在初级保健中应用已确定的问卷截止值来检测体质症状障碍的经验教训:一项横截面研究
Victoria von Schrottenberg1, Anne Toussaint2, Alexander Hapfelmeier1,3
1Department Clinical Medicine, Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Frontiers in psychiatry
|February 2, 2024
概括
使用PHQ-15和SSD-12尺度对体征性症状障碍 (SSD) 的查表明,从高患病率设置推的切断值并不能可靠地转移到初级保健. 组合#2似乎更适用,但需要进一步验证.
科学领域:
- 精神病学是一个精神病学.
- 初级医疗保健医学 一级医疗保健医学
- 心理测量 心理测量 心理测量
背景情况:
- 身体症状障碍 (SSD) 的查通常依赖于患者健康问卷-15 (PHQ-15) 和身体症状障碍-B标准尺度 (SSD-12).
- 这些仪器的推截止值是在高流行性设置中确定的.
- 这些切割线在多样化的初级保健群体中的适用性仍然不确定.
研究的目的:
- 评估两种推的切断组合 (PHQ-15和SSD-12) 的可转移性,用于在一般初级保健环境中识别SSD风险.
- 评估这些切线的报告灵敏度和特异性是否在初级保健中有效.
主要方法:
- 一项涉及420名未经选择的成人初级保健患者的横截面研究.
- 患者填写了PHQ-15和SSD-12问卷.
- 应用了两个推的切断组合:#1 (PHQ-15 ≥9和SSD-12 ≥23) 和#2 (PHQ-15 ≥8和SSD-12 ≥13).
主要成果:
- 切断组合#1发现9%的患者呈阳性,明显低于预期,这表明初级保健中的敏感性较低,特异性更高.
- 切断组合#2确定了23%的患者呈阳性,与15%或更低的SSD真实患病率一致.
- 这些发现表明,#1组合的敏感性和特异性不能直接转移到初级保健中.
结论:
- 对于PHQ-15和SSD-12的推切断组合1似乎对未被选择的初级保健患者来说过于严格.
- 切断组合#2在初级保健中表现出更好的适用性,但需要对诊断面试进行进一步验证.
- 需要进行进一步的研究,以确定初级保健机构中SSD的最佳查标准.
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