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題名 | Use of the Hospital Anxiety and Depression Scale as a Screening Tool for Patients with Headache=中文版醫院焦慮與憂鬱量表在頭痛病人中之應用 |
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作者 | 莊凱迪; 王署君; 林正修; 傅中玲; | 書刊名 | 中華醫學雜誌 |
卷期 | 62:11 1999.11[民88.11] |
頁次 | 頁749-755 |
分類號 | 415.952 |
關鍵詞 | 焦慮; 憂鬱; 頭痛; 醫院焦慮與憂鬱量表; Anxiety; Depression; Headache; Hospital anxiety and depression scale; |
語文 | 英文(English) |
中文摘要 | 背景:醫院焦慮與憂鬱量表已被廣泛應用,以篩選出合併焦慮與憂鬱疾病的身體疾病患者。研究顯示,不同語言、種族及身體疾病患者,醫院焦慮與憂鬱量表可作為適當之篩選工具。本研究之目的為評估中文版醫院焦慮與憂鬱量表應用在醫學中心頭痛門診患者之信度與效度。 方法:在1998年9月至12月間,臺北榮民總醫院頭痛門診之所有新患者皆受邀參加本研究。患者填妥中文版醫院焦慮與憂鬱量表後,均需接受依據DSM-IV診斷標準設計之半結構式精神醫學診斷會談。最後根據患者自填之醫院焦慮與憂鬱量表計算其內在信度,並通過量表與診斷之比較,計算醫院焦慮與憂鬱量表之效度。 結果:共有62位患者(21位男性,41位女性)完成本研究,在頭痛患者中,醫院焦慮與憂鬱量表有良好之內在信度,因子分析顯示出焦慮、憂鬱、恐慌及身體4項因子。結果48位患者(77%)診斷有精神疾病,其中憂鬱及焦慮疾病之頻率分別為57%及31%。醫院焦慮與憂鬱量表總分≧10分為篩選憂鬱疾病最適當之臨界點,其敏感度為85.7%,精確度為33.3%。而醫院焦慮與憂鬱量表總分≧13分則為篩選焦慮疾病最適當之臨界點,其敏感度為84.2%,精確度為41.9%。 結論:頭痛門診患者合併患有憂鬱及焦慮疾病之情形相當普遍,醫院焦慮與憂鬱量表可作為一項篩選工具。但因醫院焦慮與憂鬱量表之精確度較低,並不適宜單獨作為頭痛門診患者憂鬱與焦慮之指標。這是第1個以精神醫學診斷証實,醫院焦慮與憂鬱量表可應用在頭痛患者中作為篩選工具之研究,此將有助於對頭痛合併精神疾病之患者作進一步研究。 |
英文摘要 | Background: The Hospital Anxiety and Depression Scale (HADS) is becoming widely used in medical settings to screen for anxiety or depressive disorders. It has been shown to be a good screening instrument in different ethnic and disease populations. The objective of this study was to evaluate the validity and reliability of HADS in patients with headache at a headache clinic. Methods: Consecutive new patients to a headache clinic at the Taipei Veterans General Hospital from September to December, 1998, were recruited in the study. The participants completed the HADS questionnaire and underwent a psychiatric semistructured interview according to the Diagnostic and Statistical Manual (4th revision). The reliability and validity of the HADS were evaluated with respect to headache. Results: A total of 62 patients (21 men, 41 women) completed the study. The HADS had a good internal consistency when applied to patients suffering from headache, with a Cronbach's α coefficient of 0.84 and a split-half reliability of 0.84 Factor analysis in this sample revealed four factors: anxiety, depression, panic and somatic factors. A total of 48 patients (77%) had a psychiatric diagnosis. The frequency of depressive disorders was 57% and anxiety disorders 31%. A total HADS score of 10 or more was the optimal cut-off point for depressive disorders. The sensitivity was was 85.7%, and the specificity 33.3% A total score of at least 13 was the optimal cut-off point for anxiety disorder. The sensitivity was 84.2%, while the specificity was 41.9%. Conclusions: Depression and anxiety were quite common among patients with headache in a headache clinic. The HADS can be used as a screening instrument for depressive and anxiety disorders. Because of the low specificity, the HDAS should not be used solely as an indicator of psychiatric comorbidity among patients with headache in a headache clinic. This is the first study that verifies the use of the HADS as a psychiatric screening tool in patients with headache by comparing the scores of the HADS with psychiatric diagnoses. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。