几种焦虑症状筛查量表信度和效度的比较

Comparative study of reliability and validity between several screening scales for anxiety

目的：比较几种焦虑症状筛查量表的信度和效度。方法：对某三级综合医院的内、外、妇科门诊患者按比例随机抽样,使用简易焦虑问卷、医院焦虑抑郁量表、7条目广泛性焦虑量表、2条目广泛性焦虑量表、患者健康问卷的焦虑量表做问卷调查,并用国际神经精神科简式访谈问卷进行访谈。共收集有效问卷300份。随机抽取其中50例（实际有效35例）,在初次访谈后的7~14 d进行重测。比较各量表的信度和效度。结果：各个量表的Cronbachα信度系数为0.796～0.932,重测信度为0.820～0.906。筛查广泛性焦虑阳性最多的是医院焦虑抑郁量表,为12例,最少的是患者健康问卷的焦虑量表,为9例。灵敏度以医院焦虑抑郁量表的75%为最高,其余均在60%左右;特异度均在85%以上。各量表的受试者工作特征（ROC）曲线下面积为0.869～0.963,以患者健康问卷的焦虑量表为最大,2条目广泛性焦虑量表为最小。结论：几种量表均具有良好的信度和效度,各有优势,在筛查焦虑症状上具有一定的价值,可以根据具体情况选用。

Objective To compare the reliability and validity of several anxiety screening scales.Methods The patients enrolled for anxiety screening were randomly selected as a certain proportion from outpatient departments of internal medicine,surgery and gynecology of a tertiary general hospital.The patients were asked to complete 6 questionaire scales： the anxiety scale,the 7-item generalized anxiety disorder scale（GAD-7）,2-item generalized anxiety disorder scale（GAD-2）,hospital anxiety and depression scale（HAD）,and the anxiety syndrome part of the patient health questionaire（PHQ）.Structured interviews were then taken according to the mini international neuropsychiatric interview（MINI）.Three hundreads valid samples were collected.Fifty patients（35 of which were valid） of the 300 were chosen randomly for test-retest within 7 to 14 days after the first interview.Data were collected and analyzed for calculation and then compared the reliability and validity of the 6 scales.Results Cronbach＇ α coefficients of the 6 scales were between 0.796 and 0.932,and the test-retest reliability was between 0.820 and 0.906.HAD had the highest positive number（12）,and the anxiety syndrome part of PHQ did the least positive number（9）.The highest sensitivity was 75% in the HAD,as others were around 60%.Specificity of the 6 scales were all above 85%.The areas under relative operating characteristic（ROC） curves were between 0.869 and 0.963,with the largest in the anxiety syndrome part of the PHQ and the smallest in GAD-2.Conclusions The anxiety scale,GAD-2,GAD-7,HAD,and the anxiety syndrome part of the PHQ had good reliability and validity,and each of them had their own advantages.They all had a certain value in the screening of anxiety symptom.