Scale de evaluare n

Psihiatrie
Merlici Sorina
Medic rezident Psihiatru
Centrul Comunitar de Sntate Mintal
Botanica

Pentru evaluarea psihiatric se

folosesc ca instrumente stadartizate:
Liste de simptome, ce se cer identificate prin orice mijloace
Interviuri ce se adreseaz pacientului sau altor informani
credibili; acestea pot fi:

Structurate: bazate pe ntrebri precise i rspunsuri simple,

biunivoce
Semistructurate: se propun ntrebri multiple, unele fiind
aplicate doar n anumite mprejurri
Complexe: se bazeaz i pe date observaionale i expresive

Observaii comportamentale se includ observaii ale

comportamentului n diverse contexte, de diverse
persoane, inclusiv de-a lungul cursului vieii
Instrumente nepsihopatologice evaluarea func ionalit ii
sociale, calitatea vieii

Scale de evaluare centrate

sindromologic
Hamilton MADRAS - depresie (MADRAS MontgomeryAsberg Depression)
Hamilton, Beck anxietate
STAI, SAS, BSFS - Anxietate social, fobii speciale (Social
Trate Anxiety Inventory STAI, Social Anxiety Scale SAS,
Brief Social Fobia Scale, )
Y-BOCS - Obsesii (Yale-Brown Obsessive Compulsive
Scale)
YMRS - Manie (Young Mania Rating Scale)
PANSS, SANS Schizofrenie, Tulburri schizotipale
(Positive and Negative Symptoms Scale, SANS Scale for
Assessment of Negative Symptoms etc).

Scale de evaluare centrate

multidimensional
SCAN

Schedules for Clinical Assessment in

Neuropsychiatry OMS
CIDI Composite International Diagnostic
Interview ICD
MINI Mini International Neuropsychiatric
Interview DSM cercetare
SCID Structured Clinical Interview for DSM
Disorders DSM
BPRS - Brief Psychiatric Rating Scale

Diagnosticul pe axe
DSM-IV

5 axe
I.
II.
III.
IV.
V.

ICD-10

Psihopatologie episodic
Tulburare de personalitate
Patologie somatic
Stressori psihosociali
Funcionare global (GAF)

3 axe
VI. Patologie general
VII. Funcionare social
VIII.Factori de teren i contextuali (coduri Z

Scale de evaluare n depresie

Completate

de cercettor:
Scala Hamilton
Scala Montgomery-sberg MADRS

Completate de pacient:
Scala Beck
Scala Zung

SCALE DE EVALUARE N DEPRESIE

Hamilton

(HAM-D)
precizare de stare incipinet, starea n timpul tratamentului i dup acesta,
efectuat de clinician cu experien
21 ntrebri, primele 17 majore
8 itemi pe scal de 5 puncte 0 lipsete 4 foarte sever/ 9 itemi 0-2
puncte
Interpretate: 0-7p n limitele normei, 8-13p Depresie uoar, 14-18p
Depresie moderat, 19-22p Depresie sever
MADRS
10 itemi, 0-6p Norma, 7-19 depresie uoar, 20-34 depresie moderat,
>34 depresie sever
Beck
21 itemi, peste 13 ani
stabilire disperare, iritabilitate, autoacuzare, simptome fizice
Zung
20 itemi, scor ntre 20-80p, 20-44 N,
45-59p Depresie uoar, 60-69p moderat, 70p i mai sus Depresie sever

Scale de evaluare n anxietate

Hamilton (HAM-A), prima dat publicat n 1959
14 ntrebri orientate pe simptom
0-lipsete 4 foarte sever, specificarea severit ii
Beck Anxiety Inventory BAI
21 ntrebri, completat i evaluat de pacient/beneficiar
Starea din perioada recent, indici psihofiziologici i nivelul de anxietate
Social Anxiety Scale SAS
Publicat de Dr. Liebowitz n 1987, Pharmacopsychiatry
24 ntrebri despre comportamentul n public
simplu i rapid

Scale de evaluare n Schizofrenie

PANSS Dr. Kay, UK 1987
este efectuat de ctre clinician, include ntrebri cu privire la simptomele
pozitive, negative, psihopatologie general, riscul de agresivitate.
SANS (Scale for the Assessment of Negative Symptoms)
Aplatisare afectiv, Alogie, Abulie/Apatie, Anhedonie/Asocialitate, Atenia
Total 25 ntrebri, 5 compartimente, 0 absent 5 sever
SAPS (Scale for the Assessment of Positive Symptoms)
Halucinaii, idei delirante, tulburri de gndire, comportament bizar
PSYRATS
n halucinaii (Haddock 1999, Gonzalez 2003)
frecvena, apariia, durata, localizarea, convingerea, coninutul, intensitatea,
repercusiunile .a

Scale de evaluare n
Tulburarea Afectiv Bipolar
Chestionarul

Tulburrilor Dispozi iei (Mood Disorder

Questionnaire)
Scala de Diagnosticare a Spectrului Bipolar
(Bipolar Spectrum Diagnostic Scale)
Scala de Evaluare a Depresiei Beck (Beck Depression
Inventory)
Scala de Evaluare a Depresiei Montgomery Asberg
(Montgomery and Asberg Depression Rating Scale)
Scala Hamilton de Evaluare a Depresiei (Hamilton Depression
Rating Scale)
Scala de Evaluare a Maniei Administrat de Clinician
(Clinician-Administered Rating Scale for Mania) CARS-M
Scala de Evaluare a Maniei la Tineri (Young Mania Rating Scale)
YMRS
Lista de Verificare a Hipomaniei (Hypomania Checklist) HCL32.

Scale de evaluare in ADHD

Attention Deficit Hyperactivity Disorder

Adult ADHD Self-Report Scale (ADHD Rating Scale)

18 ntrebri, partea A, B
orientate pe simptom, pe baza DSM IV
naintat de OMS
Child Behaviour Checklist
6-18 ani, 120 ntrebri, orientate pe sindrom
Vanderbilt ADHD Diagnostic Teacher Rating Scale
35 ntrebri, 0 lips 3 foarte des +
seciunile performan i comportament
Corners-Wells Adolescent Self Report Scale

Scale de evaluare n
Gerontopsihiatrie
MMSE

(Mini Mental
State Examiation) cu
privire la funcionarea
intelectual
GDS (Geriatric
Depression Scale)
CDRS (Clinical
Dementia Rating
Scale)
CSDD (Cornell Scale
for Depression in
Dementia)

Referine
Handbook of Clinical Rating Scales and Assessment in
Psychiatry and Mental Health, Eds. Lee Baer, Mark A. Blais,
2009
PsychiatricTimes.com Clinical Scales, Web
Wikipedia List of diagnostic classification and rating
scales used in psychiatry, Web
Prof. Dr. Mircea Lzrescu, Clinica de Psihiatrie Timioara
pulsmedia.eu - revista Psihiatru.ro

PSIHIATRIA LA NCEPUTUL SEC. XX

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