康奈尔痴呆抑郁量表中文版的信度检测及临床应用研究

Validation of the Chinese Version of the Cornell Scale for Depression in Dementia and Its Applications for Clinical Research

目的:检测康奈尔痴呆抑郁量表中文版(CSDD-CV)的信度,并对AD患者抑郁的相关因素进行研究。方法:对60例阿尔茨海默病(AD)患者及其照料者进行调查,了解患者访视前1周的症状和体征。结果:CSDD-CV的Cronbach’sα系数为0.810,5个因子的Cronbach’sα系数在0.576￣0.788。CSDD-CV的平均得分为6.84(0￣21)分,CSDD-CV≥8分21例(36.84%)。除第12项外,CSDD-CV各项目与总分的相关系数在0.273￣0.782,P均<0.05。CSDD-CV与NPI总分的相关系数为0.631,P<0.05,与NPI子项目A妄想、C激越、D抑郁、G情感淡漠、I易激惹、J异常行为及K睡眠均具有显著相关性,P均<0.05。采用多元线性逐步回归分析发现AD患者出现抑郁的影响因素主要为IADL和NPI。结论:CSDD-CV具有良好的信度和效度,可以用于AD患者抑郁状态的评定,同时AD抑郁状态可能与患者精细的日常生活能力有关,而与认知功能的下降无关。

Aim： To evaluate the Chinese version of the Cornell scale for depression in dementia （CSDD- CV） as an instrument for measuring the depression in Chinese elderly peoples with Alzheimer＇ s disease（AD） and investigate the risk factors for depression. Methods： 60 AD patients were interviewed by scales including CSDD-CV about signs and symptoms occurring during the week prior to the interview. Results ： The intra-class correlation coefficient was 0.81. The mean CSDD-CV scores is 6.84. Item-total （corrected） correlation showed significant coefficients（P〈0.05） for most of all items. There was a significant correlation between the CSDD-CV and NPI（rS=0.631, P 〈 0.05）, and between the CSDD-CV and NPI items including irritability/lability, anxiety, depression/dysphoria, apathy/indifference, delusions, hallucinations, sleep （P〈0.05）. The factors that influenced depression were IADL and NPI by linear step regression. Conclusion ： The CSDD-CV can be said to meet some of the basic standards required for depression measures by testing the reliability and validity. Decline in function （IADL） but not in cognition precedes the episode of depressive symptoms in patients with probable AD.