中文版心境障碍问卷的效度与信度

Validity and reliability of the Chinese version Mood Disorder Questionnaire

目的 评估中文版心境障碍问卷（MDQ）在双相障碍（BP）患者中的信度和效度以及与重性抑郁障碍（单相抑郁障碍,UP）患者区分的最佳划界分及相应的敏感性和特异性等结果.方法 对根据美国精神障碍诊断与统计手册第4版为诊断标准确诊的284例双相障碍患者（BP组）和134例单相抑郁障碍患者（UP组）,使用中文版MDQ进行测评,其中147例双相障碍患者（51.8%）在8～14 d重测.结果 中文版MDQ对BP组评定结果的因子分析显示,选取2因子的方法最佳（因子Ⅰ、因子Ⅱ的特征根值分别为2.98、2.14）,2个因子对总方差的累积贡献率为39.4%;中文版MDQ内部因子一致性分析克隆巴赫系数（Cronbach＇s alpha）为0.77,MDQ重测相关系数为0.63（P＜0.01）;13项条目的 阳性回答率为32.4%～78.2%;经ROC曲线法评价,MDQ区分BP组与UP组的最佳划界分为7分,相应敏感性、特异性为0.64、0.80.结论 中文版MDQ的信效度指标满足心理测量学要求,并且对于临床上的心境障碍患者,可以选择7分作为区分BP与UP的最佳划界分.

Objective To investigate the validity and reliability of the Chinese version Mood Disorder Questionnaire （C-MDQ） in the patients with bipolar disorder （BP） and the optimal cutoff, sensitivity and specificity using the C-MDQ to distinguish between the BP patients and patients with major depression disorder （unipolar depression disorder, UP）. Methods The English version MDQ was translated into Chinese version with consent of the author of the questionnaire. 284 patients with BP and 134 with UP in outpatients and inpatients departments diagnostically interviewed with DSM-Ⅳ were consecutively rated by the C-MDQ. The test-retest reliability with interval of eight to fourteen days was investigated in 147 BP patients （51.8%）. Results A two-factor solution was preferred by the factors analysis. The Eigenvalues of these two factors were 2.98, 2.14 respectively. The two factors together accounted for 39.4% of the total variance. The internal consistency （Cronbach＇s alpha） of the C-MDQ was 0.77. The test-retest reliability of the C-MDQ was 0.63（P 〈0.01 ）. The frequency of positive responses to various items ranged from 32.4% to 78.2%. A C-MDQ screening score of 7 or more was chosen as the optimal cutoff between the patients with BP and UP, as it provided good sensitivity （0.64） and nice specificity （0.80）. Conclusions The study demonstrated the suitable validity and reliability of C-MDQ, suggesting that the C-MDQ is supplementary instrument to screen bipolar disorder in China, and 7 can be the cutoff when the C-MDQ used to discriminate between the BP and UP in the patients with mood disorder in clinical practice.