Kuny S, Stassen H H
Research Department, Psychiatric University Hospital Zurich, Switzerland.
J Psychiatr Res. 1993 Jul-Sep;27(3):289-307. doi: 10.1016/0022-3956(93)90040-9.
Based on a sample of 30 depressive patients, we have investigated the time course of recovery from depression in so far as this time course was assessable through changes in psychopathology syndrome scores and through changes in speaking behavior and voice sound characteristics. Specifically, our study design provided 6 repeated assessments over 2 weeks and at a fixed time in the morning each Monday, Wednesday and Friday, plus a final assessment at the patients' releases from hospital. Thus, we were able to determine the degree to which single-parameter approaches to speaking behavior and voice sound characteristics reflect the individual time course of recovery from depression. In this context, we could rely upon a calibration sample with repeated assessments on 192 healthy volunteers which yielded all necessary information concerning reproducibility and sensitivity of speech parameters. Our analysis revealed several prominent features of speaking behavior and voice sound characteristics to be closely related to the time course of recovery from depression. In particular, the parameters "F0-amplitude", "F0-6db-bandwidth" and "F0-contour" which assess important characteristics of a speaker's voice timbre, as well as the parameters "energy" and "dynamics" which assess a speaker's mean loudness and the variation of loudness over time, displayed consistently high correlations with depression syndromes. Moreover, the results of single-case analysis turned out to be in remarkable accordance with those of the cross-sectional one: in almost two-thirds of patients there existed a significant relationship over time between the global depression scores and major speech parameters. As to the remaining one-third of patients who did not fit the picture of high correlations between psychopathology and speech parameters, we found an overproportionally large number of non-improvers characterized by irregular patterns of slight improvement with subsequent deterioration, or of deterioration followed by slight improvement. In other words, one-third of patients displayed time courses of depression whose psychopathology is difficult to assess through standard exploration techniques. Accordingly, it is not clear whether the observed lack of correlation in these patients is due to insufficient data or to an actual discordance between the time development of psychopathology and that of speech parameters.
基于30名抑郁症患者的样本，我们研究了抑郁症康复的时间进程，前提是该时间进程可通过心理病理综合征评分的变化以及言语行为和语音特征的变化来评估。具体而言，我们的研究设计在2周内进行了6次重复评估，每周一、三、五上午的固定时间进行，另外在患者出院时进行了一次最终评估。因此，我们能够确定单参数方法对言语行为和语音特征的反映程度，以体现抑郁症康复的个体时间进程。在此背景下，我们可以依赖一个校准样本，该样本对192名健康志愿者进行了重复评估，得出了有关语音参数的可重复性和敏感性的所有必要信息。我们的分析揭示了言语行为和语音特征的几个突出特征，这些特征与抑郁症康复的时间进程密切相关。特别是，评估说话者音色重要特征的参数“F0振幅”、“F0 - 6分贝带宽”和“F0轮廓”，以及评估说话者平均响度和响度随时间变化的参数“能量”和“动态”，与抑郁综合征始终呈现出高度相关性。此外，单病例分析的结果与横断面分析的结果非常一致：在几乎三分之二的患者中，总体抑郁评分与主要语音参数之间随时间存在显著关系。对于其余三分之一不符合心理病理学与语音参数高度相关情况的患者，我们发现有过多数量的未改善患者，其特征是改善模式不规则，先是略有改善随后恶化，或者先是恶化随后略有改善。换句话说，三分之一患者的抑郁症时间进程，其心理病理学难以通过标准探索技术进行评估。因此，尚不清楚这些患者中观察到的缺乏相关性是由于数据不足，还是由于心理病理学的时间发展与语音参数的时间发展之间实际存在不一致。
