Parkerson G R, Broadhead W E
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
Fam Med. 1997 Mar;29(3):177-81.
Anxiety and depression are highly prevalent and underdiagnosed in primary care. This study tested the seven-item Duke Anxiety-Depression Scale (DUKE-AD) in primary care adult patients as a screener for anxiety and depression as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R).
Receiver operating characteristic curves (ROC) and odds ratios were used to test screener accuracy, and sensitivities and specificities were used to test screener efficiency in patients with anxiety and/ or depression.
In 481 patients, the ROC area for patients with major anxiety disorders (panic disorder, agoraphobia, or generalized anxiety) was 72.3%. The ROC area for major depressive disorders (major depressive disorder and/or dysthymia) was 78.3%, and the ROC area for both major anxiety and/or depressive disorders was 76.2%. Odds ratios for these same groups after controlling for sociodemographic factors were 1.043, 1.057, and 1.053, respectively. Sensitivities and specificities for these groups at the DUKE-AD score cutoff point of > 30 on a 0-100 scale were 71.4% and 59.2%, 81.8% and 63.6%, and 73.9% and 66.1%, respectively.
The DUKE-AD is a brief, easily scored questionnaire that serves as a valid screener for DSM-III-R anxiety and depression in the primary care setting.
焦虑和抑郁在初级保健中极为常见且诊断不足。本研究对初级保健成年患者进行了七项杜克焦虑抑郁量表（DUKE - AD）测试，以作为《精神疾病诊断与统计手册》（DSM - III - R）所定义的焦虑和抑郁的筛查工具。
采用受试者工作特征曲线（ROC）和比值比来测试筛查工具的准确性，并用敏感度和特异度来测试焦虑和/或抑郁患者中筛查工具的有效性。
在481例患者中，患有重度焦虑症（惊恐障碍、广场恐惧症或广泛性焦虑症）患者的ROC曲线下面积为72.3%。患有重度抑郁症（重度抑郁症和/或心境恶劣障碍）患者的ROC曲线下面积为78.3%，同时患有重度焦虑和/或抑郁症患者的ROC曲线下面积为76.2%。在控制社会人口学因素后，这些相同组别的比值比分别为1.043、1.057和1.053。在0 - 100分的量表上，当DUKE - AD评分临界值> 30时，这些组别的敏感度和特异度分别为71.4%和59.2%、81.8%和63.6%、73.9%和66.1%。
DUKE - AD是一份简短、易于评分的问卷，可作为初级保健环境中DSM - III - R焦虑和抑郁的有效筛查工具。
