中文版勇气量表在中学生中的信效度

目的评价中文版勇气量表(CS)在中学生中应用的信效度,为测量积极人格特质提供有效工具。方法采用整群抽取方法在温州市四所中学中抽取12个班级的485名中学生进行中文版CS和焦虑自评量表(SAS)评定,其中54名学生完成了2周后的CS重测。结果中文版CS内部一致性Cronbach’sα系数为0.92,2周重测信度系数为0.75(P0.01)。CS与SAS的校标关联效度系数为-0.332(P0.01),探索性因子分析显示CS具有单纬度结构。结论中文版CS在中学生中具有满意的信度和效度。     

广泛性焦虑量表在颈椎病患者焦虑情绪评估的信度和效度研究

目的:探讨广泛性焦虑量表(GAD-7)在颈椎病患者焦虑情绪评估的信度和效度。方法:应用GAD-7及焦虑自评量表(SAS)对100例颈椎病患者进行筛查,同时进行美国《精神障碍诊断与统计手册》第4版(DSM-Ⅳ)临床定式访谈(SCID)评定。随机抽取30例患者在GAD-7测定1周后再次进行GAD-7评定。结果:GAD-7 Cronbach'sα系数为0.965;各条目与量表总分的相关系数为0.882~0.938,各条目间相关系数为0.718~0.887,相关有统计学意义(P均0.01)。1周后重测信度为0.952。GAD-7总分与SAS总分的Pearson相关系数为0.884(P0.01)。探索性因子分析显示该量表为1个因子结构,解释方差82.90%。以GAD-7≥10分为划界分,GAD-7灵敏度为94.23%,特异度为93.75%;与SCID评定的一致性Kappa值为0.880(u=18.345,P0.01)。结论:GAD-7应用于颈椎病患者焦虑情绪评估具有良好的信度和效度。     

个人和社会功能量表在抑郁症中的适用性研究

目的 检测个人和社会功能量表(Personal and Social Performance scale,PSP)在抑郁症患者中的信度和效度,了解PSP在抑郁症中的适用性.方法 在全国6个精神卫生中心收集84例门诊抑郁症患者.所有的病例进行PSP、Montgomery- Asberg抑郁量表(Montgomery- Asberg Depression Rating Scale,MADRS)、大体社会功能量表(Global Assessment of Functioning Scale,GAF)评定,分析PSP在抑郁症患者中的内部一致性、与GAF的一致性以及与MADRS的相关性.另外,6例抑郁症病例在首次评定后的1周进行再次评定用以PSP重测一致性的检验.结果 PSP的内部一致性Cronbach α系数为0.760,PSP总分与GAF评分具有良好的正相关(r=0.906,P＜0.01),与MADRS总分呈负相关,具有统计学意义(r=-0.652,P＜0.01),重测一致性的kappa值为0.945(n=6,P=0.01).结论 PSP是一个操作简单、稳定性高的评估工具,可用于抑郁症患者社会功能的评估.量表中d维度(冲动和攻击行为)对整个量表的权重大,在抑郁症患者中与总分相关性欠佳.     

广泛性焦虑量表在综合性医院的信度和效度研究

目的检验中文版广泛性焦虑量表（GAD-7）在综合性医院普通门诊患者中的信度与效度。方法 600名综合性医院普通门诊患者完成GAD-7、医院焦虑抑郁量表、汉密顿焦虑量表（HA-MA）的评定。随机抽取其中44名进行GAD-7重测;96名接受美国精神障碍诊断和统计手册第4版临床定式访谈（SCID）。计算GAD-7的信度系数、敏感度、特异度等。结果 GAD-7的Cronbach’α系数为0.898,重测信度系数为0.856。GAD-7与HADS总分及焦虑分量表分值和HAMA总分相关系数分别为0.663、0.822和0.841。在GAD-7分解值取10分时,灵敏度和特异度分别为86.2%和95.5%,Kappa值为0.825。结论中文版本GAD-7在综合性医院普通门诊患者应用中具有较好的信度和效度。     

108例肝硬化患者情绪、家庭负担与生活质量的相关性

目的探讨肝硬化患者的情绪、社会支持、家庭负担与生活质量的相关性。方法通过整群抽样方法选取兰州市某三甲医院108例肝硬化患者,采用一般情况调查表、医院焦虑抑郁量表(HADS)、社会支持评定量表(SSRS)、诺丁汉健康量表(NHP)和疾病家庭负担量表(FBS)进行评定。结果 HADS-A评分≥9分者107例(99.1%),HADS-D评分≥9分95例(88.0%)。年龄50岁、50≤年龄≤60岁、年龄60岁的三组患者在疼痛(P=0.010)、活动(P=0.002)、NHP总评分(P=0.024)方面差异均有统计学意义;NHP中除睡眠以外的5个维度和总评分与HADS-A、HADS-D、HADS总评分呈正相关(P0.05或0.01),NHP的精力、情感和总评分与FBS各维度评分及总评分呈正相关(P0.05或0.01);FBS总评分、抑郁、家庭经济负担和年龄对预测NHP总评分作用显著。结论 FBS总评分、抑郁、家庭经济负担、年龄对肝硬化患者的生活质量影响明显。     

医院焦虑抑郁量表在综合性医院中的应用

目的 评价医院焦虑和抑郁量表在综合性医院住院病人中应用的信度和效度。方法 应用医院焦虑抑郁量表(HADS)对846名住院病人进行调查,并与焦虑自评量表(SAS)和抑郁自评量表(SDS)做相关分析。结果 (1)通过因素分析得到3个相互关联的因素,抑郁、精神性焦虑、精神运动性激越。(2)不同病种分析,HADS具有较高的内部一致性。(3)相关分析得到该量表与SAS、SDS存在较高的相关。(4)通过与SAS、SDS的比较得到以9分作为HADS的筛选临界值是较可靠的。结论 医院焦虑抑郁量表作为综合性医院焦虑抑郁情绪的筛查工具还是较为可靠的。     

Liebowitz 社交焦虑量表在社交焦虑障碍评定中的应用

背景在过去20年,越来越多的量表应用于评估社交焦虑障碍。Liebowitz社交焦虑量表(LiebowitzSocialAnxietyScale,LSAS)在临床及流行病学调查中应用广泛,尤其对社交焦虑障碍药物治疗疗效的评估优于其他量表[3],同时该量表是唯一一个将社交焦虑障碍的回避症状及害怕症状分开评定的量表。因此我们探讨LSAS在评定社交焦虑障碍患者与正常人群的信度及效度,以及该量表在医生评定及患者自评之间可能存在的差别。方法本研究收录在2002年10月至2003年11月期间于中山大学附属第三医院精神科门诊求诊的未经治疗的社交焦虑障碍患者作为患者组,所有患者符合美国精神障碍诊断和统计手册第四版(DSM-IV)社交焦虑障碍的诊断标准。共55例患者纳入本研究,其中男性40例,女性15例。年龄为18～37岁,平均(26.2±4.8)岁,病程2～12年,平均(5.5±4.3)年,均为社交焦虑障碍的广泛亚型。收录中山大学168名社交恐怖症量表分小于24分的大学生作为正常对照组。其中男92例,女76例,年龄为20～22岁,平均(21±0.8)岁。所有研究对象均填写由作者翻译成中文的LSAS(中文版LSAS)及自编的一般情况量表。在正常对照组中随机抽取31名学生于4周后重测LSAS量表以观其重测信度。在55例患者中随机抽取33例在自己完成量表后和一名精神科医生会晤。该精神科医生就患者的情况使用LSAS量表评分。并比较自评与医评得分的可能差别。结果①患者组及正常对照组的LSAS总分与24条项目的Cronbathα信度系数分别为0.83及0.77;②LSAS总分及各因子分在31名正常对照组4周后的重测信度为0.68～0.79;③LSAS对判别社交焦虑障碍患者与在校大学生的ROC曲线下面积为0.87±0.03,以总分大于35分为界来判断有无社交焦虑障碍,其敏感度为0.77,特异度为0.81;④患者组LSAS总分明显高于正常对照组(66.6±28.3与29.1±17.3比较;P<0.001);⑤对33例患者既行自评又行医评,自评与医评得分无明显差异(64.1±30.1与61.9±23.8比较;P>0.05)。⑥无论在患者组还是在正常组,LSAS的总害怕分均高于总回避分(分别为36.8±14.1与30.0±16.0比较及16.5±9.4与12.6±9.6比较;P<0.001)。结论LSAS具有良好的内部一致性及重测信度,在评定社交焦虑障碍患者与正常人群中有很高的敏感度与特异度,并且我们建议LSAS自评总分大于或等于35分者为可能有社交焦虑障碍。LSAS在患者中的医评与自评结果无明显差异,所以临床上可使用患者自评代替医评以节约时间。我们的结果也显示出患者与正常人群的害怕症状明显均高于回避症状,因此我们认为害怕症状可能先于回避症状出现,并且可能是对社交的害怕(负性思维)导致了回避症状的出现。     

Cornell痴呆抑郁量表的信度和效度检验

目的检测Cornell痴呆抑郁量表的信度和效度.方法对60例痴呆患者进行测试,由四位医生进行联合评定.结果Cornell痴呆抑郁量表具有良好的内部一致性,联合评定ICC=0.87、F=24.59,P＜0.01.与HAMD量表评分相比,相关系数r=0.833,P＜0.01.平行效度好,在判断抑郁程度方面F值为0.01,P＜0.01.结论Cornell痴呆抑郁量表具有良好的我信度和效度,值得在临床推广.     

曲唑酮与阿米替林治疗焦虑性神经症的对照研究

目的比较曲唑酮与阿米替林治疗焦虑性神经症的疗效和副反应.方法 64例符合CCMD-2-R诊断标准的焦虑性神经症患者,随机分为两组,应用曲唑酮(32例)、阿米替林(32例)治疗六周.采用焦虑自评量表(SAS)、Hamilton焦虑量表(HAMA)和副反应量表(TESS)评定疗效和副反应.结果曲唑酮与阿米替林治疗焦虑性神经症均有疗效,二者疗效相当(P＞0.05).曲唑酮的副反应明显少于阿米替林(P＜0.01).结论曲唑酮是治疗焦虑性神经症的安全、有效药物.     

中文版动作活动记录量表在卒中患者中的重测信度和同时效度

目的 验证中文版动作活动记录量表（MAL）在卒中患者中的重测信度和同时效度。方法 36例处于亚急性期或慢性期的卒中患者参与本研究。对患者进行中文版30个项目的MAL的使用量量表（AOU），动作质量量表（QOM)和上肢动作研究量表（ARAT）评价。结果 同一评价者两次AOU和QOM的评分评价结果之间具有高度的一致性，组内相关系数（ICC)均为0.998，MAL的AOU和QOM的评分与效标工具ARAT评分之间显著相关（Spearman等级相关系数分别为0.764和0.723，分别P＜0.01）。结论 中文版MAL在卒中患者中具有良好的重测信度和同时效度。     

An examination of the psychometric properties of the Hospital Anxiety and Depression Scale in Chinese patients with acute coronary syndrome

The psychometric properties of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for patients with acute coronary syndrome (ACS) were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis (CFA) was conducted on the HADS to establish its psychometric properties in 138 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test–retest reliability values for the HADS total and HADS anxiety sub-scales were found to be acceptable. The HADS depression sub-scale lacked acceptable internal reliability. The underlying factor structure of the HADS comprised three distinct factors, though inconsistency between the best three-factor model fit was observed between observation points. The HADS was confirmed to be a useful screening instrument to assess symptoms of psychological distress in ACS patients. Further research is required to determine the most appropriate use of HADS sub-scale structures in clinical populations.     

Positive correlation between anxiety severity and plasma levels of dehydroepiandrosterone sulfate in medication-free patients experiencing a major episode of depression

Although numerous studies have identified a correlation between dehydroepiandrosterone sulfate (DHEAS) levels and anxiety or depression, those findings remain controversial. The purpose of the present study was to determine whether a correlation exists between depression severity and anxiety severity and serum DHEAS concentrations in medication-free patients experiencing a major depressive episode. Twenty-eight medication-free major depressive outpatients (Hamilton Rating Scale for Depression 17 [HAM-D 17] score >or=17) were enrolled consecutively. Plasma DHEAS levels of all subjects were measured. Blood from subjects was drawn at 0900-1100 h Depression severity was assessed with the HAM-D 17 and the Hospital Anxiety and Depression Scale (HADS) depression subscale. Anxiety was assessed using the HADS anxiety subscale. Serum concentrations of DHEAS were measured immediately following the HAM-D 17 and HADS assessments. A significant, positive correlation was identified between HADS anxiety subscale total score and morning serum DHEAS concentration (P = 0.013) after controlling for age, gender and body mass index (BMI). No statistically significant correlations were found between depression ratings and morning serum DHEAS concentrations. This preliminary study provides pilot data indicating that morning serum DHEAS concentrations were positively correlated with HADS anxiety subscale score (anxiety severity) after controlling for age, gender and BMI in medication-free outpatients experiencing a major depressive episode. It is not known if morning serum DHEAS levels would show similar or dissimilar changes in non-depressed subjects. The present result needs subsequent replication.     

Anxiety and depression in primary care patients: predictors of symptom severity and developmental correlates

OBJECTIVE: A study in a German general practice used the Hospital Anxiety and Depression Scale (HADS) to determine the prevalence of anxiety and depression in 242 consecutive patients. The study had two additional goals: (1) to identify indicators of symptom severity and (2) to validate the HADS by relating it to measures of developmental psychopathology. METHODS: In addition to the HADS, clinical/sociodemographic data were collected. Patients filled up additional questionnaires measuring attachment characteristics, recalled parental rearing behavior, resilience, adverse childhood experiences, and physical complaints. RESULTS: Using HADS cutoff scores of > or =11 in total, we found that 21.1% of the patients showed clinically relevant anxiety levels; the rate for depression was 12.0%, that for anxiety or depression was 26.1%, and that for anxiety and depression combined was 7%. With the exception of psychiatric disorders, the HADS did not differentiate between subgroups with different somatic diseases. HADS scores were shown to be predicted by the patients' sex, family status, number of consultations, and subjective physical complaints. Patients with higher HADS scores also indicated lower resilience, more insecure attachment, and negative recalled parental rearing behavior. Resilience, attachment security, and specific parental behavior (control/warmth) independently predicted anxiety, depression, and physical complaints. CONCLUSION: This study provides further support for the usefulness of the HADS as a measure for routine screening for anxiety and depression and its relationship with constructs from developmental psychopathology. We recommend the use of the HADS in combination with potential indicators of symptom severity (fatigue, cardiovascular symptoms, high number of consultations) to identify patients needing psychosocial support.     

帕罗西汀联合认知行为疗法治疗强迫症的临床对照研究

目的比较单用帕罗西汀与帕罗西汀联合认知行为疗法对强迫症的临床疗效。方法采用半随机法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)强迫症诊断标准的86例患者分为研究组和对照组各43例,两组均给予帕罗西汀治疗,研究组在此基础上给予每周1次的认知行为治疗,均观察12周。于治疗前和治疗后第4、8、12周分别采用耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)评定临床疗效,于治疗第4、8、12周采用副反应量表(TESS)评定不良反应。结果治疗4周末起两组Y-BOCS总评分均较治疗前低(P均0.01),研究组HAMA评分低于对照组(P0.01),第8周末起研究组Y-BOCS评分低于对照组(P0.05);治疗12周末,研究组强迫行为因子评分低于对照组(P0.05),且研究组总有效率高于对照组(86.05%vs.62.79%,P0.05),研究组和对照组不良反应发生率差异无统计学意义(16.28%vs.20.93%,P0.05)。结论单用帕罗西汀与帕罗西汀联合认知行为疗法均可缓解强迫障碍患者症状,但帕罗西汀联合认知行为疗法的效果优于单用帕罗西汀治疗,尤其对强迫行为的改善更为突出。     

低频重复经颅磁刺激联合草酸艾司西酞普兰治疗广泛性焦虑障碍的临床对照研究

目的探讨低频重复经颅磁刺激(r TMS)联合草酸艾司西酞普兰对广泛性焦虑障碍(GAD)的临床疗效及安全性。方法采用随机数字表法将符合《国际疾病分类(第10版)》(ICD-10)广泛性焦虑障碍诊断标准的60例患者分为研究组和对照组各30例,研究组采用低频r TMS(1Hz)刺激右侧前额叶背外侧部联合草酸艾司西酞普兰治疗,对照组单用草酸艾司西酞普兰治疗,观察期6周。分别在治疗前和治疗后1、2、4、6周采用汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)评定疗效,于治疗后第1、2、4、6周采用副反应量表(TESS)评定不良反应。结果治疗后各时点两组HAMA、SAS评分均较治疗前低(P均0.01),从第1周末开始,研究组HAMA、SAS评分均低于对照组,差异均有统计学意义(P均0.05)。治疗6周后,研究组有效率高于对照组(86.67%vs.63.33%,χ~2=4.356,P0.05),且两组TESS评分比较差异无统计学意义[(2.33±0.96)分vs.(2.13±0.90)分,P0.05]。结论低频r TMS联合草酸艾司西酞普兰对GAD疗效可能优于单用草酸艾司西酞普兰。     

高中毕业生焦虑、抑郁情绪及相关性分析

目的探讨青岛市高中毕业生的焦虑、抑郁情绪及其相关因素。方法从青岛市4所高中以班为单位整群抽取,采用抑郁自评量表（SDS）、焦虑自评量表（SAS）、个人评价问卷（PEI）、自尊量表（SES）及青少年生活事件量表（ASLEC）对337名高三学生进行测查。结果有焦虑情绪63名,占20．1％,男女两性比较差异无显著性（P〉0．05）;有抑郁情绪92名,占29．4％,男女两性比较差异无显著性（P〉0．05）;相关性分析显示焦虑、抑郁情绪与自我评价、自尊、生活事件总分及其各因子分均有非常显著相关性（P〈0．01）。结论高中毕业生焦虑、抑郁情况严重,不容忽视。     

酒精所致精神障碍患者焦虑及抑郁的相关因素

目的探讨日饮酒量、饮酒风险程度、尼古丁依赖程度、家庭满意度和心理健康水平对酒精所致精神障碍患者焦虑及抑郁程度的影响,为酒精所致精神障碍的防治提供参考。方法于2017年7月-9月在西南医科大学附属医院精神科、泸州市精神卫生中心、自贡市第五人民医院收集符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)酒精所致精神障碍诊断标准的患者75例,同期通过广告招募普通饮酒男性56例作为对照组,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、尼古丁依赖检验量表(FTND)、一般健康问卷(GHQ-12)、酒精使用障碍量表(AUDIT)、家庭满意度表(FSS)对被试进行评定。结果酒精所致精神障碍患者SAS、SDS、AUDIT、FTND、GHQ-12评分均高于普通饮酒男性(P均0.01),SAS、SDS评分与AUDIT、GHQ-12评分均呈正相关(r=0.327～0.599,P均0.01),SDS评分与日饮酒量呈负相关(r=-0.273,P0.05)。结论酒精所致精神障碍患者存在更严重的焦虑及抑郁情绪,可能与日饮酒量、饮酒风险程度、尼古丁依赖程度和心理健康水平相关。     

Reliability and validity of the Spence Children's Anxiety Scale and the Screen for Child Anxiety Related Emotional Disorders in German children

The reliability and validity of the Spence Children's Anxiety Scale (SCAS) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were evaluated in a sample of 556 German primary school children. Both the SCAS (alpha = 0.92) and the SCARED (alpha = 0.91) were demonstrated to have high internal consistency. The validity of the SCAS and the SCARED was supported by a number of findings. First, in agreement with previous studies, girls displayed significantly higher levels of anxiety symptoms than boys. Furthermore, SCAS and SCARED scores were substantially interrelated. Finally, significant correlations were found between these two measures of anxiety symptoms and the Youth Self-Report and the Columbia Impairment Scale. The utility of the SCAS and the SCARED as screening instruments for anxiety symptoms in children is briefly discussed.     

Thyroid autoimmunity, depression and anxiety; are there any connections? An epidemiological study of a large population

OBJECTIVE: The aim of the study was to examine the relationship between antithyroid antibodies, depression, and anxiety in a large population. METHODS: In a population of 30,175 individuals aged 40-84 years, thyroid-stimulating hormone (TSH) was assessed in all women and in 50% of the men. Thyroid peroxidase autoantibodies (TPOAb) were measured in almost all samples with TSH > or = 4.0 mU/L (n = 1700) and in randomly selected samples without thyroid disease or biochemical dysfunction (n = 745). The levels of anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS). Relations were investigated with multiple logistic regression analyses. RESULTS: In individuals with normal TSH and without known thyroid disorder, the prevalence of TPOAb was 14.2% in women and 4.3% in men. The prevalence of TPOAb in participants with biochemical thyroid dysfunction was 59.0% in women and 38.9% in men. No associations were found between thyroid autoimmunity and depression or anxiety, neither crude nor adjusted for age, gender, TSH, and thyroxine (T4). CONCLUSION: Thyroid autoimmunity is a common disorder in the population, mainly affecting females. In a population-based study, no associations were found between antithyroid antibodies and depression or anxiety.