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目的:比较医院焦虑抑郁量表(HADS)和Beck抑郁问卷(BDI)在综合医院门诊病人中的评定结果 ,探讨量表间评定的一致性和量表划界分。方法:在广州15家综合医院焦虑抑郁调查样本中现场抽取229例HADS总分≧8的可疑焦虑抑郁患者,采用Beck抑郁问卷、17项汉密顿抑郁量表等进行再次评定。结果:HADS、HAD-D、BDI内部一致性良好,Cronbach琢系数分别为0.866、0.853、0.878。相关分析结果显示,HADS总分、HAD-D因子分与BDI总分、HAMD总分显著正相关,相关系数为0.415-0.853。量表的一致性分析显示,HAD-D≥9作为抑郁划界分与HAMD≥14、HAMD≥17的抑郁评定一致性Kappa值分别为0.420、0.373;BDI≥17与HAMD≥14、HAMD≥17的一致性Kap鄄pa值分别为0.535、0.508;HAD-D≥9与BDI≥17的一致性Kappa值为0.368。结论 :HADS和BDI作为两个最常用的抑郁自评量表,均具有良好的内部一致性,但HAD-D与BDI、HAMD间的评定一致性很低;BDI与HAMD间的评定一致性较好,但应用中BDI的划界分需要谨慎界定。
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Objective: This study compares the Hospital Anxiety and Depression Scale(HADS) and the Beck Depression Inventory (BDI) with regard to their psychometric properties, and investigates their agreement on detecting depression among outpatients in general hospital.Methods: 229 outpatients from 15 general hospitals who had been tested with HADS (HADS≧ 8) completed the Beck Depression Inventory and 17 items of Hamilton Depression Scale (HAMD).Results: The HADS, HADD and BDI had high internal consistency with Cronbach coefficient 0.866, 0.853, 0.878 respectively.Significant positive correction was observed among HADS, HADD and BDI scores(r 0.4150.853, P<0.01).The best agreement with HAMD ≥ 14, HAMD ≥ 17 was HADD ≥ 9, and their Kappa values were 0.420, 0.373.And the best agreement with HAMD ≥ 14, HAMD ≥ 17 was BDI ≥ 17, their Kappa values were 0.535, 0.508.The Kappa values between HADD ≥ 9 and BDI ≥ 17 was 0.368.Conclusion: As two most used selfrating depression scale, both HDAS and BDI had high internal consistency.The agreement between HADD and BDI, HAMD at the best suitable cutoff is mild to moderate.The agreement between BDI and HAMD is better, but the BDI cutoff point needs to be carefully defined in its application.
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