Utilidad clínica de la versión española de la Clinically Useful Depression Outcome Scale (CUDOS) para determinar los síntomas de respuesta precoz en pacientes diagnosticados de trastornos del ánimo

Queralt Cebrià i Morales
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Abstract

Objective: to analyse the usefulness in clinical practice of the CUDOS scale (Clinically Useful Depression Outcome Scale) to assess depressive symptomatology and identify early remission symptoms. Methods: a descriptive longitudinal prospective multicentre study in >18-year-old persons diagnosed with “mood disorder”. The validated versions of CUDOS and EQ-Decentering (the higher the decentering, the lower the depressive symptomatology) were used for data collection; age, gender, level of education, occupational status, civil status, clinical diagnosis and comorbidities were also collected. Multiple regression analysis was conducted with those variables which appeared clinically significant. Finally, the Area under the ROC Curve was calculated, in order to understand the overall performance of the CUDOS scale. Results: the study included 175 patients; almost 60% of the sample suffered Major Depressive Disorder. The initial mean score in CUDOS was 44.5. The factors predicting early remission identified by Logistic Regression Analysis at Day 4 after admission were: “I thought of a hopeless future” and “I can separate my thoughts and feelings from myself” (EQ-Decentering). The ROC curve analysis showed an Area under the ROC Curve of 0.84. Conclusions: CUDOS is a tool sensitive to change within short periods of time. The cognitive area items are the first to change during depression improvement. Pessimism regarding the future and the ability for defusion regarding thought and feelings allow to predict who will improve in their next assessment.
临床有用抑郁结果量表(CUDOS)的西班牙语版本在确定情绪障碍患者早期反应症状方面的临床效用
目的:分析CUDOS量表(临床有用抑郁结局量表)在临床实践中评估抑郁症状和识别早期缓解症状的有效性。方法:对18岁以上被诊断为“情绪障碍”的人进行描述性纵向前瞻性多中心研究。使用验证版本的CUDOS和eq -去中心化(去中心化越高,抑郁症状越低)进行数据收集;同时收集年龄、性别、文化程度、职业状况、公民身份、临床诊断和合并症。对有临床意义的变量进行多元回归分析。最后,计算ROC曲线下的面积,以了解CUDOS量表的整体性能。结果:纳入175例患者;近60%的样本患有重度抑郁症。CUDOS的初始平均得分为44.5分。在入院后第4天,通过Logistic回归分析发现预测早期缓解的因素是:“我想到了一个无望的未来”和“我可以将我的想法和感觉与自己分开”(eq - dec中心)。ROC曲线分析显示,ROC曲线下面积为0.84。结论:CUDOS是一种在短时间内对变化敏感的工具。在抑郁症改善过程中,认知区域项目首先发生变化。对未来的悲观态度和对思想和感情的化解能力可以预测谁将在下一次评估中有所改善。
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