5种抑郁症状评定工具评估精神分裂症患者抑郁症状的比较  

Comparison of 5 assessment tools for evaluating depressive symptom in patients with schizophrenia

作　　者：刘浩[1] 张鸿燕[2,3] 肖卫东[1] 刘琦[2,3] 王刚[4] 陈景旭[5] 杨甫德[5] 王高华[1] 王晓萍[1] 张彦[1] 

机构地区：[1]武汉大学人民医院精神科,武汉430060 [2]北京大学第六医院 [3]北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学),北京100191 [4]首都医科大学附属北京安定医院,北京100088 [5]北京回龙观医院,北京10009

出　　处：《中国心理卫生杂志》2015年第8期570-575,共6页Chinese Mental Health Journal

摘　　要：目的：比较5种临床常用的抑郁症状评定工具,以发现评估精神分裂症患者抑郁症状的最佳选择。方法：在国内4家精神卫生机构入组101例精神分裂症住院患者,入组和抑郁症状评估由两位精神科医生分别独立完成。使用卡尔加里精神分裂症抑郁量表中文版（CDSS-C）、汉密顿抑郁量表17项（HAMD-17）、蒙哥马利抑郁量表（MARDS）、阳性和阴性症状量表抑郁分量表（PANSS-D）及抑郁条目（PANSS-G6）评估抑郁症状,使用Barnes静坐不能量表（BAS）和锥体外系不良反应量表（SAS）评估治疗过程中出现的锥体外系不良反应。比较各工具对精神分裂症患者抑郁症状的评定及诊断效度差异。结果：各抑郁症状评定工具相互之间相关性较高（r=0.62~0.84,均P〈0.05）;HAMD-17、MARDS、PANSSD、PANSS-G6的ROC曲线下面积均小于CDSS-C的ROC曲线下面积（0.881、0.828、0.897、0.932vs.0.954,均P〈0.05）;CDSS-C得分与PANSS阴性症状、BAS、SAS得分的相关均无统计学意义（均r=0.08~0.18,均P〉0.05）。结论：卡尔加里精神分裂症抑郁量表中文版评定精神分裂症患者抑郁症状的效果最佳。Objective： To comparefive most commonly applied assessment tools for depressive symptom in schizophrenic patients, so as to give reference for selecting the optimal assessment tools. Methods： One hundred and one inpatients with schizophrenia were recruited from 4 mental health institutions, recruitment and depressive symptom assessments were completed by two psychiatrists independently. Scales including the Calgary Depression Scale for Schizophrenia-Chinese version （CDSS-C）, Hamilton Rating Scale for Depression-17 items（HAMD-17）, Mont- gomery-Asberg Depression Rating Scale （MADRS）, the depression subscale of the Positive and Negative Symptom Scale （PANSS-D）, and the Depression item of the PANSS scale （PANSS-G6） were used for evaluating depressive symptom. The Barnes Akathisia Rating Scale （BAS） and Simpson-Angus Rating Scale （SAS） were used for evalu- ating extrapyramidal symptoms occurred during treatment. The diagnostic validity and symptom evaluation of de- pressive symptoms using different tools were evaluated. Results： The depression scales were found to be highly intercorrelated （r =0.62 -0. 84, Ps 〈0.05）. In the 5 depression scales, the area under the receiver operating characteristic curve （AUROC） of the HAMD-17, MARDS, the PANSS-D and the PANSS-G6 were less than that of CDSS-C （0. 881, 0. 828, 0. 897, 0. 932 vs. 0. 954, Ps 〈 0. 05）. Moreover, the scores of CDSS-C were correlated withscores of PANSS negative symptoms subscale, BAS and SAS（r = 0. 08 -0. 18, Ps 〉 0. 05）. Conelusion： The result suggests that the Calgary Depression Scale for Schizophrenia-Chinese version （CDSS-C） may provide optimal assessment of depression in patients with schizophrenia.

关 键 词：精神分裂症 抑郁 评定 量表 效度 

分 类 号：R749.304[医药卫生—神经病学与精神病学] R749.41[医药卫生—临床医学]