持续性重度抑郁的17项汉密尔顿抑郁量表的双因素结构；结果的量度。,PLOS ONE

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持续性重度抑郁的17项汉密尔顿抑郁量表的双因素结构；结果的量度。
PLOS ONE ( IF 2.9 ) Pub Date : 2020-10-26 , DOI: 10.1371/journal.pone.0241370
Neil Nixon _{1,

2} , Boliang Guo _{1,

3} , Anne Garland ₂ , Catherine Kaylor-Hughes _{1,

3} , Elena Nixon _{1,

3} , Richard Morriss _{1,

3}

Affiliation

背景技术17个项目的汉密尔顿抑郁量表（HDRS17）在全球范围内被用作随机对照试验（RCT）中抑郁症的观察者评定量度，尽管其因素结构仍存在不确定性。这项研究调查了在中度至重度持续性重度抑郁症（PMDD）的英国精神健康环境中接受治疗的患者HDRS17的维度。方法采用探索性结构方程模型（ESEM）来检查HDRS17得分≥16的成年PMDD患者的HDRS17因子结构。参与者（n = 187）来自在英国社区心理健康环境中进行的多中心RCT评估，评估了协作治疗模型中包括CBT和心理药理学在内的抑郁症服务相对于常规治疗（TAU）的结果。通过ESEM通过测量当量/不变性（ME / I）程序检查了12个月随访期间的构建体稳定性。结果ESEM显示，HDRS17具有PMDD患者的双因素结构（基线平均（sd）HDRS17 22.6（5.2）； 87％PMDD> 1年），总体具有抑郁症因素和两组因素：营养不良和迟缓性躁动，负物料加载使情况更加复杂。这种双因素结构在12个月的随访中保持稳定。对HDRS6的分析表明，它具有一维结构，正向装载的物品在12个月内也保持稳定。结论在这组中度至重度PMDD中，HDRS17的双因素结构在12个月内保持稳定，并且对特定领域因素的负荷为负，

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The bi-factor structure of the 17-item Hamilton Depression Rating Scale in persistent major depression; dimensional measurement of outcome.

BACKGROUND The 17-item Hamilton Depression Rating Scale (HDRS17) is used world-wide as an observer-rated measure of depression in randomised controlled trials (RCTs) despite continued uncertainty regarding its factor structure. This study investigated the dimensionality of HDRS17 for patients undergoing treatment in UK mental health settings with moderate to severe persistent major depressive disorder (PMDD). METHODS Exploratory Structural Equational Modelling (ESEM) was performed to examine the HDRS17 factor structure for adult PMDD patients with HDRS17 score ≥16. Participants (n = 187) were drawn from a multicentre RCT conducted in UK community mental health settings evaluating the outcomes of a depression service comprising CBT and psychopharmacology within a collaborative care model, against treatment as usual (TAU). The construct stability across a 12-month follow-up was examined through a measurement equivalence/invariance (ME/I) procedure via ESEM. RESULTS ESEM showed HDRS17 had a bi-factor structure for PMDD patients (baseline mean (sd) HDRS17 22.6 (5.2); 87% PMDD >1 year) with an overall depression factor and two group factors: vegetative-worry and retardation-agitation, further complicated by negative item loading. This bi-factor structure was stable over 12 months follow up. Analysis of the HDRS6 showed it had a unidimensional structure, with positive item loading also stable over 12 months. CONCLUSIONS In this cohort of moderate-severe PMDD the HDRS17 had a bi-factor structure stable across 12 months with negative item loading on domain specific factors, indicating that it may be more appropriate to multidimensional assessment of settled clinical states, with shorter unidimensional subscales such as the HDRS6 used as measures of change.

更新日期：2020-10-26

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