Svanborg P, Asberg M
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Acta Psychiatr Scand. 1994 Jan;89(1):21-8. doi: 10.1111/j.1600-0447.1994.tb01480.x.
Self-assessment scales have long been used in psychiatric research even if their validity has often been questioned, one reason being poor the concordance of expert ratings. In clinical practice the use of rating scales is restricted, since they are considered to be time-consuming and perhaps even to disrupt the clinician's rapport with the patient. In the present study, a self-assessment scale, the CPRS Self-rating Scale for Affective Syndromes (CPRS-S-A), was constructed by re-phrasing in a self-rating format 19 items from the original Comprehensive Psychopathological Rating Scale (CPRS) and covering depression, anxiety and obsessional symptoms. In a group of 30 patients with depression syndromes and anxiety syndromes, the CPRS-S-A and the original CPRS were both used on 2 occasions. The patient's Global Assessment of Functioning scores ranged from 30 to 76 (mean 58), which suggests a moderate severity of illness, as does the fact that the majority were outpatients. There was a high degree of concordance between the instruments for most items and for the scores on the subscales for both diagnostic groups (i.e., the Montgomery-Asberg Depression Rating Scale and the Brief Anxiety Scale, which are both subscales drawn from the CPRS). The time taken to complete the CPRS-S-A varied from 5 to 30 min (mean 19 min for depressive and 16 min for anxiety patients on the first occasion, 13 min for both groups on the second), and the self-rating procedure was readily accepted by both groups of patients. The CPRS-S-A would thus seem to be a promising instrument for quantitative rating of symptoms in ambulatory patients, both in clinical practice and in research.
自我评估量表长期以来一直用于精神病学研究,即便其效度常常受到质疑,其中一个原因是专家评定的一致性较差。在临床实践中,评定量表的使用受到限制,因为它们被认为耗时,甚至可能破坏临床医生与患者之间的融洽关系。在本研究中,通过将原始综合精神病理评定量表(CPRS)中的19个项目改写为自评形式,构建了一个自我评估量表,即情感综合征CPRS自评量表(CPRS-S-A),涵盖抑郁、焦虑和强迫症状。在一组30例患有抑郁综合征和焦虑综合征的患者中,CPRS-S-A和原始CPRS均使用了两次。患者的功能总体评定分数在30至76分之间(平均58分),这表明疾病严重程度为中度,大多数患者为门诊患者这一事实也说明了这一点。对于两个诊断组(即蒙哥马利-阿斯伯格抑郁评定量表和简短焦虑量表,二者均为CPRS的分量表)的大多数项目以及分量表得分,两种评定工具之间具有高度一致性。完成CPRS-S-A所需时间从5分钟到30分钟不等(首次评定时,抑郁患者平均用时19分钟,焦虑患者平均用时16分钟,第二次评定时两组均为13分钟),自评程序很容易被两组患者接受。因此,CPRS-S-A似乎是一种很有前景的工具,可用于在临床实践和研究中对门诊患者的症状进行定量评定。