上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (3): 304-.doi: 10.3969/j.issn.1674-8115.2019.03.015

• 论著·临床研究 • 上一篇    下一篇

系统性红斑狼疮抑郁评估量表信度和效度比较及抑郁危险因素分析

李皎宇 *，钱丽萍 *，吴金金，李挺，叶霜   

  1. 上海交通大学医学院附属仁济医院南院风湿科，上海 201112
  • 出版日期:2019-03-28 发布日期:2019-04-28
  • 通讯作者: 叶霜，电子信箱：ye_shuang2000@163.com。
  • 作者简介:李皎宇（ 1993—），女，硕士生；电子信箱： lijiaoyu1993@163.com。钱丽萍（ 1980—），女，主管护师，本科；电子信箱： 1377478452@qq.com。*为共同第一作者。

Comparison of the reliability and validity of depression scales for systemic lupus erythematosus and analysis of depression-related risk factors

LI Jiao-yu*, QIAN Li-ping*, WU Jin-jin, LI Ting, YE Shuang   

  1. Department of Rheumatology, Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine, Shanghai 201112, China
  • Online:2019-03-28 Published:2019-04-28

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摘要： 目的 ·比较贝克抑郁量表（ Beck Depression Inventory，BDI）、抑郁自评量表（ Self-rating Depression Scale，SDS）、抑郁流行病学调查（ Center for Epidemiologic Studies Depression Scale，CES-D）3种量表应用于系统性红斑狼疮（ systemic lupus erythematosus， SLE）患者抑郁评估的信度和效度，确定更适合 SLE患者的评估量表，同时对抑郁相关危险因素进行分析。方法 ·采用知情同意、自主填写问卷的方法，对 259名 SLE患者同时采用 BDI、SDS、CES-D 3种量表进行问卷调查。分析内部一致性、重测信度、结构效度、结果判定的一致性及相关性，筛选出信度、效度最佳的量表。将该量表应用于 70例 SLE患者，采集相关临床资料初步分析抑郁相关危险因素。结果 ·量表筛选阶段回收有效问卷 240份。BDI、SDS、CES-D量表的 Cronbachs α系数分别为 0.899、0.884和 0.711； 3个量表各条目与总分均相关（ P<0.05）。BDI、SDS、CES-D 2次测评结果相关系数分别为 0.912、0.635和 0.728（P<0.01）。效度分析中， BDI、SDS、CES-D的 KMO（Kaiser-Meyer-Olkin）值分别为 0.888、0.895和 0.918，其累积变异系数分别为 63.13%、57.09%和 57.89%。BDI显示 117例（48.25%）抑郁阳性， SDS显示 154例（64.16%）抑郁阳性， CES-D显示 140例（58.33%）抑郁阳性； 3个量表相关系数为 0.939～ 0.971，有显著相关性（ P<0.01）；3种量表 κ值均大于 0.4（P<0.01）。年龄≤ 30岁、非在职和肾脏受累可能是 SLE患者发生抑郁的危险因素。结论 ·相较于 SDS和 CES-D，BDI量表整体信度和效度较高，内容简单易理解，更适合 SLE抑郁情绪的筛查；对于非在职、伴肾脏受累的年轻 SLE患者，要更加关注其情绪状态。

关键词: 系统性红斑狼疮, 抑郁, 量表, 信度, 效度, 危险因素

Abstract:

Objective · To estimate the reliability and validity of Beck Depression Inventory (BDI), Self-rating Depression Scale (SDS) and Center for Epidemiologic Studies Depression Scale (CES-D) that used for systemic lupus erythematosus (SLE) to choose a more suidepression scale, and analyze the risk factors for depression in SLE. Methods · A total of 259 questionnaires were completedSLE patients with their informed consent in the early stage. Internal consistency, test-retest reliability, construct validity, consistency and correlation of depression outcomes were analyzed. The most suiscale was used in 70 SLE patients. The results of depression screening and clinical information were collected to analyze the risk factors for SLE with depression. Results · A total of 240 valid questionnaires were collected. The Cronbachs α coefficients of BDI, SDS, and CES-D were 0.899, 0.884, and 0.711, respectively. The total scores of the three scales were correlated with every item (P<0.05). The test-retest coefficients of BDI, SDS, and CES-D were 0.912, 0.635, and 0.728, respectively (P<0.01). The result of validity analysis showed that the KMO (Kaiser-Meyer-Olkin) values of BDI, SDS, and CES-D were 0.888, 0.895, and 0.918, respectively. The total variation of main factor interpretation of BDI, SDS, and CES-D was 63.13%, 57.09%, and 57.89%, respectively. The results of BDI showed 117 patients (48.25%) with depression, while SDS showed 154 patients (64.16%) with depression and CES-D showed 140 patients (58.33%) with depression. The correlation coefficients of the three scales were 0.939-0.971 (P<0.01). κ Values of all three scales were greater than 0.4 (P<0.01). Younger than 30, unemployment and renal involvement were independent risk factors for SLE with depression. Conclusion · With better internal consistency, test-retest coefficients, good brief framework and well-understood items, BDI seems to be a more suiscale for SLE. Unemployed, renal involved and young SLE patients are more likely to suffer depression.

Key words: systemic lupus erythematosus, depression, scale, reliability, validity, risk factor

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