4种量表对创伤后应激障碍的预测效能  

Prediction efficiency of four kinds of scale for post-traumatic stress disorder

作　　者：徐向东[1] 吕淑云[1] 夏叶玲[1] 贾丽娜[1] 张莉[1] 李月娥[1] 陈亮[1] 陈晓英[1] 马瑞晨[1] 古丽娜尔·阿布都克里木[1] 

机构地区：[1]新疆精神卫生中心,乌鲁木齐830002

出　　处：《中华行为医学与脑科学杂志》2013年第6期564-567,共4页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的 比较乌鲁木齐市突发群体事件后4种量表对创伤后应激障碍（post traumatic stress disorder,PTSD）的预测效能.方法 突发群体事件受伤住院伤员共161名在受伤第3,4周用创伤后应激障碍筛查表（PTSD7）、心理健康自评问卷（SRQ20）、事件影响量表（IES）和症状自评量表（SCL-90）等进行测评,完成测查155例.受伤2个月后以美国精神障碍诊断与统计手册第四版修订版（DSM-Ⅳ-TR）轴Ⅰ障碍临床定式检查患者版对128名伤员（失访27名）进行检查和精神科诊断.结果 4种量表Youden指数最高的临界值是PTSD7总分4、SRQ20总分10、IES总分23和SCL-90总分158.分别对其灵敏度[62.0％（31/19）;68.0％ （34/16）;77.6％ （38/11）;69.6％ （32/14）]、特异度[78.7％ （13/48）;78.7％ （13/48）;65.6％ （21/40）；62.5％ （21/35）]进行比较,经x2检验,4种量表的灵敏度、特异性差异无统计学意义,x2值为2.86和6.38（均P＞0.05）.4种量表ROC曲线下面积分别为0.782,0.777,0.756,0.775（均P＜0.01）.结论 4种量表均能较好地预测PTSD,PTSD7因简单易用是心理创伤性事件后筛查预测PTSD的理想工具.创伤性事件对心理的影响是全面的,心理创伤的严重程度可能是PTSD最重要的预测指标.Objective To compare the prediction efficiency of four kinds of scale for post-traumatic stress disorder （PTSD） after emergency of a mass injury in Urumqi.Methods The 161 injured subjects were evaluated with 7-Item Screening Scale for PTSD （PTSD7）,Self-Reporting Questionnaire-20 （SRQ20）,Impact of Event Scale （IES） and Symptom Checklist90 （SCL-90） in the third or the fourth week after the injury,and 155 subjects completed the assessment.Two months after the injury,128 injured subjects with 27 lost were interviewed and diagnosed based on the Structured Clinical Interview of DSM-Ⅳ-TR Axis I Disorders （Patients＇ Edition）.Results The highest critical scores of the scales＇ Youden index were 4 with PTSD7,10 with SRQ20,23 with IES and 158 with SCL-90 respectively.The sensitivity rates were 62.0% （31/19）,68.0% （34/16）,77.6% （38/11） and 69.6% （32/14）,and the specificity rates were 78.7% （13/48）,78.7% （13/48）,65.6% （21/40） and 62.5 % （21/35） respectively for the PTSD,which showed no significant differences （x2 =2.86,6.38,P 〉 0.05）.The areas under the ROC curve of the four scales were 0.782,0.777,0.756 and 0.775 respectively （P 〈 0.01）.Conclusions All of the four scales can predict PTSD efficiently.PTSD7 is simple and easy to use,so it＇ s a desirable rating scale to predict PTSD.Traumatic events can cause comprehensive psychological impacts and the severity of psychological trauma may be the most important predictor of PTSD.

关 键 词：量表 创伤后应激障碍 预测效能 

分 类 号：R749.5[医药卫生—神经病学与精神病学]