9(1), 17 32, 2017 Panic and Agoraphobia Scale 1 2 3 2 2 2 2 4 4 1 2 3 4 Panic and Agoraphobia Scale PAS DSM-IV-TR APA, 2000 3 4 PAS PAS PAS Patient Global Impression Improvement PAS 1980 Diagnostic and Statistical Manual of Mental Disorders DSM -III APA, 1980 DSM-III-R APA, 1987 DSM-5 APA, 2013 2014 1.5 Panic and Agoraphobia Scale PAS DSM-5 APA, 2013 PAS International Classification of Diseases ICD -10 WHO, 1993 Panic Disorder Severity Scale PDSS PAS PDSS 17
Vol. 9 No. 1 2004 PAS 2008 PAS PAS 2012 PAS Bandelow 1995; 1999 DSM-IV ICD-10 PAS 5 13 1 5 0 4 PAS 1 PAS PAS PAS Bandelow PAS 2 2 1. 3 DSM-IV-TR 300.01 300.21 300.22 2 2. PDSS 2004 Limited Symptom Episode LSELSE 7 5 0 4 Panic Disorder Scale PDS; 1 Clinical Global Impression Severity CGI-S; Guy, 1976 7 1 234 5 6 7 Clinical Global Impression Improvement CGI-I; Guy, 1976 7 1 2 3 4 5 6 7 1 Patient Global Impression Improvement PGI-I; Guy, 1976 18
Panic and Agoraphobia Scale 7 1 2 3 4 5 6 7 1 2 3. 2 1 PASPDS PASPDS PAS PDSS, CGI-S 3 PAS PGI-I PDS PAS PGI-I PDS 2 4 PAS PGI-I PDS PAS PGI-I PDS PAS, PDSS, CGI-S CGI-I PDSS, PDS, CGI-S 3 PAS PAS PAS 4 2 4. 3 3 1. PAS PAS ρ CCC 0.8 0.025 ρ CCC 0.5 80 28 PAS 3 PGI-I 4 3 ρ ICC 0.8 0.025 ρ ICC 0.5 80 28 3 PGI-I 4 60 3 2. PASPAS PGI-I 4 PASPAS κ concordance correlation coefficient; CCC 3 PGI-I 4 3 PAS intraclass correlation coefficient; ICC Cronbach α 3 3. PAS PAS 3 4 PAS PGI-I Pearson 19
Vol. 9 No. 1 R version3.2.3 1. 83 Table 1 27 32.5 5667.5 34.3 DSM-IV-TR 76 91.6 60 16 19.3 Table 1 2. PASPAS Table 2 PAS PAS PAS PAS 22.1 22.1 4 12.7 13.3 PAS PAS PAS PAS 4 3. PAS PAS CCC 95 n 81 0.82 0.74, 0.88 4 n 61 0.88 PAS PAS κ Table 3 4 C 0.41 0.84 Table 1 83 300.01 300.21 300.2 1 3 PDSS 3 PGI-I 4 26 25 3 PAS ICC 0.74 95 CI: 0.36 to 0.89 Cronbach α PAS 3 4 0.86, 0.87, 0.87, PAS 4 0.84, 0.88 Table 4 4. 27 32.5 56 67.5 34.3 11.3 7 8.4 76 91.6 PASPAS 4 Table 5 6 Scree plot Parallel analysis 0 60 9 120.5 16 19.3 66 79.5 1 1.2 13.0 4.8 20
Panic and Agoraphobia Scale Table 2 PAS PAS 3 4 SD SD SD SD SD A: A1 82 1.4 1.29 83 1.4 1.34 67 1.1 1.18 61 0.7 1.00 61 0.6 0.97 A2 82 1.3 1.16 83 1.3 1.20 67 1.0 1.09 61 0.6 0.90 61 0.5 0.77 A3 82 1.1 0.98 83 1.0 0.94 67 0.8 0.91 61 0.6 0.86 61 0.5 0.81 B: B1 82 1.9 1.45 83 2.1 1.37 66 1.3 1.20 61 1.2 1.16 61 1.4 1.13 B2 82 2.8 1.11 83 2.7 1.12 66 2.7 1.23 61 2.4 1.02 61 2.3 1.12 B3 82 2.4 1.35 83 2.6 1.31 66 2.1 1.40 61 1.7 1.44 61 1.9 1.37 C: C1 82 2.5 1.23 83 2.5 1.16 66 1.6 1.14 61 1.3 1.12 61 1.6 1.06 C2 82 2.1 1.07 83 1.9 1.03 66 1.4 1.08 61 1.1 0.88 61 1.1 0.62 D: D1 81 1.3 1.36 83 1.1 1.15 67 1.0 1.25 61 0.8 1.18 61 0.7 0.93 D2 82 1.5 1.36 83 1.7 1.27 67 1.0 1.20 61 0.7 1.17 61 0.9 1.08 D3 82 1.7 1.48 83 2.0 1.43 67 1.2 1.31 61 0.8 1.27 61 1.2 1.48 E: E1 82 1.5 1.26 83 1.2 1.19 67 0.8 1.07 61 0.4 0.69 61 0.4 0.66 E2 82 0.6 0.91 83 0.5 0.87 67 0.4 0.72 61 0.3 0.70 61 0.2 0.57 81 22.1 9.88 83 22.1 9.04 66 16.2 9.33 61 12.7 8.59 61 13.3 8.34 21
Vol. 9 No. 1 4 2008 PAS PASA C B D E PAS PAS Table 3 κ 4 82 61 A: A1 0.83 0.80 A2 0.84 0.75 A3 0.66 0.81 B: B1 0.73 0.76 B2 0.72 0.79 B3 0.64 0.64 C: C1 0.51 0.57 C2 0.52 0.41 D: D1 0.64 0.73 D2 0.49 0.62 D3 0.69 0.72 E: E1 0.67 0.58 E2 0.57 0.82 PGI-IPAS CGI-I Pearson Table 7 3 4 0.43, 0.51, 4 0.68 PAS 5 PAS 5 10 PAS PAS PAS CCC 0.8 κ C 0.41 0.84 κ 00.4 0.4 0.75 0.75 1.0 Fleiss, 1981 2012 Table 4 PAS PAS 3 4 4 81 66 61 83 61 Cronbach s α 0.86 0.87 0.87 0.84 0.88 22
Panic and Agoraphobia Scale Table 5 PAS 3 4 1 2 3 4 1 2 3 4 1 2 3 4 A: A1 0.856* 0.028 0.196 0.070 0.777 0.651* 0.126 0.163 0.002 0.466 0.831* 0.137 0.250 0.091 0.781 A2 0.867* 0.224 0.097 0.101 0.822 0.978* 0.062 0.116 0.149 0.995 0.961* 0.064 0.193 0.158 0.989 A3 0.679* 0.281 0.075 0.011 0.546 0.820* 0.203 0.062 0.038 0.719 0.834* 0.266 0.055 0.017 0.770 B: B1 0.114 0.277 0.461 0.492 0.545 0.042 0.578* 0.179 0.381 0.514 0.083 0.682* 0.199 0.245 0.572 B2 0.087 0.258 0.092 0.524* 0.357 0.036 0.182 0.359 0.534* 0.449 0.061 0.233 0.069 0.041 0.065 B3 0.006 0.206 0.521* 0.302 0.405 0.048 0.276 0.127 0.674* 0.549 0.255 0.422 0.433 0.073 0.436 C: C1 0.219 0.647* 0.284 0.223 0.597 0.298 0.171 0.827* 0.177 0.834 0.190 0.215 0.641* 0.043 0.495 C2 0.240 0.930* 0.248 0.105 0.995 0.248 0.162 0.818* 0.219 0.805 0.082 0.196 0.969* 0.107 0.995 D: D1 0.317 0.354 0.428 0.263 0.477 0.344 0.648* 0.037 0.331 0.649 0.226 0.565* 0.518* 0.089 0.647 D2 0.394 0.247 0.445 0.492 0.656 0.304 0.744* 0.193 0.315 0.782 0.388 0.731* 0.277 0.139 0.781 D3 0.418 0.228 0.870* 0.105 0.995 0.283 0.875* 0.124 0.008 0.861 0.520* 0.709* 0.071 0.010 0.777 E: E1 0.222 0.321 0.295 0.010 0.239 0.479 0.151 0.329 0.099 0.370 0.080 0.212 0.109 0.564* 0.381 E2 0.058 0.045 0.004 0.376 0.147 0.118 0.310 0.238 0.128 0.183 0.084 0.067 0.023 0.991* 0.995 0.338 0.257 0.253 0.152 0.335 0.296 0.219 0.150 0.335 0.263 0.236 0.166 *: 0.5 23
Vol. 9 No. 1 Table 6 PAS 4 1 2 3 4 1 2 3 4 A: A1 0.920* 0.043 0.051 0.097 0.861 0.830* 0.186 0.077 0.138 0.748 A2 0.855* 0.020 0.078 0.085 0.745 0.916* 0.024 0.127 0.148 0.878 A3 0.876* 0.020 0.153 0.088 0.799 0.902* 0.210 0.024 0.071 0.863 B: B1 0.087 0.829* 0.078 0.076 0.706 0.153 0.866* 0.158 0.101 0.808 B2 0.144 0.624* 0.345 0.252 0.593 0.014 0.613* 0.051 0.197 0.417 B3 0.052 0.693* 0.202 0.285 0.605 0.268 0.820* 0.147 0.119 0.780 C: C1 0.234 0.294 0.880* 0.072 0.922 0.458 0.279 0.508* 0.309 0.641 C2 0.156 0.481 0.550* 0.016 0.559 0.048 0.154 0.984* 0.021 0.995 D: D1 0.392 0.384 0.142 0.282 0.401 0.426 0.267 0.393 0.034 0.408 D2 0.211 0.734* 0.158 0.047 0.610 0.369 0.681* 0.285 0.152 0.705 D3 0.426 0.430 0.159 0.125 0.408 0.476 0.276 0.350 0.058 0.428 E: E1 0.275 0.089 0.101 0.627* 0.487 0.125 0.217 0.026 0.762* 0.644 E2 0.005 0.177 0.089 0.552* 0.344 0.092 0.117 0.095 0.739* 0.577 0.362 0.347 0.170 0.121 0.362 0.298 0.187 0.153 *: 0.5 24
Panic and Agoraphobia Scale Table 7PAS PGI-I PAS CGI-I 66 61 60 Pearson 0.43 0.51 0.68 B3 D3 κ 0.12 0.21 0.4 Table 4 ICC 0.74 Cronbach α 0.8 PAS PAS PAS A C 0.5 B D E 0.5 PAS 3 4 0.43, 0.51 4 0.68 0.2 0.2 0.4 0.4 0.7 0.7 1993 PAS PAS PAS EMA, 2005 Guy, 1976; Rockville & Maryland, 1976 PAS PDSS PAS PAS PAS PAS Bandelow American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington, D.C.: American Psychiatric Association. American Psychiatric Association (1987). Diagnostic and StatisticalManual of Mental Disorders. (3rd ed.-revised). Washington, D.C.: American Psychiatric Association. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. (4th ed. Text Revision), Washington, D.C.: American Psychiatric Association. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th 25
Vol. 9 No. 1 ed.) Washington, D. C.: American Psychiatric Association. Bandelow, B. (1995). Assessing the efficacy of treatments for panic disorder and agoraphobia. II. The Panic and Agoraphobia Scale. Int. Clin. Psychopharmacol., 10, 73 81. Bandelow, B. (1999). Panic and Agoraphobia Scale (PAS). Göttingen, Bern, Toronto, Seattle: Hogrefe & Huber Publishers. European Medicines Agency (2005). Guideline on clinical investigation of medical products indicated for the treatment of panic disorder. Fleiss, J. L. (1981). Chapter13 Statistical Methods for Rates and Proportions (2nd ed.). New York: John Wiley & Sons 212 236. Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology Revised. United States. 1993 2012 Panic and Agoraphobia Scale PAS 4 2008 Panic and Agoraphobia Scale PAS-J 37, 1053 1064. 2014 43, 96 106. Rockville, Maryland (1976). United States Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs. DHEW Publication Number (ADM), 76 338, 218 222. 2004 Panic Disorder Severity Scale PDSS-J 7, 1155 1168. World Health Organization (1993). Diagnostic criteria for research. In: The ICD-10 Classification of Mental and Behavioral Disorders. WHO; Geneva. 26
Panic and Agoraphobia Scale Reliability and Validity of the Japanese Version of the Panic and Agoraphobia Scale Patient Hisanobu Kaiya 1 Hana Ishii 2 Mina Masaki 3 Chika Komatsu 2 Kyoko Noguchi 2 Yojiro Sakai 2 Eiji Yoshida 2 Kazuhiko Kuribayashi 4 Takayuki Imaeda 4 1 Warakukai Medical Corporation, Panic Disorder Research Center 2 Warakukai Medical Corporation, Akasaka Clinic 3 Warakukai Medical Corporation, Yokohama Clinic 4 Pfizer Japan Inc. Abstract A Japanese version of the self-rating format of the Panic and Agoraphobia Scale (PAS) was developed and its reliability and validity were investigated. Outpatients diagnosed with panic disorder or agoraphobia according to the DSM-IV-TR were assessed using both the clinician-administered version of the PAS and the self-rating format of the PAS on the first clinic visit, after 3 days, and after 4 weeks. We found that the self-rating PAS showed sufficient reliability, especially when untreated patients were educated about their disease before the treatment. However, the Pearson s coefficient of correlation between the self-rating PAS and the Global Impression Improvement score was not highly significant as the correlation between the clinician-administered PAS and the Global Impression Improvement score. Our results indicate that the clinician-administered PAS should be used as a primary test while the self-rating PAS should be used as a secondary test in clinical research. Key Words: panic disorder, agoraphobia, rating scale, reliability, validity 27
Vol. 9 No. 1 Appendix B.Bandelow Version 08.11.93 1 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 A1 0. 1 1. 1 1 2. 1 2 3 3. 1 4 6 4. 1 7 A2 1 0. 1 1. 28
Panic and Agoraphobia Scale 2. 3. 4. A3 0. 1. 1 10 2. 10 60 3. 1 2 4. 2 U 0. 1. 2. 3. 4. B1 1 0. 1. 2. 3. 4. B2 01. 02. 03. 04. 05. 06. 07. 08. 09. 29
Vol. 9 No. 1 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. B3 0. 1. 2. 3. 4. C1 1 0. 1. 2. 3. 4. C2 0. 1. 2. 3. 4. 30
Panic and Agoraphobia Scale D1 1 0. 1. 2. 3. 4. D2 1 0. 1. 2. 3. 4. D3 1 0. 1. 2. 3. 4. E1 1 0. 1. 2. 3. 4. E2 0. 1. 31
Vol. 9 No. 1 2. 3. 4. B.2.: 0; 1; 2; 3; 4; U 32