Preliminary Preparation And Application Of Self-Rating Depression State Scale Based On The Principle Of Differentiation Syndrome Elements

Objective:This study aims to compile and evaluate a self-rating depression status scale for with TCM characteristics according to the disease differentiation and syndrome differentiation combined principle on the basis of syndrome elements differentiation,in hope of providing objective reference for TCM clinical syndrome differentiation of depression and offering identification tools for clinical diagnosis and therapeutic effect evaluation of depression.Methods:1.Item screening.Item screening is performed by subjective and objective combined methods,together with expert opinions,through five statistical methods including difficulty analysis,response analysis,correlation coefficient method,Cronbach coefficient method,and factor analysis method.A self-evaluation depression scale first draft is established.2.Item assignment.The weight of item is determined using Logistic regression Enter,and its contribution to the regression equation is judged by calculating the corresponding regression coefficient of each item.Then scores are assigned to the items accordingly.3.Establishment of diagnosis model and determination of threshold value.A diagnosis model at each dimension is established according to the assignment result and corresponding option scores of the item.The threshold value is determined using ROC curve analysis method.The integral of each dimension is calculated and a ROC curve is drawn based on the diagnosis model at each dimension.Then,the optimal diagnostic threshold value of each dimension is determined by calculating the area under the curve.4.Diagnostic experiment.Five indexes including sensitivity,specificity,judgment accuracy,positive likelihood ratio,and negative likelihood ratio are adopted to assess the diagnostic performance of the scale diagnostic model and threshold value based on the experimental principles of epidemiological diagnosis.Results:1."Self-rating Depression Status Scale" is established,including 54 items at11 dimensions.2.A diagnostic model at 11 dimensions is established,and the diagnostic threshold value is determined according to the ROC curve.The area under ROC curve is between 0.7 and 0.9,P<0.05.The diagnostic threshold value at the disease differentiation dimension is 53.5,and the diagnostic threshold values of liver,heart,spleen,kidney,phlegm,qi deficiency,yin deficiency,yang deficiency,blood deficiency,and qi stagnation at the syndrome differentiation dimension are 44.5,56.5,41.5,34.5,48.5,58.5,41,42.5,38.5,31.5,respectively.3.The results of diagnostic experiments indicate that the depression status scale at the disease differentiation dimension,and liver,spleen,kidney,qi deficiency,yin deficiency,yang deficiency,blood deficiency,and qi stagnation at the syndrome differentiation dimension have high sensitivity,specificity,and accuracy,suggesting that the scale has superior diagnostic efficacy.The specificity and accuracy at the phlegm and heart dimensions are relatively low with poor diagnostic efficacy and insufficient stability,which needs further improvement.Conclusion:The Self-rating Depression Status Scale compiled can well manifest the dialectical thinking of TCM,which is professional and objective.It is applicable to TCM clinical disease and syndrome identification of depression,and is feasible to provide reference for TCM clinical research and efficacy evaluation of depression.