HAMD与SDS区分抑郁症严重程度的准确性研究  

Study on the accuracy of distinguishing the severity of depression between HAMD and SDS

作　　者：刘宝燕 赵晋[1] 郑冬 LIU Baoyan;ZHAO Jin;ZHENG Dong(Department of Psychiatry,Geleshan Hospital District,Chongqing Mental Health Center,Chongqing 400036,China)

机构地区：[1]重庆市精神卫生中心歌乐山院区精神科,400036

出　　处：《重庆医学》2021年第18期3174-3177,3181,共5页Chongqing medicine

基　　金：2019年重庆市精神卫生中心院级科研项目(2019-yjkt-17)。

摘　　要：目的研究自评抑郁量表(SDS)与汉密尔顿抑郁量表(HAMD)对区分抑郁症不同严重程度的准确性。方法选取2017年9月至2019年9月该院收治的162例抑郁症患者为研究对象,均根据国际疾病分类标准第10版(ICD-10)评估患者抑郁症严重程度,并以此结果为金标准,将其分为轻度抑郁组(46例)、中度抑郁组(62例)、重度抑郁组(54例)。比较3组SDS及HAMD评分,分析SDS、HAMD评分区分抑郁症严重程度与ICD-10评估结果的一致性。结果SDS、HAMD评分随患者抑郁程度加重而明显增加(P<0.05)。SDS评分诊断轻、中、重度抑郁的灵敏度分别为0.696、0.597、0.519,特异度分别为0.681、0.830、0.898,准确率分别为0.685、0.741、0.772,阳性预测值分别为0.464、0.685、0.718,阴性预测值分别为0.849、0.769、0.789,与ICD-10评估结果一致性检验的Kappa值分别为0.327、0.438、0.448。HAMD评分诊断轻、中、重度抑郁的灵敏度分别为0.848、0.855、0.667,特异度分别为0.862、0.880、0.944,准确率分别为0.858、0.870、0.852,阳性预测值分别为0.709、0.815、0.857,阴性预测值分别为0.935、0.907、0.850,与ICD-10评估结果一致性检验的Kappa值分别为0.670、0.728、0.647。结论HAMD较SDS对区分抑郁症严重程度的准确性更高。Objective To study the accuracy of self rating Depression Scale(SDS)and Hamilton Depression Scale(HAMD)in distinguishing different severity of depression.Methods A total of 162 patients with depression admitted to hospital from September 2017 to September 2019 were selected as the research objects.All the patients were assessed the severity of depression according to international statistical classification of diseases injuries and causes of death 10th revision(ICD-10),and they were divided into the mild depression group(46 cases),the moderate depression group(62 cases)and the severe depression group(54 cases).SDS and HAMD scores of the three groups were compared,and the consistency of SDS and HAMD scores in distinguishing the severity of depression with ICD-10 was analyzed.Results SDS and HAMD scores increased significantly with the aggravation of depression(P<0.05).The sensitivity of SDS score in the diagnosis of mild,moderate and severe depression was 0.696,0.597 and 0.519,respectively.The specificity was 0.681,0.830 and 0.898,respectively.The accuracy rate was 0.685,0.741 and 0.772,respectively.The positive predictive values was 0.464,0.685 and 0.718,respectively.The negative predictive values was 0.849,0.769 and 0.789,respectively.The kappa values of consistency test with ICD-10 was 0.327,0.438 and 0.448,respectively.While the sensitivity of HAMD score in the diagnosis of mild,moderate and severe depression was 0.848,0.855 and 0.667,respectively.The specificity were 0.862,0.880 and 0.944,respectively.The accuracy rates was 0.858,0.870 and 0.852,respectively.The positive predictive values were 0.709,0.815 and 0.857,respectively.The negative predictive values was 0.935,0.907 and 0.850,respectively.The kappa values of consistency test with ICD-10 were 0.670,0.728 and 0.647,respectively.Conclusion HAMD is more accurate than SDS in distinguishing the severity of depression.

关 键 词：抑郁症 严重程度 国际疾病分类标准第10版 自评抑郁量表 汉密尔顿抑郁量表 

分 类 号：R749.41[医药卫生—神经病学与精神病学]