这位患者是否有普遍的焦虑或恐慌障碍? :理性临床检查的系统审查
Nathaniel R Herr1, John W Williams2, Sophiya Benjamin3
1Department of Psychology, American University, Washington, DC.
JAMA
|July 25, 2014
概括
这次审查发现,通用焦虑障碍表第7项 (GAD-7) 和患者健康问卷在初级保健机构查通用焦虑障碍和恐慌障碍方面是有效的.
科学领域:
- 精神病学是一个精神病学.
- 主要护理医学 医疗保健
- 诊断的准确性 诊断的准确性
背景情况:
- 通用焦虑症 (GAD) 和恐慌症是普遍存在的,但在初级保健中经常被忽视的疾病.
- 有效的查工具对于改善这些焦虑障碍的检测和管理至关重要.
研究的目的:
- 系统地评估成年人GAD和恐慌障碍的自我报告查仪器的诊断准确性.
- 为初级保健机构确定可靠和实用的工具.
主要方法:
- 从1980年到2014年4月,在主要数据库 (MEDLINE,PsycINFO,Cochrane图书馆) 进行了全面的文献搜索.
- 包括前性诊断准确性研究,将自我报告仪器与黄金标准临床诊断 (DSM/ICD标准) 进行比较.
主要成果:
- 综合焦虑症尺度第7项 (GAD-7) 显示了对GAD检测的强表现 (LR+5.1,LR-0.13).
- 患者健康问卷显示了惊慌失调查的高准确性 (LR+78,LR-0.20).
- 在10项涉及2785名GAD患者和2637名恐慌障碍患者的研究中,确定了9种仪器.
结论:
- 在初级保健中,GAD-7和患者健康问卷是有希望的,可行的GAD和恐慌症查工具.
- 由于发现的复制性有限,建议在不同的初级保健人群中进一步验证.
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