蒙特利尔认知评估量表在稳定期双相情感障碍患者中应用的初步研究  

Preliminary Study of the Application of Montreal Cognitive Assessment Among Patients With Euthymic Bipolar Disorder at Stable Stage

作　　者：肖霖[1] 林小玲[1] 王庆妍[1] 唐四元[1] 

机构地区：[1]中南大学湘雅护理学院,湖南省长沙市410013

出　　处：《中国全科医学》2015年第25期3100-3103,共4页Chinese General Practice

基　　金：2014年中南大学硕士生自主探索创新项目(2014zzts329)

摘　　要：目的探讨蒙特利尔认知评估量表(Mo CA)在稳定期双相情感障碍(BPD)患者中应用的信、效度,并确定其筛查BPD患者认知功能障碍的临界值。方法选取2013年11月—2014年5月在长沙市中南大学湘雅二医院精神科病房住院的稳定期BPD患者125例为病例组及同期跟病例组性别、年龄、文化程度相匹配的医院职工及社会志愿者130例为对照组。对两组进行一般资料问卷调查及Mo CA测试,量表信度检验采用一致性信度和重测信度;量表效度检验采用结构效度、已知组别效度及同时效度;采用受试者工作特征(ROC)曲线确定Mo CA筛查BPD患者认知功能障碍的临界值。结果 Mo CA的Cronbach'sα系数为0.762,重测信度系数为0.824;验证性因子分析显示Mo CA结构合理,两组Mo CA总分间差异有统计学意义〔(22.2±3.9)分比(25.4±2.3)分,P<0.01〕;Mo CA总分与发病年龄呈正相关,与病程、住院次数、总发作次数、抑郁发作次数、躁狂发作次数、混合发作次数、汉密尔顿抑郁量表(HAMD)得分呈负相关(P<0.05);Mo CA筛查BPD患者认知功能障碍的临界值为24分,所对应的灵敏度为0.723,特异度为0.688,曲线下面积为0.759〔95%CI(0.700,0.819)〕。结论 Mo CA在筛查BPD患者认知功能障碍中具有良好的信、效度,在临界值为24分时具有较高的灵敏度和特异度,可用于我国稳定期BPD患者认知功能的评估。Objective To explore reliability and validity of Montreal Cognitive Assessment（MoCA）in the screening of patients with euthymic bipolar disorder（BPD）at stable stage and to determine the critical value of the scale in the screening of cognitive disorder in BPD patients. Methods We enrolled 125 patients with BPD at stable stage who were admitted into the psychiatric ward of the Second Xiangya Hospital of Central South University from November 2013 to May 2014 as case group,and we enrolled 130 controls,including hospital employees and social volunteers,who had corresponding gender,age,educational degree as control group. General Questionnaire survey and MoCA test were conducted on the two groups. Consistent reliability and test - retest reliability were investigated in the reliability test;construct validity,known - group - validity and concurrent validity were investigated in the validity test. ROC curve was used to determine the critical value of MoCA in the screening of cognitive disorder in BPD patients. Results For MoCA,the Cronbach＇s α coefficient was 0. 762 and the retest reliability coefficient was 0. 824. Confirmatory factor analysis validated the structure of MoCA. The two groups were significantly different in the total score of MoCA〔（22. 2 ± 3. 9）vs. （25. 4 ± 2. 3）,P 〈 0. 01〕;the total score of MoCA was positively correlated with the age of onset and was negatively correlated with the illness duration,times of hospitalization,total times of episode,times of depressive episode,times of manic episode,times of mixed episode and HAMD（P 〈 0. 05）. The critical value of MoCA in the screening of cognitive disorder in BPD patients was 24,with a sensitivity of 0. 723,a specificity of 0. 688,and an area under ROC curve of 0. 759〔95% CI（0. 700,0. 819）〕. Conclusion MoCA has good reliability and validity in the screening of cognitive disorder in BPD patients. It has superior sensitivity and specificity when critical value is 24 points. MoCA can be applied in the assessment of co

关 键 词：蒙特利尔认知评估量表 双相情感障碍 信度 效度 临界值 

分 类 号：R395.6[哲学宗教—心理学]