三个常用抑郁量表筛查癫痫患者伴抑郁的比较

Comparative study about three depression scales for screening depression in patients with epilepsy

目的比较贝克抑郁量表第2版(BDI-Ⅱ)、医院焦虑抑郁量表-抑郁分量表(HADS-D)、流调用抑郁自评量表(CES-D)用于对癫痫患者伴抑郁的筛查。方法采用BDI-Ⅱ、HADS-D、CES-D评价117例癫痫患者的抑郁情况,采用ROC曲线比较HADS-D、BDI-Ⅱ、CES-D的筛查性能。结果癫痫伴抑郁患者共33例。BDI-Ⅱ取临界值16,抑郁筛查的灵敏性和特异性大约都是90%,CES-D取临界值15时灵敏性大于80%,特异性72.6%。HADS-D在临界值9分时灵敏性和特异性均大于80%,而HADS-D临界值7分的敏感性91.3%,特异性76.8%。三个量表的阴性预测值都大于90%,ROC曲线下面积的比较没有统计学差异(均P>0.05)。结论 HADS-D是一种对癫痫伴抑郁更简洁、方便有效的筛查工具。

Objective To assess and compare the Beck Depression Inventory-II （ BDI-Ⅱ） , Hospital Anxiety and Depression Scale-Depression Subscale （ HADS-D） and Center for Epidemiologic Studies Depression Scale （ CES-D） as screening instruments for depression in patients with epilepsy .Methods One hundred and seventeen patients diagnosed with epilepsy were evaluated by BDI-Ⅱ, HADS-D and CES-D, the performance of BDI-Ⅱ, HADS-D and CES-D was evaluated by ROC curve .Results There were 33 epileptics with depression .The sensitivity and specificity of BDI-Ⅱfor the diagnosis of depression was around 90% for critical value 16, the sensitivity of CES-D was more than 80%for critical value 15, and specificity was 72.6%.The sensitivity and specificity of HADS-D was more than 80%for critical value 9, and the sensitivity of HADS-D was 91.3% for critical value 7, and specificity was 76.8%.Three instruments showed a negative predictive value of over 90%.Comparisons of the areas under the ROC curve for these instrument were not statistically significant difference （all P〉0.05）.Conclusion HADS-D is a brief efficient screening instruments to identify depression in patients with epilepsy .