CAJ | 학술논문

目的:评估12项一般健康问卷(12-item General Health Questionnaire,GHQ-12)中文版的假阳性和假阴性率及其相关因素.方法:采用多阶段分层整群随机抽样在全省共抽取15000人.以DSM-Ⅳ轴Ⅰ障碍用临床定式检查中文版(Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders,SCID)为金标准,以GHQ-12总分3分为切分值,对15000名受试中的10%质控样本(1510人)进行分析.结果:共1449人(96.0%)完成GHQ-12和SCID两项调查.控制抽样设计因素后,GHQ-12的假阳性率和假阴性率分别为14.6%和7.8%.控制其他考虑因素和抽样设计因素后,GHQ-12假阳性与居住于经济不发达的城市(城市Ⅱ型)、自评躯体健康差、因为精神问题寻求过帮助和目前结婚或同居的调整OR(95%CI)分别为2.23(1.24～4.01)、2.36(1.36～4.10)、1.53(1.10～2.14)和0.51(0.30～0.86).GHQ-12假阴性与35～49岁年龄组、居住于经济不发达农村(农村Ⅲ型)的调整OR(95%CI)分别为25.9(1.18～5.67)和2.72(1.21～6.14).结论:影响12项一般健康问卷中文版假阳性和假阴性的因素不同.识别或筛选精神障碍的12项一般健康问卷中文版切分值应根据受试的不同特征进行调整.
목적:평고12항일반건강문권(12-item General Health Questionnaire,GHQ-12)중문판적가양성화가음성솔급기상관인소.방법:채용다계단분층정군수궤추양재전성공추취15000인.이DSM-Ⅳ축Ⅰ장애용림상정식검사중문판(Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders,SCID)위금표준,이GHQ-12총분3분위절분치,대15000명수시중적10%질공양본(1510인)진행분석.결과:공1449인(96.0%)완성GHQ-12화SCID량항조사.공제추양설계인소후,GHQ-12적가양성솔화가음성솔분별위14.6%화7.8%.공제기타고필인소화추양설계인소후,GHQ-12가양성여거주우경제불발체적성시(성시Ⅱ형)、자평구체건강차、인위정신문제심구과방조화목전결혼혹동거적조정OR(95%CI)분별위2.23(1.24～4.01)、2.36(1.36～4.10)、1.53(1.10～2.14)화0.51(0.30～0.86).GHQ-12가음성여35～49세년령조、거주우경제불발체농촌(농촌Ⅲ형)적조정OR(95%CI)분별위25.9(1.18～5.67)화2.72(1.21～6.14).결론:영향12항일반건강문권중문판가양성화가음성적인소불동.식별혹사선정신장애적12항일반건강문권중문판절분치응근거수시적불동특정진행조정.
Objective: To evaluate the false positive rate and false negative rate of the Chinese version of the 12-item General Health Questionnaire (GHQ-12) and the related factors in the epidemiological survey of mental ill-nesses in Zhejiang Province. Method: A total of 15000 subjects were randomly selected from the province-wide using multi-stage stratified cluster randomization. Analyses for this paper were made in the quality control sample,10% of the total 15000 subjects (1510 subjects) in which the Chinese version of Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders (SCID) was used as a golden criterion, and a cutoff score of the GHQ-12 was set to ≥ 3 to define GHQ-12 cases. Results: Totally 1449 subjects (96.0%) completed both the GHQ-12 and the SCID. Adjusted for sampling effects, the false positive and negative rates of the GHQ-12 were respective 14.6% and7.8%. Adjusted for other considered correlates and sampling effects, the adjusted odds ratios (AORs) of GHQ-12 false positive with living in less economically developed urban areas (urban type Ⅱ), with self-reportedly poor physical health, with having ever sought help because of mental problems and with being currently married/co-habited were respective 2.23 (95% CI:1.24～4.01), 2.36(1.36～4.10), 1.53 (1.10～2.14) and 0.51 (0.30～0.86) while AORs of GHQ-12 false negative with being aged 35～49 year group and living in less econom-ically developed rural areas (rural type Ⅲ) were respective 2.59 (1.18～5.67) and 2.72 (1.21～6.14). Conclusion:Factors related to the GHQ-12 false positive and negative are different. The cutoff scores of the GHQ-12 should be used based on the characteristics of subjects during identifying or screening mental illnesses.