中文版双相抑郁评估量表信效度及最佳界值  

The Chinese version of the bipolar depression rating scale for bipolar disorder:its reliability,validity and optimal threshold

作　　者：魏艳艳 尹璐[1] 徐海婷[1] 张索远 黄文倩 陈景旭[1] WEI Yanyan;YIN Lu;XU Haiting;ZHANG Suoyuan;HUANG Wenqian;CHEN Jingxu(Beijing Hui-Long Guan Hospital,Peking University,Beijing 100096,China)

机构地区：[1]北京回龙观医院,北京102200

出　　处：《中国神经精神疾病杂志》2021年第12期710-715,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：北京回龙观医院龙跃计划资助项目(编号:LY202101);北京市属医院科研培育计划项目(编号:PX2022079);北京市医院管理中心临床医学发展专项经费(编号:XMLX202150)。

摘　　要：目的将双相抑郁评估量表(bipolar depression rating scale,BDRS)翻译成中文,在中国双相障碍(bipolar disorder,BD)患者中评估其信效度,并探讨其判断BD缓解的最佳界值。方法在取得原作者同意后,对英文版BDRS进行翻译、回译、修订等,形成中文版BDRS(BDRS-C)。选取18~65岁的BD患者176例,采用BDRS-C、17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD-17)、蒙哥马利和阿斯伯格抑郁量表(Montgomery and Asberg depression scale,MADRS)和杨氏躁狂评定量表(Young mania rating scale,YMRS)进行评定,并抽取47例患者在5 d内重测BDRS-C。根据患者HAMD-17总分≤7分并且YMRS评分<6分判定为缓解期。结果BDRS-C内部一致性Cronbach’sα系数为0.940,BDRS-C评估者间信度(组内相关系数)为0.952,重测信度(组内相关系数)为0.939。探索性因子分析显示该量表为3因子结构,因子分别为原发性抑郁症状群、继发性抑郁症状群、混合症状群,解释方差64.6%。BDRS-C评分与HAMD-17(r=0.883,P<0.001)、MADRS(r=0.906,P<0.001)、YMRS(r=0.355,P<0.001)评分均呈正相关。176例BD患者中63例为缓解期,BDRS-C判断BD缓解的ROC曲线下面积为0.959,最佳界值为8分,此时敏感度95.27%,特异度87.61%。结论BDRS-C具有良好的信度和效度,判断BD缓解的最佳分界为≤8分。该量表不仅能评估BD抑郁发作的症状严重程度,也是评估BD干预治疗有效性的可靠工具,可在我国推广应用。Objective To evaluate the reliability and validity of the Chinese version of the Bipolar Depression Rating Scale(BDRS) in Chinese patients with bipolar disorder, and to explore the optimal threshold for assessing remission. Methods After obtaining the consent of the original author, the research group translated and revised the English version of BDRS to form the Chinese version of BDRS(BDRS-C). BDRS-C, the 17-item Hamilton depression scale(HAMD-17), the Montgomery and Asberg depression scale(MADRS) and the Young mania rating scale(YMRS)were used to evaluate 176 patients aged 18~65 years old who met DSM-5 BD diagnostic criteria, and 47 patients were selected for re-testing BDRS-C within 5 days. Remission was determined by HAMD-17 score ≤7 and YMRS score <6.Results A total of 176 cases were enrolled, including 63 cases in remission. The Cronbach′s α coefficient of BDRS-C internal consistency was 0.940. The inter-rater reliability of BDRS-C was 0.952, and the test-retest reliability was 0.939.Exploratory factor analysis showed that the scale had a three-factor structure: primary depressive symptoms cluster,secondary depressive symptoms cluster and mixed symptoms cluster, which explained 64.6% of the total variance. BDRSC score was significantly positively correlated with HAMD-17(r=0.883, P<0.001), MADRS(r=0.906, P<0.001) and YMRS(r=0.355, P<0.001) scores. The area under ROC curve of BDRS-C was 0.959, the optimal threshold was 8 points,the sensitivity was 95.27%, and the specificity was 87.61%.Conclusion BDRS-C has good reliability and validity, and the optimal threshold for assessing BD remission is ≤8 points. It not only can evaluate the severity of BD depressive episodes, but also can be a useful tool to evaluate the effectiveness of BD intervention, which can be promoted and implicated in China.

关 键 词：双相抑郁评估量表 双相障碍 抑郁发作 量表 信度 效度 

分 类 号：R749.4[医药卫生—神经病学与精神病学]