医院焦虑抑郁量表在中国香港类风湿关节炎患者焦虑抑郁障碍筛查中的表现

E. Lok, C. Mok
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引用次数: 0

摘要

目的:评价医院焦虑抑郁量表(HADS)在香港类风湿性关节炎(RA)患者抑郁障碍和焦虑障碍筛查中的应用效果。方法:邀请博爱医院门诊的连续RA患者在精神科医生对抑郁障碍和焦虑障碍进行临床评估之前,使用DSM-IV轴I障碍患者研究版中英对照结构化临床访谈,完成HADS问卷的中文-粤语版。HADS的心理测量特性通过受试者工作特性(ROC)曲线分析进行分析。结果:在HADS全量表中,任何精神疾病在16分的最佳分界点处的敏感性和特异性分别为83.0%和81.0%(ROC曲线下面积[AUC]0.91)。在抑郁分量表(HADS-D)中,任何抑郁障碍在10分的最佳分界线处的灵敏度和特异性为89.7%和84.8%,对于焦虑分量表(HADS-A),在任何焦虑障碍的最佳截止分数为8时,敏感性和特异性分别为88.5%和74.1%(AUC 0.87)。HADS-D对任何抑郁障碍的筛选性能均优于重性抑郁障碍。HADS-A对广泛性焦虑症的筛查性能优于任何焦虑症。结论:HADS具有良好的精神障碍筛查性能,HADS-D具有良好的抑郁障碍筛查性能。另一方面,HADS-A对广泛性焦虑症的治疗效果优于任何焦虑症。
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The Performance of the Hospital Anxiety and Depression Scale for Screening of Anxiety and Depressive Disorders in Chinese Patients with Rheumatoid Arthritis in Hong Kong
Objective: To evaluate the performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depressive disorders and anxiety disorders in patients with rheumatoid arthritis (RA) in Hong Kong. Methods: Consecutive RA patients in the outpatient clinic of Pok Oi Hospital were invited to complete the validated Chinese-Cantonese version of the HADS questionnaire before clinical assessment by a psychiatrist for depressive disorders and anxiety disorders using the Chinese-bilingual Structured Clinical Interview for DSM-IV Axis I disorders, patient research version. Psychometric properties of the HADS were analyzed by the receiver operating characteristic (ROC) curve analysis. Results: For the HADS full scale, sensitivity and specificity at the optimal cut-off score of 16 for any psychiatric disorders were 83.0% and 81.0%, respectively (area under ROC curve [AUC] 0.91). For the depression subscale (HADS-D), sensitivity and specificity at the optimal cut-off score of 10 for any depressive disorders were 89.7% and 84.8%, respectively (AUC 0.93). For the anxiety subscale (HADS-A), sensitivity and specificity at the optimal cut-off score of 8 for any anxiety disorders were 88.5% and 74.1%, respectively (AUC 0.87). The HADS-D showed better screening properties for any depressive disorders than major depressive disorder. The HADS-A showed better screening properties for generalized anxiety disorder than any anxiety disorders. Conclusion: The HADS had good performance to screen for any psychiatric disorders and the HADS-D had good performance to screen for any depressive disorders. On the other hand, the HADS-A performed better for generalized anxiety disorder than for any anxiety disorders.
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