Morasso G, Costantini M, Baracco G, Borreani C, Capelli M
Department of Psychology, National Institute for Cancer Research, Genova, Italy.
Oncology. 1996 Jul-Aug;53(4):295-302. doi: 10.1159/000227576.
Screening for psychological distress in cancer patients is important, considering the high prevalence of psychiatric disorders responsive to treatment. The aim of this study is to test the psychometric properties of the Psychological Distress Inventory (PDI), a 13-item self-administered questionnaire developed to measure psychological distress in cancer patients.
The PDI was tested in three samples of 434 cancer patients. In the first sample (n = 102) it was administered with the State Trait Anxiety Inventory (STAI) and with the Eysenck Personality Questionnaire (EPQ). Its validity as a screening method for psychiatric disorders was evaluated through a clinical interview in the second sample (n = 107). The third sample (n = 225) provided information on the ability of the PDI to discriminate among patients in different clinical phases of disease and allowed an estimate of the prevalence of psychiatric disorders in these groups of patients.
A 0.88 alpha coefficient was obtained in the whole study sample. The correlations with the STAI scales were > 0.70. A positive correlation with neuroticism (r = 0.59) and a negative correlation with extroversion (r = -0.34) was observed. In the second sample, 67 patients (62.6%) received a psychiatric diagnosis according to the ICD-X criteria. The mean PDI scores were significantly lower for the 40 patients with no psychiatric diagnosis (mean 24.5) as compared with the 49 patients with adjustment disorders (mean 36.4) and with the 12 patients with depressive disorders (mean 40.8). The area under curve, estimated through a Receiver-Operating Characteristics analysis, was 0.88. A cut-off of 29 was associated with a 75% sensitivity and a 85% specificity. In the third sample, the lowest PDI scores were in patients with no evidence of disease (mean 24.7, 95% CL 23.0-26.4) as compared to patients undergoing antineoplastic treatment (mean 30.9, 95% CL 28.9-32.9) and to patients under palliative therapy (mean 36.0, 95% CL 34.0-37.9). The estimated prevalence of patients with psychiatric disorders in these three groups were respectively 5.0, 56.6 and 98.8%.
Our results suggest that the PDI is a reliable and valid tool for measuring psychological distress in cancer patients and to detect psychiatric disorders through a screening procedure.
鉴于对治疗有反应的精神障碍在癌症患者中普遍存在，对癌症患者进行心理困扰筛查很重要。本研究的目的是测试心理困扰量表（PDI）的心理测量特性，该量表是一份包含13个条目的自填式问卷，旨在测量癌症患者的心理困扰。
对434名癌症患者的三个样本进行了PDI测试。在第一个样本（n = 102）中，将其与状态-特质焦虑量表（STAI）和艾森克人格问卷（EPQ）一起使用。在第二个样本（n = 107）中，通过临床访谈评估其作为精神障碍筛查方法的有效性。第三个样本（n = 225）提供了关于PDI区分不同疾病临床阶段患者能力的信息，并对这些患者组中精神障碍的患病率进行了估计。
在整个研究样本中获得了0.88的α系数。与STAI量表的相关性> 0.70。观察到与神经质呈正相关（r = 0.59），与外向性呈负相关（r = -0.34）。在第二个样本中，根据ICD-X标准，67名患者（62.6%）被诊断为精神疾病。40名无精神疾病诊断的患者的平均PDI得分（平均24.5）显著低于49名患有适应障碍的患者（平均36.4）和12名患有抑郁症的患者（平均40.8）。通过受试者工作特征分析估计的曲线下面积为0.88。截断值为29时，敏感性为75%，特异性为85%。在第三个样本中，与接受抗肿瘤治疗的患者（平均30.9，95%置信区间28.9 - 32.9）和接受姑息治疗的患者（平均36.0，95%置信区间34.0 - 37.9）相比，无疾病证据的患者的PDI得分最低（平均24.7，95%置信区间23.0 - 26.4）。这三组患者中精神障碍患者的估计患病率分别为5.0%、56.%和98.8%。
我们的结果表明，PDI是一种可靠且有效的工具，可用于测量癌症患者的心理困扰，并通过筛查程序检测精神障碍。
