The Establishment Of The Five-states Depression Scale

Objectives:1.Systematic review of the main viewpoints and reasonable core of the theory of depression in TCM.Based on mining depression theory in classics of TCM “Huang Di Nei Jing”,and researching history literature and medical books according to the chronicle of han,tang,song,yuan,ming and qing,with the help of insights about depression and depressive syndrome of all famous doctor of past dynasties zhang zhongjing,jin yuan 4 authority,zhang jingyue,Ye Tianshi,and summarizing the inheritance and innovation of all of modern TCM authority and national physician masters to predecessors theory,Outlines the comprehensive understanding of motherland medicine for depression and depression syndrome.2.Scientific elaboration on the theory of depressive disorder(depression)in western medicine.Through the interpretation of western medicine understanding of depression,including review and induce to the epidemiology,pathogenesis,etiology of depression,and drug therapy,physical therapy and psychological therapy and so on,the new view,new ideas and new means of depression are tried to be found out.They can complement each other and provide new ideas for the development of TCM.3.Review the compilation of TCM scale and TCM depression scale systematically.By reviewing systematically the localization of Chinese experts and scholars in psychological measurement methods and the original design of clinical scale based on the Chinese culture and Chinese thinking characteristics,the basic differences of TCM scale and western medicine scale are analyzed,which reveal localization efforts and achievements of Chinese scholars in the field of psychological measurement and analysis are of positive significance and reference value for the development of localization scale.4.Establishment of a five-states depression scale with Chinese localization and clinical practicality.Reviewing about depression and depressive syndrome of TCM classics and authority and summarizing the western medicine knowledge and insights about depression and showing the effort of the process of the localization in psychological measurement of TCM experts,the ultimate goal focused on how to develop and compile the actual Chinese localization and clinical practical depression scale with Chinese cultural characteristics as well as to better fit the Chinese environment.This purpose is challenging and has great practical significance.Methods:1.Literature Research Method.The establishment theory of five-states depression scale and the set of the "five" based on TCM ancient books " Huang Di Nei Jing " and the discussion of the generations of physicians and medical books about "five",at the same time combining with many discussions about depression in Western medicine.A core group of 5 TCM psychiatrists with associate chief physician and above degrees refers to the depression words in the depression scale in the psychological measurement reference books,such as the manual of mental health assessment scale and the general psychological assessment scale;refers to the diagnosis of depression and depression disorder of the current diagnostic system(DSM-4,CCMD-3,ICD-10),and form an alternative entry for the establishment of the test table.Arranging and analyzing systematically modern psychology thought of TCM and the five elements theory of TCM and the history and views of western psychology and the current literature on psychosomatic disease research and related theories.Consistency is kept by setting the basic concepts and terminology of this study in advance to ensure that terms and their connotations in this study.2.Delphi Expert Consultation Method.Constructing entry table of five-states depression scale based on previous literature retrieval,open questionnaire were designed.By Delphi expert consultation method,three rounds of consultations were conducted on 14 experts,soliciting opinions of experts on the rationality and accuracy of the entry table once again.Through expert consultation,the entry of the five-states depression scale was adjusted and determined.3.Questionnaire Survey.On the basis of expert consultation,a five-states depression scale was drawn up,and a questionnaire survey was conducted among 33 doctors and nurses in the First Affiliated Hospital of Henan University of TCM.In the course of the scale survey,the form of the scale,the number of entries in the scale,the time required by the scale and the scoring rules of the scale are determined.4.Clinical Validation.From april in 2016 to april in 2017,the verification work of the scale in 297 depressed patients in clinical psychological department of the First Affiliated Hospital of Henan College of TCM was carried out.With the Hamilton depression scale as a reference scale,the reliability of five state depression scale(test-retest reliability,split half reliability),validity test(content validity,standard association validity,construct validity)was tested.5.Data Statistics Method.According to research methods of the scale science,entries of original scale were screened further by using SPSS19.0,the result of the pre-test(reliability validity)and evaluating was evaluated,the clinical verification results of scale(reliability validity)was analyzed.Structural model was drawn by using AMOS.Results:1.Item Screening On the basis of setting up item pool(37 items),according to the results of three rounds of expert questionnaire screening,7 items were excluded at first time,4 items were excluded at second time,1 item was excluded at third time.Finally,there were 25 items of five-states depression scale.2.Preliminary investigation The survey to 89 depression patients of clinical psychology department in the first affiliated hospital of Henan university of Traditional Chinese Medicine showed that internal consistency coefficient(Cronbach a coefficient)of five state depression scale was 0.738,retest reliability was 0.885,split-half reliability was 0.807,and criterion-related validity was 0.844,exploratory factor analysis showed that KMO value was 0.72,approximate chi-square value was 1210.869,five factors were extracted by principal component analysis(characteristics root>1),cumulative variance contribution rate of 5 factors was 67.028%(>60%).3.Clinical Verification The survey to 306 depression patients of clinical psychology department in the first affiliated hospital of Henan university of Traditional Chinese Medicine showed that internal consistency coefficient(Cronbacha coefficient)of five state depression scale was 0.767,retest reliability was 0.821,split-half reliability was 0.834,criterion-related validity was0.791,exploratory factor analysis showed that KMO value was 0.831,approximate chi-square value was 4184.431,five factors were extracted by principal component analysis(characteristics root>1),cumulative variance contribution rate of 5 factors was 68.68%(>60%).Confirmatory factor analysis showed that the goodness-of-fit of card square test(X2/ df)was 1.627,close to 1,the goodness of fit index(GFI)was 0.897,close to 0.9,comparative fit index(CFI)was 0.959,greater than 0.9,root mean square error of approximation(RMSEA)was 0.045,less than 0.05.Conclusions:1.The depression syndrome theory of TCM is rich in connotation and has important academic value and practical significance.By comparing with western psychology,it enriches the multi cultural model of modern psychology.2.The five-state depression scale was consistent with Chinese thinking habits and reflected the characteristics of Chinese culture.3.Through statistical tests,the five-state depression scale had better reliability and validity,and reached the requirements of the scale science.