CAJ | 학술논문

目的研究中文版32项轻躁狂症状清单(HCL-32)在双相障碍(BP)患者中的信度、效度以及与重性抑郁障碍(单相抑郁障碍,UP)区分的最佳划界分、敏感性和特异性等.方法征得HCL-32原作者同意后,对英文版本量表互译后适当修改成中文版本HCL-32.以美国精神障碍诊断与统计手册第四版为诊断标准,在深圳市及上海市精神卫生中心门诊及住院部收集300例双相障碍、156例重性抑郁障碍患者.所有研究对象使用中文版HCL-32进行测评,其中155例双相障碍患者(51.7%)在8～14d重测.结果 BP患者的中文版HCL-32结果的KMO值0.83,Bartlett球形检验卡方值有统计学意义(P＜0.01).因子分析显示前2个因子的特征值较佳(6.32,3.00),前2个因子对总方差的累积贡献率为29.1%.中文版HCL-32的Cronbach's alpha值0.86,因子Ⅰ、Ⅱ分别为0.86,0.69.HCL-32重测相关系数为0.62.32项条目阳性回答率为11.6%～89.7%.BP患者的HCL-32分平均分为(16.6±6.2)分,而UP患者的HCL-32分平均分为(10.9±6.4)分,差异有统计学意义(P＜0.01).经ROC曲线法,HCL-32对于BP患者与单相抑郁障碍患者的最佳划界分为14分,相应敏感性、特异性为0.74,0.66,阳性预测值0.81,阴性预测值0.57.结论中文版HCL-32经在双相患者中初步测试,其信度、效度满足心理测量学要求,并可作为双相障碍筛查的辅助工具.
목적 연구중문판32항경조광증상청단(HCL-32)재쌍상장애(BP)환자중적신도、효도이급여중성억욱장애(단상억욱장애,UP)구분적최가화계분、민감성화특이성등.방법 정득HCL-32원작자동의후,대영문판본량표호역후괄당수개성중문판본HCL-32.이미국정신장애진단여통계수책제사판위진단표준,재심수시급상해시정신위생중심문진급주원부수집300례쌍상장애、156례중성억욱장애환자.소유연구대상사용중문판HCL-32진행측평,기중155례쌍상장애환자(51.7%)재8～14d중측.결과 BP환자적중문판HCL-32결과 적KMO치0.83,Bartlett구형검험잡방치유통계학의의(P＜0.01).인자분석현시전2개인자적특정치교가(6.32,3.00),전2개인자대총방차적루적공헌솔위29.1%.중문판HCL-32적Cronbach's alpha치0.86,인자Ⅰ、Ⅱ분별위0.86,0.69.HCL-32중측상관계수위0.62.32항조목양성회답솔위11.6%～89.7%.BP환자적HCL-32분평균분위(16.6±6.2)분,이UP환자적HCL-32분평균분위(10.9±6.4)분,차이유통계학의의(P＜0.01).경ROC곡선법,HCL-32대우BP환자여단상억욱장애환자적최가화계분위14분,상응민감성、특이성위0.74,0.66,양성예측치0.81,음성예측치0.57.결론 중문판HCL-32경재쌍상환자중초보측시,기신도、효도만족심리측량학요구,병가작위쌍상장애사사적보조공구.
Objective To investigate the validity and reliability of the Chinese version HCL-32(CV-HCL-32) in the patients with bipolar disorder(BP) and the best cut-off between the patients with BP and patients with major depression disorder (unipolar depression disorder, UP). Methods The English version HCL-32 was translated into Chinese version after the agreement of the author of the HCL-32. 300 consecutive patients with BP and 156 consecutive patients with UP in outpatients and inpatients departments diagnostically interviewed with DSM-Ⅳ were rated by CV-HCL-32. The test-retest reliability with interval of eight to fourteen days was investigated in 155 patients (51.7%) with BP in the bipolar patients. Results A two-factor solution was preferred by the factors analysis. The Eigenvalues of the two factors were 6.32, 3.00 respectively. The two factors together accounted for 29.1% of the total variance. The internal consistency( Cronbach's alpha) of the CV-HCL-32 was 0.86.The test-retest reliability of the CV-HCL-32 was 0.62(P＜ 0.01 ). The frequency of positive responses to various items ranged from 11.6% to 89.7%. The mean score of CV-HCL-32 was statistically higher in patients with BP( 16.6 ± 6.2) than that of UP ( 10.9 ± 6.4). A CV-HCL-32 screening score of 14 was chosen as the optimal cutoff between the patients with BP and UP, as it provided good sensitivity (0.74) and specificity (0.66). The positive and negative predictive power for this cut-off was 0.81 and 0.57. Conclusions The study demonstrated the suitable validity and reliability of CV-HCL-32, suggested that the CV-HCL-32 is useful questionnaire for screening bipolar disorder in China.