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  • Validez y Reproducibilidad Del Inventario para Depresión de Beck en Un Hospital de Cardiología

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    MARTHA COLON
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    Validez y reproducibilidad del Inventario para Depresión de Beck en un hospital de cardiología

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    6 views6 pages

    Validez y Reproducibilidad Del Inventario para Depresión de Beck en Un Hospital de Cardiología

    Uploaded by

    MARTHA COLON

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 6
    Validez y reproducibilidad del Inventario para Depresion de Beck en un hospital de cardiologia* Mario Torras-Castillo’ Edmundo Hernéndez-Malpi Héctor A. Ortega-Soto** Summary ‘Atthough the prevalence of depressive syndromes in medi- cally ill patients is high, its detection and, consequently, ts ‘treatment is infrequent. The lack of reliable and validated cli- ‘ical instruments for the measurement of depressive symp- ‘toms in this kind of pationts plays an important role in this Undesirable clinical fact. Most of the depression scales used in. psychiatry are unuseful since the included somatic symptoms can be related either with depression or with Physical illness. However, some authors have reported that ‘the Beck’s Depression Inventory (BO!) is a satisfactory instru- ‘ment forthe diagnosis and severity measurement of depres- sive syndromes in general hospital's patients. “The aim of this study isthe evaluation of the reliability and the performance as a diagnostic for depression, of a Spanish traslated version of the BD! in a cardiologic hospital. Ninety ‘six consecutive in-patients ofthe National Institute of Cardio logy “Ignacio Chavez”, between 16 and 60 years old, were evaluated. All the patients had a cardiovascular disease; the ‘evolution time ranged from 6 to 16330 days; the most fre- ‘quent diseases were rheumatic and ischemic illnesses. Fity nine percent ofthe subjects were females and their mean age (4/- sd) was 43.8 +/~ 17.3 years; the age of tho males was ‘47.3 +/- 14.6. The BDI was administrated two times with an interval of 48 hrs. Together with the first BDI, the subjects answered a socio-demographic questionaire. A'semistructur- ‘ed interview developed ad hoc for this study, based on DSM- Il erteria for the diagnosis of major depression, dysthymic isorder, adjustment reaction with depressed mood, organic ‘cerebral syndrome of the affective type, generalized anxiety disorder, and adjustment reaction with anxiety, was blindly (to BDI results) performed by a psychiatrist in 67% of the Pationts. In one half of the sample the BDI preceded the inter- ‘Yew: in the other haf the interview was followed by the BD. Roliablty test-retest coefficients were high: Pearson's ¢ = 0.89, Spearman's tho = 0.88, corrected intraclass correla tion coefficient = 0.77, Spearman-Brown (ANOVA approach) (0.87; all of them with a p 0.001. Patients with @ depressive syndrome scored significantly higher in BDI than those with an anxiety syndrome or without psychiatric diagnosis (19.4 +/- 8.2, 10.0 +/-4.2, 7.9 4/-5.6, respectively; F [2,64] = 22 p < 0.0001; depressive patients vs. anxious or without diagnosis: p 0.08, ¢ test for uncorre- lated samples with Bonferroni's correction). * Parts do esto trabajo consttuyeron is tesis que, pare obtener el diploma de Especialista on Psiquiatia presontaron los doctores ‘ores y Heméndex Malpcs, ** Dison de Investigaciones Clinicas, Instituto Mexicano do Psi- ‘quia. Cols. México-Xochimico 107, Col. San Lorenzo Huipuleo, alpen, 14370 México, D. F Enviar la corrspondencie al Dr. Héctor A. Ortoga-Soto. ‘The diagnostic performance ofthe test was analyzed by the ROC method; the cut-off point of 14 showed the best equil= brium between sensibiity and specificity. “The design of the study fits the requirements for a phase IV study ofa diagnostic test, as proposed by Feinstein (17); .. itevaluates the behavior of the test on the clinical rounds 10 be used, without a priory fixed prevalence of the illness. So, the predictive positive or negative power of the test can be reallably estimated by a Bayesian technic for diferent preva- lence values. In our case, with a prevalence of 48% (cut-of point: 14) the positive predictive power —the probability that 2 subject with @ positive result in the test has the illness — was of 85%; however, with a prevalence of 15%; the positive predictive power falls down t0 52%. t can be concluded thet our Spanish translated version is highly reliable and has a satisfactory performance 3s 9 diag- ‘nostic test for depressive syndromes in our sample of cardio- logic patient. Resum Los sindromes depresivos son frecuentes en los pacientes ‘médicamente enfermos: sin embargo, pocas veces se reco rhocen y se tratan. Entre los factores que explican esta defi- Ciencia destaca la falta de instrumentos clinimétricos adecua- sdamente evaluados. El presente trabajo muestra las carac- teristicas del Inventario para Depresion de Beck (IDB) para ‘emplearlo como prueba diagnstica de los sindromes depre- sivos en los pacientes de un hospital de tercer nivel dela ciu= dad de México; también, se indica la capacidad para repetir los resultados “prueba-contraprucba’. Durante el periodo de julio a diciembre de 1987, se estur diaron 96 pacientes hospitalizados, mayores de 18 afios, que ‘sabian leer y escribir. Todos padecian de una enfermedad car- diovascular. A todos los pacientes se les aplicé el mismo dia, tun cuestionario sobre sus datos personales y el IDB; 48 horas depués se les aplicé nuevamente el IDB. Al 67% de los pacientes se le sometié una entrevista semiestructurada or un psiquiatra experimentado. Dicha entrevista se estruc~ 1ur6 ad hoe con los eriterios diagnésticos del DSM-lll para:

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