中文版神经精神科生物节律评估访谈在抑郁症患者中信效度研究  

Reliability and validity of the Chinese version of Biological Rhythms Interview of Assessment in Neuropsychiatry in patients with major depressive disorder

作　　者：洪柳 吴创鑫 章隽宇[2] 李旭娟 蒋斌勋 钞雪林[4] 李文飞[5] 刘文 黄乐萍[1] 汪作为[1] Hong Liu;Wu Chuangxin;Zhang Junyu;Li Xujuan;Jiang Binxun;Chao Xuelin;Li Wenfei;Liu Wen;Huang Leping;Wang Zuowei(Division of Mood Disorders,Shanghai Hongkou Mental Health Center,Shanghai 200083,China;Institute of Life Science,Nanchang University,Nanchang 330031,China;Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College,Hangzhou 310015,China;The First Affiliated Hospital,Nanchang University,Nanchang 330006,China;Anhui Metal Health Center,Hefei 230022,China)

机构地区：[1]上海市虹口区精神卫生中心,上海200083 [2]南昌大学生命科学研究院,南昌330031 [3]浙江树人大学树兰国际医学院附属树兰杭州医院,杭州310015 [4]南昌大学第一附属医院,南昌330006 [5]安徽省精神卫生中心,合肥230022

出　　处：《中华精神科杂志》2023年第2期98-105,共8页Chinese Journal of Psychiatry

基　　金：上海市卫生健康委员会科研课题(202040318);上海市精神心理疾病临床医学研究中心(19MC1911100);上海市医学重点专科建设计划(ZK2019A06);虹口区卫生健康委员会医学科研课题(虹卫2103-11);虹口区临床医学优秀青年人才培养计划(HKYQ2022-12)。

摘　　要：目的检验中文版神经精神科生物节律评估访谈(Chinese Version of Biological Rhythms Interview of Assessment in Neuropsychiatry,BRIAN-C)量表在抑郁症患者中的信度及效度。方法采用BRIAN-C量表、16项抑郁症状快速评估量表(16-Item Quick Inventory of Depressive Symptomatology Self-Report,QIDS-SR16)、广泛性焦虑量表(7-Item Generalized Anxiety Disorder Scale,GAD-7)、6项生活质量问卷(6-Item Short Form Health Survey,SF-6),对122例抑郁症患者及122名对照者进行施测,分别采用鉴别力指数D、相关性分析评价条目的区分度、同质性,采用Cronbach′sα系数、Spearman-Brown系数、组内相关系数(intraclass correlation efficient,ICC)、重测相关系数评价信度,分别采用验证性因素分析、相关性分析、受试者操作特征(receiver operating characteristic,ROC)曲线评价结构效度、校标效度、预测效度。结果条目区分度及同质性分析均显示差异有统计学意义(P<0.05),Cronbach′sα系数为0.911,Spearman-Brown系数为0.807;ICC为0.639[95%置信区间(confidence interval,CI):0.375~0.729]、重测相关系数r为0.43(P=0.001);验证性因素分析显示拟合度指标为:χ^(2)/df=1.937,拟合优度指数(goodness-of-fit index,GFI)为0.822,比较拟合指数(comparative fit index,CFI)为=0.877,非规范拟合指数(Tucker-lewis index,TLI)为0.855,近似均方根误差(root mean square error of approximation,RMSEA)为0.088;BRIAN-C得分与QIDS-SR16、GAD-7、SF-6得分均呈显著相关性(r分别为0.74、0.46、-0.69,均P<0.05);ROC曲线显示区分抑郁症与对照者的曲线下面积(area under curve,AUC)为0.939(95%CI:0.909~0.970,P<0.05),29分是最佳临界值,其对应的灵敏度为0.861,特异度为0.926。结论BRIAN-C具有良好的信效度,可在中国文化背景中有效评估抑郁症患者的生物节律。Objective To verify the reliability and validity of the Chinese Version of Biological Rhythms Interview of Assessment in Neuropsychiatry(BRIAN-C)in patients with major depressive disorder(MDD).Methods A total of 122 patients with MDD and 122 controls were recruited and measured with the BRIAN-C,16-Item Quick Inventory of Depressive Symptomatology Self-Report(QIDS-SR16),7-Item Generalized Anxiety Disorder Scale(GAD-7)and 6-Item Short Form Health Survey(SF-6).The index D and correlation analysis were conducted to evaluate the discrimination and homogeneity of the items,respectively.The Cronbach′sαcoefficient,Spearman-Brown coefficient,intraclass correlation coefficient(ICC)and retest correlation coefficient were conducted to evaluate the reliability.Confirmatory factor analysis,correlation analysis and the receiver operating characteristic(ROC)curve were conducted to evaluate the construct validity,criterion validity and prediction validity,respectively.Results The item distinction and homogeneity analysis showed significant differences(P<0.05).The Cronbach′sαcoefficient and the Spearman-Brown coefficient were 0.911 and 0.807,while the ICC and the correlation coefficient r of test-retest reliability were 0.639(95%confidence interval(CI):0.375-0.729)and 0.43(P=0.001),respectively.Confirmatory factor analysis showed that the fit indexesχ^(2)/dF=1.937,goodness-of-fit index(GFI)=0.822,comparative fit index(CFI)=0.877,Tucker-lewis index(TLI)=0.855,and root mean square error of approximation(RMSEA)=0.088.The score of BRIAN-C was significantly correlated with that of QIDS-SR16,GAD-7 or SF-6(r=0.74,0.46,-0.69,all P<0.05).The ROC curve suggested that the area under curve(AUC)was 0.939(95%CI:0.909-0.970,P<0.05)for distinguishing MDD patients from controls.The optimal cut-off was 29,with 0.861 sensitivity and 0.926 specificity.Conclusions The BRIAN-C scale has good reliability and validity,which is supposed to be used in Chinese cultural background to evaluate the biorhythms in patients with MDD.

关 键 词：抑郁症 可重复性 结果 神经精神科生物节律评估访谈 

分 类 号：R749.4[医药卫生—神经病学与精神病学]