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首页> 美国卫生研究院文献>Lippincott Williams Wilkins Open Access >Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist
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Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist

机译：普通人群大规模基因研究中终生症状的专家和自我评估以及重大抑郁症的诊断：临床访谈和自我检查清单的比较

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Major depression disorder (MDD) is a complex neuropsychiatric disorder and an increasing number of genetic risk variants are being identified. Investigation of their influence in the general population requires accurate and efficient assessment of depressive symptoms. Here, clinical interviews conducted by clinicians are the gold standard. We investigated whether valid and reliable clinical phenotypes can be obtained efficiently using self-administered instruments. Lifetime depressive symptoms and lifetime MDD diagnosis were assessed in 464 population-based individuals using a clinical interview and a structured, self-administered checklist. Analyses were carried out of the following: (i) intraclass correlations (ICC) between checklist and interview; (ii) sensitivity/specificity of the checklist; and (iii) the association of interview and checklist with a positive family history of MDD (FH-MDD+). The correspondence of the self-administered checklist with the clinical interview was good for most depressive symptoms (ICC=0.60–0.80) and moderate for MDD diagnosis (ICC=0.45). With the consecutive inclusion of MDD diagnostic criteria, sensitivity decreased from 0.67 to 0.46, whereas specificity remained high (0.95). For checklist and interview, strong associations were found between FH-MDD+ and most depressive symptoms and MDD diagnosis (all odds ratio≥1.83). The self-administered checklist showed high reliability for both the assessment of lifetime depressive symptoms and screening for individuals with no lifetime diagnosis of MDD. However, attention is warranted when the aim is to identify MDD cases. The positive association between depressive symptomatology and FH-MDD+ indicates the usefulness of both instruments to assess patients in genetic studies. Our data suggest that the more time-efficient and cost-efficient self-administered instruments also allow for the assessment of depressive symptoms accurate enough to investigate the influence of MDD genetic risk variants in the general population.
机译：重度抑郁症（MDD）是一种复杂的神经精神疾病，正在发现越来越多的遗传风险变异体。要调查他们对普通人群的影响，需要准确有效地评估抑郁症状。在这里，临床医生进行的临床访谈是金标准。我们调查了使用自我管理的工具是否可以有效获得有效和可靠的临床表型。使用临床访谈和结构化的自我检查清单，对464位基于人群的个体的终生抑郁症状和终生MDD诊断进行了评估。进行了以下分析：（i）清单和访谈之间的类内相关性（ICC）； （ii）清单的敏感性/特异性； （iii）访谈和清单与MDD阳性家族史（FH-MDD +）的关联。自我检查清单与临床访谈的对应对大多数抑郁症状（ICC = 0.60–0.80）有益，对MDD诊断适度（ICC = 0.45）。连续纳入MDD诊断标准后，敏感性从0.67降至0.46，而特异性仍然很高（0.95）。在检查清单和访谈中，发现FH-MDD +与大多数抑郁症状和MDD诊断之间有很强的关联性（所有比值比≥1.83）。自我管理的清单显示出对终生抑郁症状的评估和筛查无终生MDD诊断的个体的高度可靠性。但是，当要确定MDD病例时，应引起注意。抑郁症状与FH-MDD +之间的正相关关系表明，这两种工具都可用于评估基因研究中的患者。我们的数据表明，更省时，更具成本效益的自我管理工具还可以使抑郁症症状的评估足够准确，以调查一般人群中MDD遗传风险变异的影响。

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