背景:恐慌症严重程度量表(PDSS)有望成为恐慌症的全球标准评分量表。为了使临床量表有用,我们需要一个指导方针来解释它的分数和变化,以及定义临床变化点,如反应和缓解。
方法:我们使用了两项关于惊恐障碍的大型随机对照试验的个体患者数据(共n=568)。研究参与者接受了PDSS和临床总体印象(CGI)-严重程度和-改善。我们应用等百分位链接技术来绘制PDSS和CGI-Severity之间的对应关系,PDSS和CGI改进的数字变化,以及PDSS和CGI改进的百分比变化。
结果:根据是否存在广场恐惧症,对PDSS总分的解释有所不同。当病人没有广场恐惧症时,分数范围0-1对应于“正常,“2-5带有”边界线,\"6-9与\"轻微生病,“10-13患有中度疾病,\"和14及以上,\"严重生病。“当病人有广场恐惧症时,分数范围3-7意味着“边缘病,\"8-10\"轻微生病,“11-15”中度疾病,“和16岁及以上”严重生病。“PDSS变化和CGI-Improvement之间的关系以百分位数变化比数字变化更线性,对于那些有或没有广场恐惧症的人来说是无法区分的。75-100%的下降被认为是“非常大的改善,“这40-74%”大大改善,“和10-39%”最小改进。
结论:我们建议将惊恐障碍的“缓解”定义为PDSS评分为5分或更低,其“反应”减少40%或更多。
BACKGROUND: The Panic Disorder Severity Scale (PDSS) is promising to be a standard global rating scale for panic disorder. In order for a clinical scale to be useful, we need a
guideline for interpreting its scores and their changes, and for defining clinical change points such as response and remission.
METHODS: We used individual patient data from two large randomized controlled trials of panic disorder (total n=568). Study participants were administered the PDSS and the Clinical Global Impression (CGI)--Severity and --Improvement. We applied equipercentile linking technique to draw correspondences between PDSS and CGI-Severity, numeric changes in PDSS and CGI-Improvement, and percent changes in PDSS and CGI-Improvement.
RESULTS: The interpretation of the PDSS total score differed according to the presence or absence of agoraphobia. When the patients were not agoraphobic, score ranges 0-1 corresponded with \"Normal,\" 2-5 with \"Borderline,\" 6-9 with \"Slightly ill,\" 10-13 with \"Moderately ill,\" and 14 and above with \"Markedly ill.\" When the patients were agoraphobic, score ranges 3-7 meant \"Borderline ill,\" 8-10 \"Slightly ill,\" 11-15 \"Moderately ill,\" and 16 and above \"Markedly ill.\" The relationship between PDSS change and CGI-Improvement was more linear when measured as percentile change than as numeric changes, and was indistinguishable for those with or without agoraphobia. The decrease by 75-100% was considered \"Very much improved,\" that by 40-74% \"Much improved,\" and that by 10-39% \"Minimally improved.\"
CONCLUSIONS: We propose that \"remission\" of panic disorder be defined by PDSS scores of five or less and its \"response\" by 40% or greater reduction.