この患者さんは,一般的な不安やパニック障害を患っていますか? : 合理的な臨床試験の体系的なレビュー
Nathaniel R Herr1, John W Williams2, Sophiya Benjamin3
1Department of Psychology, American University, Washington, DC.
JAMA
|July 25, 2014
まとめ
このレビューでは,一般的不安障害スケール7項 (GAD-7) と患者健康アンケートが,プライマリケア環境における一般的不安障害とパニック障害のスクリーニングに有効であることが判明しました.
科学分野:
- 精神科医は精神病を患っている.
- プライマリーケア医療 プライマリーケア医療
- 診断の精度 診断の精度
背景:
- 一般的な不安障害 (GAD) とパニック障害は,プライマリーケアで流行していますが,しばしば見過ごされている状態です.
- 効果的なスクリーニングツールは,これらの不安障害の検出と管理を改善するために不可欠です.
研究 の 目的:
- 成人におけるGADとパニック障害の自己報告スクリーニング・インstrumentの診断精度を体系的に評価する.
- プライマリケア施設の信頼できる実用的なツールを特定する.
主な方法:
- 1980年から2014年4月まで,主要なデータベース (MEDLINE,PsycINFO,Cochrane Library) で包括的な文献検索が行われました.
- 将来の診断の正確性に関する研究を含み,自己報告機器と,ゴールドスタンダード臨床診断 (DSM/ICD基準) を比較した.
主要な成果:
- 汎用不安障害スケール第7項目 (GAD-7) は,GAD検出の強力なパフォーマンスを示しました (LR+5.1,LR-0.13).
- 患者の健康に関するアンケートでは,パニック障害のスクリーニングにおいて高い精度を示した (LR+78,LR-0.20).
- GADの患者2785人,パニック障害の患者2637人を含む10の研究で,9つの楽器が特定されました.
結論:
- GAD-7とPatient Health Questionnaireは,プライマリケアにおけるGADとパニック障害の有望で実行可能なスクリーニングツールです.
- 発見の複製が限られているため,多様なプライマリケア集団でのさらなる検証が推奨されています.
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