中文版 Kutcher 青少年抑郁量表测评青少年样本的效度与信度

摘要

目的：检验中文版 Kutcher 青少年抑郁量表（11项）（KADS-11）的效度、信度，确定其敏感度、特异度和划界值等，以期对中国青少年抑郁症状的筛查提供有用的工具。方法：选取黑龙江、辽宁、河北、河南、江西、湖南6个省和上海市的11～17岁中小学学生3180例，使用 KADS-11和儿童抑郁量表（CDI）对全部样本进行抑郁症状的筛查，并由精神科医生对 CDI≥19分的学生（435例）使用 DSM-IV 做抑郁症的诊断评估，1个月后从上海地区的样本随机抽取73例以同样的程序对 KADS-11、CDI 进行重测。结果：探索性因子分析结果显示 KADS-11有2个因子，使用验证性因子分析检验，两因子模型适配度较好，并且优于单因子模型，KADS-11与 CDI 总分之间呈正相关（r ＝0.74，P ＜0.01），经诊断的抑郁症组在 KADS-11各条目及总分得分上均高于非抑郁症组（P ＜0.001）；KADS-11量表在受试者工作特征曲线（ROC）下的面积 AUC ＝0.94，11个条目的 AUC 值都在0.7～0.9之间，选取总分≥9分作为 KADS-11的划界值，此时，敏感度为89％，特异度为90％；KADS-11的 Cronbach α系数为0.84，奇偶分半相关系数为0.77（P ＜0.01），间隔1个月的重测信度为0.77（P ＜0.01）。结论：中文版 Kutcher 青少年抑郁量表（11项）具有良好的效度、信度，且对青少年抑郁症筛查的准确性较高，可以用于对我国青少年抑郁症状的筛查。%Objective:To assess the validity and reliability of the Chinese version of the eleven-item Kutcher Adolescent Depression Scale (KADS-11)in Chinese adolescents,calculate its optimal cut-off value and the sensi-tivity and specificity,and explore the possibility of providing a useful tool to assess the severity of adolescent de-pressive symptoms.Methods:Totally 3180 students aged 11 -17 years were selected from schools in 6 provinces and Shanghai.All of them were asked to complete the KADS-11 and Children Depression Inventory (CDI). Students whose CDI scores were above 19 (including 19)were diagnosed with the DSM-IV criteria of depressive disorder,73 students from Shanghai sample were assessed with KADS-11 and CDI to analyze the test-retest reliabil-ity 1 month later.Results:Exploratory factor analysis showed that KADS-11 had 2 factors,and confirmatory factor analysis tested proved the 2-factor model fit better than the one-factor model.The KADS-11 total scores were posi-tively correlated with CDI total scores (r =0.74,P <0.01 ),and the KADS-11 scores were higher in depressive group than those in non-depressive group.The mean area under the curve (AUC)of KADS-11was 0.94,the mean area under the curve of each item ranged from 0.7 to 0.9.The optimal cut-off point of KADS-11 was total score≥9,sensitivity and specificity were 89% and 90% respectively.The Cronbach's alpha coefficient of the KADS-11 was 0.84,the spilt-half reliability coefficient was 0.71 (P <0.01),and the test-retest coefficient was 0.77 (P <0.01).Conclusion:The KADS-11 is appropriate for Chinese adolescents because of its good validity,reliability and diagnosis accuracy,it could be used to assess depressive symptoms for adolescents.