易怒
心理学
焦虑
临床心理学
苦恼
判别效度
精神科
萧条(经济学)
社会心理的
收敛有效性
焦虑症
心理测量学
内部一致性
宏观经济学
经济
作者
Mark Zimmerman,Iwona Chelminski,Diane Young,Kristy Dalrymple,Emily Walsh,Lia K. Rosenstein
摘要
Article Abstract Objective: To acknowledge the clinical significance of anxiety in depressed patients, DSM-5 included criteria for an anxious distress specifier for major depressive disorder. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we modified our previously published depression scale to include a subscale assessing the DSM-5 anxious distress specifier. Method: From December 1995 to August 2013, 773 psychiatric outpatients with major depressive disorder completed the Clinically Useful Depression Outcome Scale (CUDOS) supplemented with questions for the DSM-5 anxious distress specifier (CUDOS-A). To examine discriminant and convergent validity, the patients were rated on clinician severity indices of depression, anxiety, and irritability. Discriminant and convergent validity was further examined in a subset of patients who completed other self-report symptom severity scales. Test-retest reliability was examined in a subset who completed the CUDOS-A twice. We compared patients who did and did not meet the DSM-5 anxious distress specifier on indices of psychosocial functioning and quality of life. Results: The CUDOS-A subscale had high internal consistency and test-retest reliability; was more highly correlated with other self-report measures of anxiety than with measures of depression, substance use problems, eating disorders, and anger; and was more highly correlated with clinician severity ratings of anxiety than depression and irritability. CUDOS-A scores were significantly higher in depressed outpatients with a current anxiety disorder than in depressed patients without a comorbid anxiety disorder (P < .001). Finally, patients who met the DSM-5 anxious distress specifier reported poorer psychosocial functioning and quality of life than patients who did not meet the anxious distress specifier. Conclusions: In the present study of a large sample of psychiatric outpatients, the CUDOS-A was a reliable and valid measure of the DSM-5 anxious distress specifier for major depressive disorder.
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