CAJ | 학술논문

目的：评价心境障碍自知力量表（ mood disorders insight scale，MDIS）中文版的信度和效度。方法：131例符合美国精神障碍诊断与统计手册第4版心境障碍诊断标准的患者完成MDIS中文版测试，由精神科医师采用临床总体印象量表（ CGI）和自知力视觉尺度量表评估其疾病严重程度和自知力；同时，家属也完成自知力视觉尺度量表。随机抽取50例患者间隔7 d后重测MDIS。计算量表Cron_bach’s α系数和两次评分的相关系数，评价量表的内部一致性和1周重测信度；采用因子分析方法考评结构效度；通过MDIS评分与精神科医师及家属的自知力视觉尺度量表评分相关分析来考察效标效度；通过比较重度和轻中度疾病严重程度患者MDIS得分差异来考评实证效度。结果：①信度：MDIS量表总Cronbach’s α系数为0?81，1周重测信度系数为0?82；②效度：探索性因子分析显示MDIS符合两因子结构，贡献率达65?75％；验证性因子分析的拟合优度指数为0?900，赋范拟合指数为0?931，标准化残差均方根为0?064；③患者MDIS分值与精神科医师及家属自知力视觉尺度评分之间相关系数分别为0?74和0?59（ P均＜0?05），与CGI评分相关系数为—0?87（ P＜0?05）。轻中度与重度躁狂发作患者MDIS量表分值差异具有统计学意义（ P＜0?05）。结论：MDIS中文版具有较好的信度和效度，可用于快速有效地评估心境障碍患者的自知力。
목적：평개심경장애자지역량표（ mood disorders insight scale，MDIS）중문판적신도화효도。방법：131례부합미국정신장애진단여통계수책제4판심경장애진단표준적환자완성MDIS중문판측시，유정신과의사채용림상총체인상량표（ CGI）화자지력시각척도량표평고기질병엄중정도화자지력；동시，가속야완성자지력시각척도량표。수궤추취50례환자간격7 d후중측MDIS。계산량표Cron_bach’s α계수화량차평분적상관계수，평개량표적내부일치성화1주중측신도；채용인자분석방법고평결구효도；통과MDIS평분여정신과의사급가속적자지력시각척도량표평분상관분석래고찰효표효도；통과비교중도화경중도질병엄중정도환자MDIS득분차이래고평실증효도。결과：①신도：MDIS량표총Cronbach’s α계수위0?81，1주중측신도계수위0?82；②효도：탐색성인자분석현시MDIS부합량인자결구，공헌솔체65?75％；험증성인자분석적의합우도지수위0?900，부범의합지수위0?931，표준화잔차균방근위0?064；③환자MDIS분치여정신과의사급가속자지력시각척도평분지간상관계수분별위0?74화0?59（ P균＜0?05），여CGI평분상관계수위—0?87（ P＜0?05）。경중도여중도조광발작환자MDIS량표분치차이구유통계학의의（ P＜0?05）。결론：MDIS중문판구유교호적신도화효도，가용우쾌속유효지평고심경장애환자적자지력。
Objective:To evaluate the validity and reliability of the Chinese version of mood disorders in_sight scale( MDIS)? Method:One hundred and thirty_one patients with mood disorders( dignositic and statis_tical manual of mental disorders,fourth edition)were administered with the Chinese version of MDIS?The dis_ease severity and insight of mood disorders were assessed with clinical global impression scale( CGI)and a cli_nician_rated insight visual analogue scale?Family members of patients were also required to assess the insight of patients with a kin_rated insight visual analogue scale?Fifty patients were randomly selected and re_assessed with MDIS one week later? Cronbach’s α coefficient and Pearson correlation coefficient between two assessment scores were calculated to evaluate the internal consistency and one_week re_test reliability of MDIS?Factor ana_lyses were used to examine the construct validity?Criteria_related validity was assessed through correlation analy_sis between patients’MDIS and clinician_rated and kin_rated insight visual analogue scale scores?The empirical validity was examined through comparisons between MDIS scores of patients with mild_to_moderate and severe disease? Results:①Reliability:Cronbach ’s α and one_week re_test reliability coefficients were 0?81 and 0?82,respectively;②Validity:exploratory factor analysis indicated that MDIS had a 2 factor structure,account_ing for 65?75% of the total variance?Indicators for the goodness of the two factor structure in confirmatory factor analysis were:goodness_of_fit index:0?900,normed fit index:0?931,and root mean square error of approxima_tion:0?064;③Correlation coefficients between patients’MDIS and clinician_rated and kin_rated visual analogue scale scores were 0?74( P<0?05 )and 0?59( P<0?05 ),respectively?Correlation coefficient between MDIS and CGI was —0?87(P<0?05)?Significant differences in MDIS scores were detected between mild_to_moder_ate and severe patients with manic episode(P<0?05)? Conclusion:Chinese version MDIS has good reliabil_ity and validity and thus can be used as a fast and effective tool to assess insight of patients with mood disorders.