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Abstract：
This study aims to explore the reliability, validity, and feasibility of Clinically Useful Depression Outcome Scale (CUDOS) in screening mixed features in patients diagnosed with mania.
A total of 109 patients with (hypo-) manic episode were recruited. The reliability of Chinese version of CUDOS (CUDOS-C) were analyzed with Cronbach\'s alpha and intraclass correlation coefficient (ICC). Spearman correlation coefficient was used to analyze the validity by comparing the correlation between CUDOS-C and Patient Health Questionnaire-9 (PHQ-9), 32-item Hypomania Checklist (HCL-32). The score of MINI (hypo-) manic episode with mixed features-DSM-5 Module-Chinese version(MINI-M-C) ≥ 2 was considered as the gold standard of mixed features, and the receiver operating characteristic (ROC) curve analysis was used to calculate the optimal cut-off values of CUDOS-C score.
The Cronbach\'s alpha value of CUDOS-C was 0.898, and the ICC of CUDOS-C test-retest was 0.880 (95% CI: 0.812-0.923, p < .05).The CUDOS-C score was significantly correlated with PHQ-9 score (r = 0.893, p = .000), but not with HCL-32 score(r = 0.088, p = .364).The area under ROC curve was 0.909 (95% CI: 0.855 to 0.963, p < .001) for CUDOS-C identifying mixed features in mania. The optimal cut-off value was 11 with a sensitivity of 0.854 and a specificity of 0.868. The CUDOS-C (score ≥ 12) identified 40.4% of the patients with mixed features, which was higher than those diagnosed by clinicians (18.3%) and screened using MINI-M-C (37.6%).
The results indicate the CUDOS-C is a reliable and valid self-administered questionnaire for assessing depressive symptoms and screening patients with mixed mania.
A total of 109 patients with (hypo-) manic episode were recruited. The reliability of Chinese version of CUDOS (CUDOS-C) were analyzed with Cronbach\'s alpha and intraclass correlation coefficient (ICC). Spearman correlation coefficient was used to analyze the validity by comparing the correlation between CUDOS-C and Patient Health Questionnaire-9 (PHQ-9), 32-item Hypomania Checklist (HCL-32). The score of MINI (hypo-) manic episode with mixed features-DSM-5 Module-Chinese version(MINI-M-C) ≥ 2 was considered as the gold standard of mixed features, and the receiver operating characteristic (ROC) curve analysis was used to calculate the optimal cut-off values of CUDOS-C score.
The Cronbach\'s alpha value of CUDOS-C was 0.898, and the ICC of CUDOS-C test-retest was 0.880 (95% CI: 0.812-0.923, p < .05).The CUDOS-C score was significantly correlated with PHQ-9 score (r = 0.893, p = .000), but not with HCL-32 score(r = 0.088, p = .364).The area under ROC curve was 0.909 (95% CI: 0.855 to 0.963, p < .001) for CUDOS-C identifying mixed features in mania. The optimal cut-off value was 11 with a sensitivity of 0.854 and a specificity of 0.868. The CUDOS-C (score ≥ 12) identified 40.4% of the patients with mixed features, which was higher than those diagnosed by clinicians (18.3%) and screened using MINI-M-C (37.6%).
The results indicate the CUDOS-C is a reliable and valid self-administered questionnaire for assessing depressive symptoms and screening patients with mixed mania.
摘要：
本研究旨在探讨可靠性，有效性，临床有用的抑郁结果量表（CUDOS）在诊断为躁狂症的患者中筛查混合特征的可行性。
共纳入109例躁狂发作患者。用Cronbachα和组内相关系数（ICC）分析了中文版CUDOS（CUDOS-C）的可靠性。通过比较CUDOS-C与患者健康问卷-9(PHQ-9)的相关性,采用Spearman相关系数进行效度分析。32项低躁狂清单（HCL-32）。混合特征的MINI（亚）躁狂发作评分-DSM-5模块-中文版（MINI-M-C）≥2被认为是混合特征的黄金标准，受试者工作特征（ROC）曲线分析用于计算CUDOS-C评分的最佳截止值。
CUDOS-C的Cronbachα值为0.898，CUDOS-C重测的ICC值为0.880（95％CI：0.812-0.923，p<.05）。CUDOS-C评分与PHQ-9评分显著相关(r=0.893,p=.000),但不与HCL-32评分（r=0.088，p=.364）。CUDOS-C识别躁狂症混合特征的ROC曲线下面积为0.909（95％CI：0.855至0.963，p<.001）。最佳临界值为11，灵敏度为0.854，特异性为0.868。CUDOS-C（评分≥12）确定40.4％的患者具有混合特征，高于临床医生诊断(18.3%)和使用MINI-M-C筛查(37.6%)。
结果表明CUDOS-C是评估抑郁症状和筛查混合躁狂症患者的可靠且有效的自我管理问卷。
共纳入109例躁狂发作患者。用Cronbachα和组内相关系数（ICC）分析了中文版CUDOS（CUDOS-C）的可靠性。通过比较CUDOS-C与患者健康问卷-9(PHQ-9)的相关性,采用Spearman相关系数进行效度分析。32项低躁狂清单（HCL-32）。混合特征的MINI（亚）躁狂发作评分-DSM-5模块-中文版（MINI-M-C）≥2被认为是混合特征的黄金标准，受试者工作特征（ROC）曲线分析用于计算CUDOS-C评分的最佳截止值。
CUDOS-C的Cronbachα值为0.898，CUDOS-C重测的ICC值为0.880（95％CI：0.812-0.923，p<.05）。CUDOS-C评分与PHQ-9评分显著相关(r=0.893,p=.000),但不与HCL-32评分（r=0.088，p=.364）。CUDOS-C识别躁狂症混合特征的ROC曲线下面积为0.909（95％CI：0.855至0.963，p<.001）。最佳临界值为11，灵敏度为0.854，特异性为0.868。CUDOS-C（评分≥12）确定40.4％的患者具有混合特征，高于临床医生诊断(18.3%)和使用MINI-M-C筛查(37.6%)。
结果表明CUDOS-C是评估抑郁症状和筛查混合躁狂症患者的可靠且有效的自我管理问卷。
