Background:ududDepression goes often unrecognised and untreated in non-psychiatric medical settings. Screening has recently gained acceptance as a first step towards improving depression recognition and management. The Primary Care Screener for Affective Disorders (PC-SAD) is a self-administered questionnaire to screen for Major Depressive Disorder (MDD) and Dysthymic Disorder (Dys) which has a sophisticated scoring algorithm that confers several advantages. This study tested its performance against a ‘gold standard’ diagnostic interview in primary care.ududMethods:ududA total of 416 adults attending 13 urban general internal medicine primary care practices completed the PC-SAD. Of 409 who returned a valid PC-SAD, all those scoring positive (N=151) and a random sample (N=106) of those scoring negative were selected for a 3-month telephone follow-up assessment including the administration of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) by a psychiatrist who was masked to PC-SAD results.ududResults:ududMost selected patients (N=212) took part in the follow-up assessment. After adjustment for partial verification bias the sensitivity, specificity, positive and negative predictive value for MDD were 90%, 83%, 51%, and 98%. For Dys, the corresponding figures were 78%, 79%, 8%, and 88%.ududConclusions:ududWhile some study limitations suggest caution in interpreting our results, this study corroborated the diagnostic validity of the PC-SAD, although the low PPV may limit its usefulness with regard to Dys. Given its good psychometric properties and the short average administration time, the PC-SAD might be the screening instrument of choice in settings where the technology for computer automated scoring is available.
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机译:背景: ud ud在非精神科医疗机构中,抑郁症常常无法识别和治疗。筛查最近已被接受,这是改善抑郁症识别和管理的第一步。情感障碍初级保健筛查器(PC-SAD)是一项自我管理的调查表,用于筛查重度抑郁症(MDD)和运动障碍性疾病(Dys),该方法具有先进的评分算法,具有多种优势。这项研究是针对初级保健中的“金标准”诊断性访谈测试其性能的。 ud ud方法: ud ud总共有416名参加13种城市常规内科初级保健实践的成年人完成了PC-SAD。在返回有效PC-SAD的409位患者中,选择所有得分均为阳性(N = 151)的人和随机样本(N = 106)得分为阴性的人,进行为期3个月的电话随访评估,包括对结构化患者的管理对PC-SAD结果进行掩盖的精神科医生对DSM-IV-TR轴I障碍(SCID-I)的临床访谈。 ud ud结果: ud ud大多数选定的患者(N = 212)参加了以下活动:评估。调整部分验证偏倚后,MDD的敏感性,特异性,阳性和阴性预测值分别为90%,83%,51%和98%。对于Dys,相应的数字分别为78%,79%,8%和88%。 ud ud结论: ud ud尽管某些研究局限性提示我们在解释我们的结果时要谨慎,但本研究证实了PC-SAD的诊断有效性,尽管较低的PPV可能会限制其在Dys方面的用途。鉴于其良好的心理计量特性和较短的平均管理时间,在可以使用计算机自动评分技术的环境中,PC-SAD可能是筛选工具。
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