广泛性焦虑量表在综合医院心理科门诊筛查广泛性焦虑障碍的诊断试验  

Diagnostic test of screening generalized anxiety disorders in general hospital psychological department with GAD-7

作　　者：曲姗[1] 胜利[2] 

机构地区：[1]北京大学人民医院,北京100044 [2]北京和睦家医院,北京100015

出　　处：《中国心理卫生杂志》2015年第12期939-944,共6页Chinese Mental Health Journal

摘　　要：目的：用诊断试验研究,探讨广泛性焦虑量表（GAD-7）对综合医院门诊患者广泛性焦虑障碍的筛查功能,检验其对不同严重程度广泛性焦虑障碍的分界值.方法：选取综合医院心理科就诊者646例,包括300例不符合任何精神科诊断的咨询者和346例精神障碍患者.所有受试均完成GAD-7自评,以简明国际神经精神访谈（M.I.N.I.）评估做广泛性焦虑障碍诊断为“金标准”,用汉密尔顿焦虑量表（HAMA）评估病情严重程度.结果：GAD-7的内部一致性系数为0.93.因子分析显示GAD-7具有较好结构效度.符合广泛性焦虑障碍诊断107例,针对全部受试者（n=646）GAD-7评分的ROC曲线下面积0.86（95％CI：0.83～0.89）;以6分为分界值时敏感度和特异度分别为91％和71％.以HAMA为标准,GAD-7对轻度、中度、重度焦虑障碍的分界值为4分、9分、12分.结论：广泛性焦虑量表具有良好的效度和信度,可用于综合医院中对广泛性焦虑障碍初筛、识别和严重程度评估.量表制定者推荐的分界值在国内综合医院心理科应用中需稍加调整.Objective： Using a diagnostic test research, to explore the reliability and validity of the 7-tiem Generalized Anxiety Disorder Scale （GAD-7） on screening of generalized anxiety disorder（GAD） in general hospi- tal, and to determine the cut points for GAD with different severities. Methods： Six hundred and forty-six help-seek- ers （n = 646） consulting the outpatient department of psychology in a general hospital were collected continuous- ly. Among them, 300 were normal person without any psychiatric diagnosis, 346 were patients with mental disor- ders. All of subjects were asked to fulfill GAD-7, and were assessed by a psychiatrist with the Mini-International Neuropsychiatric Interview （ M. I. N. I. ） and Hamilton Anxiety Scale（HAMA）. The M. I~ N. I. diagnosis was a gold standard to diagnose GAD, and HAMA was used to assess the illness severity. Result： Cronbach ~ coefficient of GAD-7 was 0. 93. Factor analysis showed good structure validity of GAD-7. There were 107 patients who were di- agnosed GAD according to M. I. N. L assessment. For the all help-seekers （n = 646）, the area under the receiver op- erator characteristic analysis （ROC） of GAD-7 was 0. 86 （95% CI： O. 83 -0. 89） for GAD. With 6 as the critical value for anxiety disorder screening, the sensitivity was 0. 91 and specificity was 0. 71, respectively. By the result of HAMA as the standard to rank different levels of anxiety disorder, the cut points of GAD-7 for mild, moderate, andsevere anxiety disorder was 4, 9 and 12. Conclusion： It suggests that GAD-7 has satisfying reliability and validity, and is applicable for screening GAD and assessment of its severity of outpatients in general hospital. The recom- mended cut points of GAD-7 should be adjusted for outpatients in general hospital in China.

关 键 词：广泛性焦虑量表 信度 效度 焦虑 诊断试验 

分 类 号：R749.72[医药卫生—神经病学与精神病学]