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首页> 外文期刊>Journal of geriatric psychiatry and neurology >Depressive symptoms in Parkinson Disease: Degree of association and rate of agreement of clinician-based and self-report measures
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Depressive symptoms in Parkinson Disease: Degree of association and rate of agreement of clinician-based and self-report measures

机译：帕金森氏病的抑郁症状：基于临床医生和自我报告措施的关联度和同意率

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Depression in Parkinson disease (PD) is associated with faster disease progression, lower activities of daily living, and more severe cognitive impairment. Even mild symptoms of depression may impact outcomes in patients with PD. Nevertheless, a low rate of agreement has been reported between patient and clinician ratings of depression, suggesting that clinicians may underestimate depression in patients with PD. However, to accurately compare the rates of agreement, comparable estimates are needed so that patient and clinician ratings have similar meaning (eg, mild, moderate, severe, etc). The purpose of this study was to examine this question by investigating the degree of association and rate of agreement of levels of symptom severity among self-report and clinician ratings using established cutoffs that correspond to more comparable estimates of these levels for both patient and clinician. Our findings suggest that patient's self-report of depressive symptoms was significantly correlated with clinician-based report irrespective of the stage of disease. Moreover, patients demonstrated a 72% rate of agreement with clinicians in classifying symptoms as asymptomatic, mildly symptomatic, or fully symptomatic, a rate significantly higher than the rate of 35% previously reported. This difference in rate of agreement may be accounted for using varying criteria for severity levels across the studies. Findings suggest that clinician and patient reports show a high rate of agreement across a range of depressive symptoms and that self-report measures may provide a relatively efficient means of detecting depressive symptoms especially if patients are disinclined to initiate their report.
机译：帕金森氏病（PD）的抑郁症与疾病进展更快，日常生活活动能力降低以及更严重的认知障碍有关。即使是轻微的抑郁症状也可能影响PD患者的预后。然而，据报道，患者和临床医生对抑郁症的评价率较低，这表明临床医生可能低估了PD患者的抑郁症。但是，为了准确比较同意率，需要进行可比的估计，以便患者和临床医生的评级具有相似的含义（例如，轻度，中度，重度等）。这项研究的目的是通过使用既定的临界值来调查自我报告和临床医生评级之间症状严重性水平的关联度和一致性率，从而检验此问题，该临界值对应于患者和临床医生对这些水平的更可比估计。我们的发现表明，患者的抑郁症状自我报告与基于临床医生的报告显着相关，而与疾病的阶段无关。此外，在将症状分类为无症状，轻度症状或完全症状的患者中，与临床医生达成一致的比率为72％，该比率明显高于先前报道的35％的比率。一致性率的差异可能是由于在整个研究中使用不同的严重性水平标准而造成的。研究结果表明，临床医生和患者的报告在一系列抑郁症状中显示出很高的一致性，自我报告措施可能提供检测抑郁症状的相对有效的方法，尤其是如果患者不愿提出报告时。

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