抑郁症中西医结合量表的信度和效度研究  

Study of Validity and Reliability of Integrated Traditional Chinese and Western Medicine Rating Scale of Depression

作　　者：刘兰英[1] 骆利元 张媛媛[1] 金卫东[1] LIU Lanying;LUO Liyuan;ZHANG Yuanyuan;JIN Weidong(Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang,China)

机构地区：[1]浙江省立同德医院精神卫生科,浙江杭州310012

出　　处：《中华中医药学刊》2019年第3期542-546,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81403502)

摘　　要：目的:构建临床实用的中西医结合抑郁症量表。方法:采用汉密尔顿抑郁量表及自评抑郁量表进行测试,通过30例抑郁症被试的预实验,初步确定中西医结合抑郁症量化评估系统;对249例抑郁症被试进行测试,验证该系统的信度、效度。结果:中西医结合抑郁症量化评估系统由34个评估条目构成,分为5个因子,分别命名为:肝郁气滞、心脾两虚、气结痰阻、脾肾阳虚、气郁化火因子,各因子重测相关系数在0.861～0.908之间,总量表内部一致性Alpha系数0.867,分半信度为0.838。每个评估条目评分者信度Kappa系数0.71～0.78(P<0.01);因子分析结果5个因子与设计的结果大体一致,累计贡献率为47.85%。效标效度:量表总分与汉密尔顿抑郁量表总分正相关0.716(P<0.01);与自评抑郁量表总分正相关0.450(P<0.01)。结论:初步编制的中西医结合抑郁症量表具有良好的信度、效度,在临床上具有可操作性和实用性。Objective: To develop a quantitative scoring system of integrated traditional Chinese and western medicine rating scale for depression. Methods: The pre - experiment, including 30 depression subjects taking the Hamilton Depression Scale and Self - Rating Depression Scale, was used to screen scoring items. Through 249 depression subjects' results ,reliability and validity were tested. Results: The evaluation of integrated traditional Chinese and western medicine rating scale for depression had 34 items and contained 5 factors including stagnation of liver Qi, deficiency of heart and spleen, phlegm-Qi stagnation and binding, spleen-kidney Yang deficiency and Qi depression transforming into fire. The correlation coemcient of test-retest reliability of each pattern element was between 0. 861 and 0. 908. The internal consistency reliability of the system was 0. 867(P <0. 01). The split-half reliability was 0. 838 and raters Kappa coefficients for each item were range from 0. 71 to 0. 78 ( P < 0. 01). The results of factor analysis showed that 5 syndromes were roughly consistent with anticipated results, and accumulating contribution rate was 47. 85%. Criterion validity: the total scores of the scale was positively correlated between with the total scores of the Hamilton depression scale and the Self-Rating Depression Scale were respectively 0.716 and 0. 450( P < 0. 01 ). Conclusion: This study demonstrates our proposed integrated traditional Chinese and western medicine rating scale for depression has eminently acceptable reliability and validity, and operability for the clinical use.

关 键 词：抑郁症 中西医结合 量表 编制 信度 效度 

分 类 号：R749.4[医药卫生—神经病学与精神病学]