三种量表评价心房颤动患者焦虑抑郁的比较

目的 探讨心房颤动患者焦虑抑郁情绪的发生情况,以及医院焦虑抑郁自评量表（HADS）、Zung氏焦虑自评量表（SAS）抑郁自评量表（SDS）、汉密尔顿焦虑量表（HAMA）、抑郁量表（HAMD）评定焦虑抑郁的一致性和非精神心理专科医师判断心房颤动患者焦虑抑郁状态时对量表的选择.方法 入选心房颤动患者179例,分别采用HADS、SAS/SDS、HAMA/HAMD评定受试者的情绪情况,对患者焦虑抑郁评分、3种量表一致性及2种自评量表填写质量进行统计分析.结果 根据HADS的焦虑分量表（HADa）评分,心房颤动患者焦虑情绪阳性68例,占38.0％;根据HADS的抑制分量表（HADd）评分,抑郁情绪阳性86例,占48.0％ SAS评分焦虑情绪阳性71例,占39.7％;SDS评分抑有郁情绪阳性77例,占43.0％.HAMA评分焦虑情绪阳性65例,占36.3％;HAMD评分抑郁情绪阳性76例,占42.5％.3种量表评定一致性检验,HADa、SAS与HAMA Kappa值分别为0.438、0.337,HADd、SDS与HAMD Kappa值分别为0.416、0.395.结论 心房颤动患者常伴有焦虑或抑郁情绪;HADS与HAMA、HAMD具中等一致性,SAS、SDS与HAMA、HAMD具轻度一致性.HADS具有较好的有效性和实用性,更适于非精神专科对心房颤动患者焦虑抑郁情绪的筛查.

Comparison of three scales to detect anxiety and depression evaluation in the patients with atrial fibrillation

Objective To explore the emotional disorders （anxiety and depression） and the hospital anxiety and depression scale （HADS）,Zung self evaluation scale （SAS/SDS）,Hamilton anxiety and depression scale （HAMA/HAMD） in assessment anxiety and depression among atrial fibrillation （AF）,To explore the feasibility of the HADS as a conventional screened implement for anxiety and depressive disorder of the AF patients in general hospital.Methods A total 179 patients with AF who had tested by HADS and SAS/SDS completed the HAMA/ HAMD.Internal consistency,and agreement （Kappa coefficient and McNemar test） were analyzed.Results The results of HADS were anxiety occurred in 38.0％ （68 cases） while depression occurred in 48.0％ （86 cases）.The results of SAS/SDS were anxiety occurred in 39.7％ （71 cases） while depression occurred in 43.0％ （77 cases）.The results of HAMA/HRSD were anxiety occurred in 36.3％ （65 cases）while depression occurred in 42.5％ （76 cases）of 179 patients diagnosed with AF.The agreement with （HADa）,Kappa values of SAS and HAMA were 0.438,0.337,respectively （P ＜0.01）.The agreement with HADd,SDS and HAMD their Kappa values were 0.416,0.395,respectively（P ＜0.01）.Conclusions AF patients usually has emotional disorders （anxiety or depression）.The consistency between HADS and HAMA/HAMD to screen anxiety and depressive disorder are mid-level,between SAS,SDS and HAMA,HAMD are minor.HADS is more effective and practical can be employed as a diagnostic screened implement for anxiety and depressive disorder of AF patients in general hospital.