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頁籤選單縮合
題名 | 老人憂鬱自我評量表(Self-CARE[D])的效度研究=Validation of the Chinese Version of the Self-CARE[D] in an Elderly Community Sample in Taiwan |
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作者 | 曾憲洋; 陳正生; 唐子俊; 張明永; 鄭泰安; | 書刊名 | 臺灣精神醫學 |
卷期 | 14:2 2000.06[民89.06] |
頁次 | 頁52-61 |
分類號 | 417.78735 |
關鍵詞 | 老人憂鬱自我評量表; 效度; 憂鬱量表; 老人憂鬱症; Self-CARE[D]; Validity; Depression scale; Geriatric depression; |
語文 | 中文(Chinese) |
中文摘要 | 目的:本研究以一臺灣社區老人樣本檢定「老人憂鬱自我評量表」(Self-CARE[D]) 之效度,並測試將其改為訪談方式進行資料收集之可行性。方法:首先以二階段式翻譯並以10名65歲以上的老人為樣本作前測,修定成適合國人文化之中文版「老人憂鬱自我評量表」[C-Self-CARE-D]。然後以隨機取樣方法在某社區選取年滿65歲以上居民120名,進行訪談式評量。此外,由精神科醫師在不知道評量得分的結果下,採用中文版GMS-AGECAT進行臨床會談,以獲得適當的臨床診斷。量表結果依GMS診斷為效標,並以ROC分別統計最佳分割點及效度值。 結果:共有119位(99.2%)老人完成訪談,平均年齡為72.9±5.3歲。結果發現C-Self-CARE[D]的分割點在3/4分時,其篩選能力最佳:敏感性和特異性分別為84.6%和78.2%,R.O.C.曲線下面積為0.816。以上述訪談方式評估此量表時,受訪者的性別、年齡及教育程度並未影響此量表之作答。 結論:本研究結果顯示「老人憂鬱自我評量表」在篩選憂鬱症的能力良好,可適用於社區老年人的憂鬱症之研究,達到早期診斷的目標;並且能夠適用於大型的老人憂鬱症流行病學的研究。由於國人老人之平均教育程度較低,改以訪談而非自填式進行資料之收集為一可行之方式。 |
英文摘要 | Objective: We report clozapine-induced obsessive-compulsive symptoms in two schizophrenic patients and discuss pharmacological strategies for treatment. Case Reports: Case one had suffered from schizophrenia since the age of 20, and over the following 11 years had been admitted to hospitals several times due to exacerbation of psychotic symptoms. His auditory hallucination and persecutory delusions had persisted despite adequate dosage and duration of two kinds of conventional antipsychotics, fluphenazine and haloperidol. Because of this limited response, he received a trial of clozapine 300 mg/day for 3 months. However, he suffered from obsessive thoughts two months after starting the new regimen. Upon admission for this episode, he was anxious and had suicidal ideation. His clozapine regimen was reduced to 250 mg/day with sertraline 150 mg/day and obsessions subsided one month later. Case two had suffered from schizophrenia since the age of 15, and over the following 9 years had been admitted to our hospital due to refractory psychotic symptoms. Clozapine was then given at a dosage of 400 mg/day for 4 years and then at 500 mg/day for 2 years and 8 months. He suffered from obsessions and compulsions after the second year of treatment at 500 mg/day and he was sent to our hospital for management two years and eight months after beginning the 500 mg/day clozapine regimen. After alteration of his regimen to clozapine 200 mg/day, risperidone 4 mg/day and sertraline 150 mg/day, his obsessions and compulsions improved five months later. Conclusion: The results of these two cases suggest that clozapine-induced obsessive-compulsive symptoms may be effectively treated by dose reduction of clozapine or by the addition of serotonin reuptake inhibitors. |
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