心境障碍问卷筛查双相障碍的初步分析

发布时间：2018-07-02 14:11

  本文选题：心境障碍问卷 + 双相障碍　； 参考：《浙江大学》2012年硕士论文

【摘要】：背景双相障碍(bipolar disorder,BPD)具有高发病率、高自杀致死率、高致残率的特点。目前临床存在低诊断率,低正确治疗率,流行病学调查低发病率的现象,主要原因是双相障碍临床相的复杂性,诊断标准很难统一。因此,寻找对BPD具有筛查、诊断价值的量化指标有重要的意义。 目的了解心境障碍问卷(MDQ)筛查双相障碍的价值,为临床诊断提供辅助工具。 方法对48例符合ICD-10抑郁症诊断标准的住院患者,采用MDQ评定；以美国精神障碍诊断与统计手册第四版轴Ⅰ障碍定式检查-病人研究版(SCID-Ⅰ/P)为标准对患者进行重新诊断,比较两种方法的结果。 结果48例抑郁症患者中,以MDQ得分≥7分判断为双相障碍共13例(27.1%)；SCID-Ⅰ/P诊断为双相障碍共17例(35.4%),其中MDQ得分≥7分的11例。受试者操作特征曲线(ROC)分析表明,MDQ≥7分筛查双相障碍的敏感性为0.647,特异性为0.935。采用MDQ筛查与SCID-Ⅰ/诊断的具有较好一致性。以MDQ≥6分作为判断BPD的阳性标准,则MDQ从所有17例SCID-Ⅰ/P诊断为BPD患者中筛查出了12例,而31例单相抑郁患者中MQD结果有29例6分,显示MDQ评分≥6分时筛查双相障碍的敏感性为0.706,特异性为0.935；而如果以MDQ≥5分为阳性结果,则MDQ从所有17例BPD患者中筛查出了14例,而31例单相抑郁患者中MQD结果有26例5分,显示MDQ评分≥5分时特异性仍较理想,为0.839,但敏感性提高到了0.824。 结论住院抑郁症患者中未被识别的双相障碍比例较高, MDQ是一种简单、可信的筛查量表,有助于提高临床医生对双相障碍的识别率。仅从临床筛查目的来讲,以5分为划界分MDQ筛查BPD更理想。
[Abstract]:Background bipolar disorder (bpd) is characterized by high incidence, high suicide fatality rate and high disability rate. At present, there are low diagnosis rate, low correct treatment rate and low incidence of epidemiology investigation. The main reason is the complexity of the clinical phase of bipolar disorder, and the diagnostic criteria are difficult to unify. Therefore, it is of great significance to search for quantitative indexes with screening and diagnostic value for bpd. Objective to investigate the value of mood disorder questionnaire (MDQ) in the screening of bipolar disorder and to provide an auxiliary tool for clinical diagnosis. Methods Forty-eight inpatients who met the ICD-10 criteria for depression were assessed by MDQ, and the patients were re-diagnosed according to the American Diagnostic and Statistical Manual for Psychiatric Disorder, fourth Edition, Axis 鈪，

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