症狀檢核表 90-修訂版 (SCL-90-R) 之台灣健康成人常模研究

Abstract

Background: Emotional symptoms come along with brain diseases. Evaluating emotional symptoms could help reduce the emotional comorbidity, simplifying the patients’ problems, alleviating their distresses, and easing the caretakers’ burden. Appropriate tools with good reliability and validity to assess emotional disturbances have clinical utility in differential diagnosis, treatment plan, and rehabilitation. Symptom Checklist-90-Revised (SCL-90-R) is widely used in neurologic patients to evaluate their emotional disturbances. However, lack of Taiwanese normative data limits the use of the SCL-90-R, and the psychometric properties have not been explored with Taiwanese data. Objectives: The objectives of the research are to establish the Taiwanese normative data of the SCL-90-R, to examine the appropriacy of the norm, to assess the demographic effects, and to examine the psychometric properties. Methods: The study recruited 356 participants representative of healthy literate adult Taiwanese population from the community. The family members or friends of the participants were also recruited as the informants. After the cognitive screening tests and short interview, all the participants and the informants filled the SCL-90-R. Exploratory and confirmatory factor analyses were used to examine the factor structures. Two subgroups of sample size of 30 were used to test the test-retest reliability and the validity. The study recruited 33 patients with temporal lobe epilepsy and 90 patients with very mild to mild dementia with Alzheimer’s disease, Parkinson’s disease, and traumatic brain injury for investigating the construct validity. Results: The CFA corroborated the original nine-factor solution, but the EFA only found one factor of general distress. The SCL-90-R had good internal consistency, and it could reliably classify the level of distress over time. The informants could provide reliable information when the symptoms are obvious. The SCL-90-R dimensions measuring somatic, depressive, anxiety, and general distress symptoms were validated, and the other dimensions correlated with corresponding problematic personalities measured by the Ko's Mental Health Questionnaire, providing indirect validating evidence. The obsessive-compulsive dimension of the SCL-90-R might be an index of mental inefficiency. The differences between the patient groups and the normative data were consistent with the literature. The gender and education effects were only small. The normative data has sound appropriacy. Conclusion: The SCL-90-R could provide important clinical information about patients’ emotional symptoms in Taiwan, and it could provide base rate information regarding the symptom domains.