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Abstract：
A useful scale for identification of mixed features in major depressive episodes (MDE) patients is urgent in China. This study aimed to evaluate the reliability and validity of the Chinese version of the Clinically Useful Depression Outcome Scale supplemented with questions for the DSM-5 mixed features specifier (Chinese-CUDOS-M) in MDE patients.
A total of 152 MDE patients were recruited and assessed using Chinese-CUDOS-M, Patient Health Questionnaire-9 (PHQ-9) and 32-item Hypomania Checklist (HCL-32). Principal component analysis (PCA) and exploratory factor analysis (EFA) were conducted. The predictive validity was calculated by the area under the receiver operating characteristic curve (AUROC).
The Cronbach\'s alpha of Chinese-CUDOS-M was 0.85. PCA showed three common factors with eigenvalue greater than 1; the eigenvalue of factor I was 4.96, with 38.1% of variance explanation. Chinese-CUDOS-M depression subscale was associated with PHQ-9 (r = 0.83, p<0.01), and manic subscale was associated with HCL-32 (r = 0.73, p< 0.01). AUROC of the Chinese-CUDOS-M for patients with mixed depression was 0.90 (95%CI: 0.85-0.95), with a cut-off value of 7, sensitivity of 0.95, and specificity of 0.73. Furthermore, AUROC was 0.88 in patients with major depressive disorder (MDD), with a cut-off value of 7, sensitivity of 0.96, and specificity of 0.71. AUROC was 0.92 in bipolar disorder (BD) depression patients, with a cut-off value of 9, sensitivity of 0.89, and specificity of 0.87.
Our study shows that the Chinese-CUDOS-M can identify mixed features in both MDD and BD depression with satisfactory reliability and validity.
A total of 152 MDE patients were recruited and assessed using Chinese-CUDOS-M, Patient Health Questionnaire-9 (PHQ-9) and 32-item Hypomania Checklist (HCL-32). Principal component analysis (PCA) and exploratory factor analysis (EFA) were conducted. The predictive validity was calculated by the area under the receiver operating characteristic curve (AUROC).
The Cronbach\'s alpha of Chinese-CUDOS-M was 0.85. PCA showed three common factors with eigenvalue greater than 1; the eigenvalue of factor I was 4.96, with 38.1% of variance explanation. Chinese-CUDOS-M depression subscale was associated with PHQ-9 (r = 0.83, p<0.01), and manic subscale was associated with HCL-32 (r = 0.73, p< 0.01). AUROC of the Chinese-CUDOS-M for patients with mixed depression was 0.90 (95%CI: 0.85-0.95), with a cut-off value of 7, sensitivity of 0.95, and specificity of 0.73. Furthermore, AUROC was 0.88 in patients with major depressive disorder (MDD), with a cut-off value of 7, sensitivity of 0.96, and specificity of 0.71. AUROC was 0.92 in bipolar disorder (BD) depression patients, with a cut-off value of 9, sensitivity of 0.89, and specificity of 0.87.
Our study shows that the Chinese-CUDOS-M can identify mixed features in both MDD and BD depression with satisfactory reliability and validity.
摘要：
在中国，迫切需要一种有用的量表来识别重度抑郁发作（MDE）患者的混合特征。本研究旨在评估中文版临床有用抑郁结果量表的信度和效度，并补充了针对MDE患者的DSM-5混合特征说明符（Chinese-CUDOS-M）的问题。
共招募了152名MDE患者，并使用中国CUDOS-M进行了评估，患者健康问卷-9(PHQ-9)和32项轻度躁狂检查表(HCL-32)。采用主成分分析(PCA)和探索性因子分析(EFA)。通过受试者工作特征曲线下面积（AUROC）计算预测有效性。
中国CUDOS-M的克朗巴赫α为0.85。PCA显示三个共同因子的特征值大于1；因子I的特征值为4.96，方差解释为38.1％。Chinese-CUDOS-M抑郁量表与PHQ-9相关(r=0.83,p<0.01),躁狂子量表与HCL-32相关(r=0.73,p<0.01)。中国-CUDOS-M对混合型抑郁症患者的AUROC为0.90（95CI：0.85-0.95），截断值为7，灵敏度为0.95，特异性为0.73。此外，重度抑郁障碍（MDD）患者的AUROC为0.88，截止值为7，灵敏度为0.96，特异性为0.71。双相情感障碍（BD）抑郁症患者的AUROC为0.92，截断值为9，灵敏度为0.89，特异性为0.87。
我们的研究表明，中文-CUDOS-M可以识别MDD和BD抑郁症的混合特征，具有令人满意的信度和效度。
共招募了152名MDE患者，并使用中国CUDOS-M进行了评估，患者健康问卷-9(PHQ-9)和32项轻度躁狂检查表(HCL-32)。采用主成分分析(PCA)和探索性因子分析(EFA)。通过受试者工作特征曲线下面积（AUROC）计算预测有效性。
中国CUDOS-M的克朗巴赫α为0.85。PCA显示三个共同因子的特征值大于1；因子I的特征值为4.96，方差解释为38.1％。Chinese-CUDOS-M抑郁量表与PHQ-9相关(r=0.83,p<0.01),躁狂子量表与HCL-32相关(r=0.73,p<0.01)。中国-CUDOS-M对混合型抑郁症患者的AUROC为0.90（95CI：0.85-0.95），截断值为7，灵敏度为0.95，特异性为0.73。此外，重度抑郁障碍（MDD）患者的AUROC为0.88，截止值为7，灵敏度为0.96，特异性为0.71。双相情感障碍（BD）抑郁症患者的AUROC为0.92，截断值为9，灵敏度为0.89，特异性为0.87。
我们的研究表明，中文-CUDOS-M可以识别MDD和BD抑郁症的混合特征，具有令人满意的信度和效度。
