Barsky A J, Ahern D K, Delamater B A, Clancy S A, Bailey E D
Department of Psychiatry, Harvard Medical School, Boston, Mass., USA.
Arch Fam Med. 1997 May-Jun;6(3):241-5. doi: 10.1001/archfami.6.3.241.
To develop a self-report screening instrument to assist in the differential diagnosis of medical outpatients complaining of palpitations.
Patients completed self-report questionnaires assessing somatization, cardiac symptoms, and hypochondriacal concerns about health. Principal components analysis was performed to identify a subset of questions that could be used to distinguish patients with palpitations who have panic disorder from those with palpitations who do not have panic disorder.
Sixty-seven medical outpatients referred for Holter monitoring because of a complaint of palpitations.
Patients with palpitations were classified into 2 groups, those with and those without current panic disorder (established with a structured, diagnostic interview). The sensitivity, specificity, and posttest probability of the screening instrument were determined.
A reliable, stable, 10-item instrument was derived. It seems to tap diffuse, vague, or generalized somatic complaints and worry about physical illness. With the use of a criterion cutoff score of 21, this instrument had a sensitivity of 0.81, a specificity of 0.80, and a post-test probability of.57 in detecting current panic disorder in patients with palpitations.
A psychometrically sound and brief self-report instrument was developed to assist in the differential diagnosis of palpitations. It can be used to identify patients whose symptoms are more likely to result from panic disorder and in whom ambulatory monitoring might be deferred.
开发一种自我报告筛查工具，以协助对主诉心悸的门诊患者进行鉴别诊断。
患者完成自我报告问卷，评估躯体化、心脏症状以及对健康的疑病性担忧。进行主成分分析，以确定可用于区分有心悸且患有惊恐障碍的患者与有心悸但未患惊恐障碍的患者的一组问题。
67名因主诉心悸而被转诊进行动态心电图监测的门诊患者。
有心悸的患者被分为两组，即目前患有惊恐障碍的患者和未患有惊恐障碍的患者（通过结构化诊断访谈确定）。确定筛查工具的敏感性、特异性和验后概率。
得出一种可靠、稳定的包含10个条目的工具。它似乎能够反映弥漫性、模糊或全身性的躯体不适以及对身体疾病的担忧。使用21分的标准临界值时，该工具在检测有心悸的患者目前是否患有惊恐障碍方面，敏感性为0.81，特异性为0.80，验后概率为0.57。
开发了一种心理测量学上合理且简短的自我报告工具，以协助心悸的鉴别诊断。它可用于识别那些症状更可能由惊恐障碍引起且可能无需进行动态监测的患者。
