Therefore, the aim of this study was first to translate into French the both scales, and after back translation, to obtain the agreement of the original authors. Second, the aim was to establish values and to establish the cut-off beyond of which French subjects could be considered as anhedonic. One hundred and twenty-three subjects were included: 72 control subjects without mental disorders and 51 stable schizophrenic patients defined by the DSM III-R, ICD 9, ICD 10, RDC or Feighner criteria. According to the literature, schizophrenic patients had higher scores for both scales than control subjects (p < 0.001; Student t test). The social anhedonia scores are different due to cultural variations. The distribution of physical anhedonia scores in control subjects or in schizophrenic patients differed from normal distributions (respectively, p < 0.05; p < 0.0001; Shapiro-Wilks test). The distribution of social anhedonia scores differed from normal distributions (p < 0.01) only in schizophrenic patients but not in control subjects. By maximising the Younden indice [Sensitivity + Specificity -1], the cut-off of the physical anhedonia score was 18 (Younden indice = 0.45), and the cut-off of the social anhedonia score was 12 (Younden indice = 0.24). In using this cut-off, the French physical anhedonia scale had a good positive predictive value (evaluated by logistic regression) for schizophrenia. Therefore, a patient with a physical anhedonia score beyond 18 have a probability of 64% to be schizophrenic. In contrast, the social anhedonia scale was less discriminant for schizophrenia. Indeed, patient with a social anhedonia score beyond 12 have a probability of 52% to be schizophrenic. This French version of Chapman's anhedonia scales could be considered as an useful instrument to assess anhedonia, in particular physical anhedonia, in schizophrenic patients.
尽管查普曼社会和身体量表是评估精神分裂症快感缺失最常用的工具,但作者尚未对其法语翻译进行验证。因此,本研究的目的首先是将这两个量表翻译成法语,在回译后,获得原作者的认可。其次,目的是确定正常值并确定临界值,超过该临界值的法国受试者可被视为快感缺失。共纳入123名受试者:72名无精神障碍的对照受试者和51名根据《精神疾病诊断与统计手册》第三版修订本(DSM III-R)、《国际疾病分类》第九版(ICD 9)、《国际疾病分类》第十版(ICD 10)、研究诊断标准(RDC)或费格纳标准定义的稳定精神分裂症患者。根据文献,精神分裂症患者在两个量表上的得分均高于对照受试者(p < 0.001;学生t检验)。由于文化差异,社会快感缺失得分有所不同。对照受试者或精神分裂症患者身体快感缺失得分的分布与正态分布不同(分别为p < 0.05;p < 0.0001;夏皮罗-威尔克检验)。社会快感缺失得分的分布仅在精神分裂症患者中与正态分布不同(p < 0.01),而在对照受试者中并非如此。通过最大化约登指数[敏感度 + 特异度 - 1],身体快感缺失得分的临界值为18(约登指数 = 0.45),社会快感缺失得分的临界值为12(约登指数 = 0.24)。使用该临界值时,法语版身体快感缺失量表对精神分裂症具有良好的阳性预测价值(通过逻辑回归评估)。因此,身体快感缺失得分超过18的患者患精神分裂症的概率为64%。相比之下,社会快感缺失量表对精神分裂症的鉴别能力较差。事实上,社会快感缺失得分超过12得患者患精神分裂症的概率为52%。这个法语版的查普曼快感缺失量表可被视为评估精神分裂症患者快感缺失,特别是身体快感缺失的有用工具。