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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Redefining diagnostic symptoms of depression using Rasch analysis: testing an item bank suitable for DSM-V and computer adaptive testing.
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Redefining diagnostic symptoms of depression using Rasch analysis: testing an item bank suitable for DSM-V and computer adaptive testing.

机译：使用Rasch分析重新定义抑郁症的诊断症状：测试适用于DSM-V的项目库和计算机自适应测试。

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OBJECTIVE: We aimed to redefine the optimal self-report symptoms of depression suitable for creation of an item bank that could be used in computer adaptive testing or to develop a simplified screening tool for DSM-V. METHOD: Four hundred subjects (200 patients with primary depression and 200 non-depressed subjects), living in Iraqi Kurdistan were interviewed. The Mini International Neuropsychiatric Interview (MINI) was used to define the presence of major depression (DSM-IV criteria). We examined symptoms of depression using four well-known scales delivered in Kurdish. The Partial Credit Model was applied to each instrument. Common-item equating was subsequently used to create an item bank and differential item functioning (DIF) explored for known subgroups. RESULTS: A symptom level Rasch analysis reduced the original 45 items to 24 items of the original after the exclusion of 21 misfitting items. A further six items (CESD13 and CESD17, HADS-D4, HADS-D5 and HADS-D7, and CDSS3 and CDSS4) were removed due to misfit as the items were added together to form the item bank, and two items were subsequently removed following the DIF analysis by diagnosis (CESD20 and CDSS9, both of which were harder to endorse for women). Therefore the remaining optimal item bank consisted of 17 items and produced an area under the curve (AUC) of 0.987. Using a bank restricted to the optimal nine items revealed only minor loss of accuracy (AUC = 0.989, sensitivity 96%, specificity 95%). Finally, when restricted to only four items accuracy was still high (AUC was still 0.976; sensitivity 93%, specificity 96%). CONCLUSIONS: An item bank of 17 items may be useful in computer adaptive testing and nine or even four items may be used to develop a simplified screening tool for DSM-V major depressive disorder (MDD). Further examination of this item bank should be conducted in different cultural settings.
机译：目的：我们的目标是重新定义适合于创建可用于计算机自适应测试的项目库的抑郁症的最佳自我报告症状，或为DSM-V开发简化的筛查工具。方法：采访了居住在伊拉克库尔德斯坦的400名受试者（200名原发性抑郁症患者和200名非抑郁症患者）。迷你国际神经精神病学访谈（MINI）用于定义严重抑郁症的存在（DSM-IV标准）。我们使用库尔德语中提供的四种众所周知的量表检查了抑郁症状。部分信用模型已应用于每种工具。随后使用通用项目等效项来创建项目库，并探索已知子组的差异项目功能（DIF）。结果：症状水平Rasch分析在排除21个不合适的项目后将原来的45个项目减少到原来的24个项目。由于不匹配，另外六个项目（CESD13和CESD17，HADS-D4，HADS-D5和HADS-D7以及CDSS3和CDSS4）被删除，因为将这些项目加在一起形成了项目库，随后在移除以下两个项目时通过诊断进行的DIF分析（CESD20和CDSS9，这两个对女性而言都较难认可）。因此，剩余的最佳项目库由17个项目组成，并且曲线下的面积（AUC）为0.987。使用限制为最佳九个项目的存储库仅显示出较小的准确性损失（AUC = 0.989，灵敏度96％，特异性95％）。最后，当仅限于四个项目时，准确性仍然很高（AUC仍为0.976;灵敏度为93％，特异性为96％）。结论：17个项目的项目库可能在计算机自​​适应测试中有用，并且9个甚至四个项目可用于开发DSM-V重度抑郁症（MDD）的简化筛选工具。应在不同的文化背景下对该商品库进行进一步检查。

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