中文版心境障碍自知力量表信效度初步研究

Validity and reliability of Chinese version of mood disorders insight scale: a preliminary study

目的:评价心境障碍自知力量表(mood disorders insight scale,MDIS)中文版的信度和效度。方法:131例符合美国精神障碍诊断与统计手册第4版心境障碍诊断标准的患者完成MDIS中文版测试,由精神科医师采用临床总体印象量表(CGI)和自知力视觉尺度量表评估其疾病严重程度和自知力;同时,家属也完成自知力视觉尺度量表。随机抽取50例患者间隔7 d后重测MDIS。计算量表Cronbach’sα系数和两次评分的相关系数,评价量表的内部一致性和1周重测信度;采用因子分析方法考评结构效度;通过MDIS评分与精神科医师及家属的自知力视觉尺度量表评分相关分析来考察效标效度;通过比较重度和轻中度疾病严重程度患者MDIS得分差异来考评实证效度。结果:1信度:MDIS量表总Cronbach’sα系数为0.81,1周重测信度系数为0.82;2效度:探索性因子分析显示MDIS符合两因子结构,贡献率达65.75%;验证性因子分析的拟合优度指数为0.900,赋范拟合指数为0.931,标准化残差均方根为0.064;3患者MDIS分值与精神科医师及家属自知力视觉尺度评分之间相关系数分别为0.74和0.59(P均<0.05),与CGI评分相关系数为-0.87(P<0.05)。轻中度与重度躁狂发作患者MDIS量表分值差异具有统计学意义(P<0.05)。结论:MDIS中文版具有较好的信度和效度,可用于快速有效地评估心境障碍患者的自知力。

Objective：To evaluate the validity and reliability of the Chinese version of mood disorders in-sight scale（ MDIS）. Method：One hundred and thirty-one patients with mood disorders（ dignositic and statis-tical manual of mental disorders,fourth edition）were administered with the Chinese version of MDIS.The dis-ease severity and insight of mood disorders were assessed with clinical global impression scale（ CGI）and a cli-nician-rated insight visual analogue scale.Family members of patients were also required to assess the insight of patients with a kin-rated insight visual analogue scale.Fifty patients were randomly selected and re-assessed with MDIS one week later. Cronbach’s α coefficient and Pearson correlation coefficient between two assessment scores were calculated to evaluate the internal consistency and one-week re-test reliability of MDIS.Factor ana-lyses were used to examine the construct validity.Criteria-related validity was assessed through correlation analy-sis between patients’MDIS and clinician-rated and kin-rated insight visual analogue scale scores.The empirical validity was examined through comparisons between MDIS scores of patients with mild-to-moderate and severe disease. Results：①Reliability：Cronbach ’s α and one-week re-test reliability coefficients were 0.81 and 0.82,respectively;②Validity：exploratory factor analysis indicated that MDIS had a 2 factor structure,account-ing for 65.75% of the total variance.Indicators for the goodness of the two factor structure in confirmatory factor analysis were：goodness-of-fit index：0.900,normed fit index：0.931,and root mean square error of approxima-tion：0.064;③Correlation coefficients between patients’MDIS and clinician-rated and kin-rated visual analogue scale scores were 0.74（ P〈0.05 ）and 0.59（ P〈0.05 ）,respectively.Correlation coefficient between MDIS and CGI was -0.87（P〈0.05）.Significant differences in MDIS scores were detected between mild-to-moder-ate and severe patients with manic episode（P〈0.05）. Conclusion：Chinese version MDIS has good reliabil-ity and validity and thus can be used as a fast and effective tool to assess insight of patients with mood disorders.