中文版Kutcher青少年抑郁量表测评青少年样本的效度与信度

Validity and reliability of the Chinese version of the Kutcher Adolescent Depression Scale

目的：检验中文版Kutcher青少年抑郁量表（11项）（KADS-11）的效度、信度,确定其敏感度、特异度和划界值等,以期对中国青少年抑郁症状的筛查提供有用的工具。方法：选取黑龙江、辽宁、河北、河南、江西、湖南6个省和上海市的11-17岁中小学学生3180例,使用KADS-11和儿童抑郁量表（CDI）对全部样本进行抑郁症状的筛查,并由精神科医生对CDI≥19分的学生（435例）使用DSM-IV做抑郁症的诊断评估,1个月后从上海地区的样本随机抽取73例以同样的程序对KADS-11、CDI进行重测。结果：探索性因子分析结果显示KADS-11有2个因子,使用验证性因子分析检验,两因子模型适配度较好,并且优于单因子模型,KADS-11与CDI总分之间呈正相关（r=0.74,P〈0.01）,经诊断的抑郁症组在KADS-11各条目及总分得分上均高于非抑郁症组（P〈0.001）;KADS-11量表在受试者工作特征曲线（ROC）下的面积AUC=0.94,11个条目的 AUC值都在0.7-0.9之间,选取总分≥9分作为KADS-11的划界值,此时,敏感度为89%,特异度为90%;KADS-11的Cronbachα系数为0.84,奇偶分半相关系数为0.77（P〈0.01）,间隔1个月的重测信度为0.77（P〈0.01）。结论：中文版Kutcher青少年抑郁量表（11项）具有良好的效度、信度,且对青少年抑郁症筛查的准确性较高,可以用于对我国青少年抑郁症状的筛查。

Objective：To assess the validity and reliability of the Chinese version of the eleven-item Kutcher Adolescent Depression Scale （KADS-11）in Chinese adolescents,calculate its optimal cut-off value and the sensi-tivity and specificity,and explore the possibility of providing a useful tool to assess the severity of adolescent de-pressive symptoms.Methods：Totally 3180 students aged 11 -17 years were selected from schools in 6 provinces and Shanghai.All of them were asked to complete the KADS-11 and Children Depression Inventory （CDI）. Students whose CDI scores were above 19 （including 19）were diagnosed with the DSM-IV criteria of depressive disorder,73 students from Shanghai sample were assessed with KADS-11 and CDI to analyze the test-retest reliabil-ity 1 month later.Results：Exploratory factor analysis showed that KADS-11 had 2 factors,and confirmatory factor analysis tested proved the 2-factor model fit better than the one-factor model.The KADS-11 total scores were posi-tively correlated with CDI total scores （r =0.74,P 〈0.01 ）,and the KADS-11 scores were higher in depressive group than those in non-depressive group.The mean area under the curve （AUC）of KADS-11was 0.94,the mean area under the curve of each item ranged from 0.7 to 0.9.The optimal cut-off point of KADS-11 was total score≥9,sensitivity and specificity were 89% and 90% respectively.The Cronbach＇s alpha coefficient of the KADS-11 was 0.84,the spilt-half reliability coefficient was 0.71 （P 〈0.01）,and the test-retest coefficient was 0.77 （P 〈0.01）.Conclusion：The KADS-11 is appropriate for Chinese adolescents because of its good validity,reliability and diagnosis accuracy,it could be used to assess depressive symptoms for adolescents.