两种抑郁自评量表对心血管疾病患者抑郁症状评定的一致性研究

Agreement of two scales in assessment depression in patients with cardiovascular diseases

目的探讨医院焦虑抑郁量表抑郁亚量表(HDAS-D)和抑郁自评量表(SDS)对心血管疾病患者抑郁症状评定的一致性。方法抽取615例心血管疾病患者应用HADS-D、SDS进行测评,并对30例患者在首次测评2周后进行重测。计量资料间比较采用F检验,计数资料间的比较采用χ2检验。采用同质性信度Cronbach’sα系数、重测信度检测量表的信度。HADS-D与SDS评分之间的相关性采用Pearson相关分析。量表评定的一致性检验,计算Kappa值。结果 HADS-D、SDS同质性信度Cronbach'sα系数分别为0.806和0.842,HADS-D、SDS重测信度组内相关系数(ICC)分别为0.932和0.938。HADS-D与SDS总分间的Pearson相关系数为0.663(P<0.001)。量表评定的一致性检验显示,以HADS-D≥8分作为抑郁划界分,与SDS≥50分一致性检验,Kappa值为0.59(u=16.94,P<0.001)。结论 HADS-D与SDS均具有较好的信度,HADS-D与SDS间抑郁评定一致性为中等程度。

Objective To explore the agreement of Hospital Anxiety and Depression Scale-Depression Subscale(HADS-D) and Self-Rating Depression Scale(SDS) in assessment depression in patients with cardiovascular diseases. Methods 615 patients with cardiovascular diseases were enrolled in this study, Using HADS, SDS to assess the depressive symptoms, 30 patients were selected to receive retest two weeks late. The statistical difference was compared using F test for measurement data, using Chi-square test for enumeration data. The reliability of HADS-D and SDS were tested using homogeneity reliability Cronbach’s alpha coefficient, test-retest reliability. The correlation between HADS-D and SDS was tested using Pearson correlation analysis. The agreement in assessment depression between HADS-D and SDS was tested using the Kappa value. Results The HADS-D and SDS had high homogeneity reliability with Cronbach’s α coefficient(0.806, 0.842 respectively), and the retest reliability(intra-class correlation coefficient, ICC) was 0.932, 0.938 respectively. The correction between HADS-D and SDS score was 0.663(P<0.001). The Kappa value between HADS-D≥8 and SDS≥50 was 0.59(u=16.94, P<0.001). Conclusion HADS-D and SDS have good reliability, the agreement in assessment depression between HADS-D and SDS at the best suitable cut-off score is moderate.