[1]陈思路,季卫东,易正辉.德尔菲法确定首次抑郁发作核心症状的诊断指标[J].青岛大学学报(医学版),2018,54(04):384-388,392.[doi:10.11712/jms201804002]
 CHEN Silu,JI Weidong,YI Zhenghui.DELPHI METHOD USED TO IDENTIFY DIAGNOSTIC INDICATORS FOR CORE SYMPTOMS IN PATIENTS WITH FIRST-EPISODE DEPRESSION[J].JOURNAL OF QINGDAO UNIVERSITY (MEDICAL SCIENCES),2018,54(04):384-388,392.[doi:10.11712/jms201804002]
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德尔菲法确定首次抑郁发作核心症状的诊断指标()
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《青岛大学学报(医学版)》[ISSN:2096-5532/CN:37-1217/R]

卷:
第54卷
期数:
2018年04期
页码:
384-388,392
栏目:
出版日期:
2018-07-05

文章信息/Info

Title:
DELPHI METHOD USED TO IDENTIFY DIAGNOSTIC INDICATORS FOR CORE SYMPTOMS IN PATIENTS WITH FIRST-EPISODE DEPRESSION
文章编号:
2096-5532(2018)04-0384-06
作者:
陈思路1季卫东1易正辉2
(1 上海市长宁区精神卫生中心,上海 200335; 2 上海市精神卫生中心)
Author(s):
CHEN Silu JI Weidong YI Zhenghui
(Changning Mental Health Center, Shanghai 200335, China)
关键词:
抑郁症症状评估早期诊断德尔菲法
Keywords:
depressive disorder symptom assessment early diagnosis Delphi method
分类号:
R749.41
DOI:
10.11712/jms201804002
文献标志码:
A
摘要:
目的 通过德尔菲法(也称专家评估法:Delphi Method)确定首次抑郁发作病人的核心症状的诊断指标。
方法 在本市各级精神卫生中心及综合性医院门诊,邀请精神卫生领域专家47位,分别进行3轮专家问卷调查。德尔菲法采用五尺度评分法、百分权重法等评价方法,结合算术均数、等级和、满分比等变量,使用专家权威程度、专家集中程度、专家积极系数等为评价指标,确立首发抑郁病人的核心症状的诊断指标及权重。
结果 3轮调查专家权威程度高(Cr1=0.82,Cr2=0.86,Cr3=1.00),对核心症状的集中程度为91.2%、83.8%、86.1%。变异系数显示专家一致性较高、专家协调程度较高。前2轮调查显示,首次抑郁发作核心症状中,心境低落有6个诊断指标,兴趣丧失有7个诊断指标,精力减低有7个诊断指标,主要集中在精神、神经、心理症状方面。
结论 首次抑郁发作的症状与双相障碍抑郁发作、抑郁反复发作的特异性不同,除了症状学、量表、病史等诊断手段,进一步的生物化学、影像学等的早期检查,对于首发、早期或前驱期的抑郁发作病人的诊断鉴别及预后疗效评估,有着非常重要的意义。
Abstract:
Objective To investigate the diagnostic indicators for core symptoms in patients with first-episode depression using the Delphi Method.
Methods A total of 47 experts specialized in mental health were invited from mental health centers and comprehensive hospitals in the city, and three rounds of questionnaire survey were performed. A five-scale scoring method and a percentage weight method were used in combination with the variables including arithmetic mean, rank sum, and full mark ratio, and degree of expert authority, expert concentration degree, and expert positive coefficient were used as assessment indices to identify the diagnostic indicators for core symptoms and their weight in patients with first-episode depression.
Results The three rounds of the surveys had a high degree of expert authority (Cr1=0.82, Cr2=0.86, Cr3=1.00), and the degree of concentration on core symptoms was 91.2%, 83.8%, and 86.1%, respectively. Coefficient of variation showed high consistency and coordination degree between experts. The first two rounds of the surveys showed that there were 6 diagnostic indicators for mood depression, 7 for loss of interest, and 7 for reduced vigor, which mainly focused on the spiritual, neural, and psychological symptoms.
Conclusion First-episode depression is different from depressive episodes in bipolar disorder and recurrent depressive episodes. Besides symptomatology, scales, and medical history, early biochemical and imaging examinations have great significance in differential diagnosis and prognostic evaluation of patients with first-episode, early-stage, or prodromal depression.
更新日期/Last Update: 2018-07-08