病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信效度检验

目的检验病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信度和效度。方法方便抽取河南省济源、新乡两地共3所中学,再以班级为单位采用整群抽样方法抽取初中一年级到高中三年级的14~18岁在校中学生471名进行PHQ-9测查,同时进行美国《精神障碍诊断与统计手册(第4版)》(DSM-IV)临床定式访谈(SCID)抑郁量表评定和贝克抑郁量表(BDI)评定。在样本中选取88人4周后完成PHQ-9重测。结果 PHQ-9总分的Cronbachα系数为0.85,条目间相关系数为0.289~0.560,各条目与PHQ-9总分相关系数为0.616~0.730,4周后重测信度为0.88。PHQ-9总分与BDI总分Pearson相关系数为0.77,主成分因子分析显示因子(躯体化-情感因子)突出。PHQ-9评估抑郁情绪的最佳划界分为10分,灵敏度为93.33%,特异度为96.83%;ROC曲线下面积(AUC)为0.984(95%CI 0.969~0.993)。结论 PHQ-9应用于青少年抑郁情绪评估中具有良好的信度与效度,10分为该量表的最佳诊断划界分。     

广泛性焦虑量表-7在中国综合医院住院患者中的信效度研究

目的:评估中文版广泛性焦虑障碍量表(the generalized anxiety disorder 7-item scale,GAD-7)在国内综合医院住院患者中应用的信效度。方法:以简明国际神经精神访谈(MINI)作为"金标准",评价GAD-7中文版的效标效度。方便抽取四川大学华西医院肿瘤科、心脏内科、疼痛科、风湿免疫科及甲乳科569例住院患者进行GAD-7评测,在完成初次评定后的第10天采用系统抽样方法随机抽取其中40例患者进行GAD-7重测,并连续纳入不同分数段的150例患者于调查当天进行中文版MINI诊断性访谈。使用SPSS 18.0分析处理数据。结果:GAD-7的Cronbach's系数为0.90,各条目间的相关系数为0.483~0.712(P均0.01),各条目与GAD-7总分的相关系数为0.734~0.820,重测信度系数为0.76(P0.01)。在GAD-7分界值为9分时,灵敏度(66.70%)和特异度(85.80%)最佳。GAD-7的ROC曲线下面积(AUC)为0.84(95%CI:0.76~0.92),验证性因子分析显示该量表确为一因子结构,即焦虑因子(解释方差59.56%)。结论:中文版GAD-7在综合医院住院患者应用中具有良好的信效度,适用于该人群焦虑障碍的筛查。     

病人健康问卷抑郁量表(PHQ-9)在社区老年人群中的应用——信度与效度分析

目的检验病人健康问卷抑郁量表(PHQ-9)在老年人中的信度与效度。方法应用PHQ-9对社区622名老年人进行评定,进行同质性信度研究;1周后对随机抽取的61名老人进行再次评定,进行重测信度研究;从622名老人中抽取195名进行定式精神检查(SCID-Ⅰ)抑郁量表评定,进行PHQ-9的效度研究。结果PHQ-9内部一致性系数(Cronbach′α系数)为0.8325,条目间的相关系数为0.233～0.523,各条目与量表总分的相关系数为0.451-0.693。61名老人重测PHQ-9信度系数0.934,PHQ-9的灵敏度为88%,特异度为99%。结论PHQ-9在我国社区老年人群中也具有良好的信度与效度,并且条目简洁,操作方便,易于掌握和节省时间,值得在临床,尤其是基层社区卫生中心推广使用。     

广泛性焦虑量表在颈椎病患者焦虑情绪评估的信度和效度研究

目的:探讨广泛性焦虑量表(GAD-7)在颈椎病患者焦虑情绪评估的信度和效度。方法:应用GAD-7及焦虑自评量表(SAS)对100例颈椎病患者进行筛查,同时进行美国《精神障碍诊断与统计手册》第4版(DSM-Ⅳ)临床定式访谈(SCID)评定。随机抽取30例患者在GAD-7测定1周后再次进行GAD-7评定。结果:GAD-7 Cronbach'sα系数为0.965;各条目与量表总分的相关系数为0.882~0.938,各条目间相关系数为0.718~0.887,相关有统计学意义(P均0.01)。1周后重测信度为0.952。GAD-7总分与SAS总分的Pearson相关系数为0.884(P0.01)。探索性因子分析显示该量表为1个因子结构,解释方差82.90%。以GAD-7≥10分为划界分,GAD-7灵敏度为94.23%,特异度为93.75%;与SCID评定的一致性Kappa值为0.880(u=18.345,P0.01)。结论:GAD-7应用于颈椎病患者焦虑情绪评估具有良好的信度和效度。     

汉密顿抑郁量表6项版本(HAMD-6)的信度及效度研究

目的检验汉密顿抑郁量表6项版本(HAMD-6)的信度与效度。方法选用汉密顿抑郁量表6项版本(HAMD-6)与24项版本(HAMD-24)对264例住院及门诊抑郁症患者和32名正常对照进行了评定;并对随机抽取的34例住院患者在第1次评定后3天进行第2次评定;由经培训的2名评定员对其中的10名抑郁症患者同时施行量表评定,进行评分者信度研究;将HAMD-6与另3个版本(17项、21项、24项)进行相关分析,进行效度研究。结果HAMD-6的内部一致性系数Cronbachs的α为0.474,条目间的平均相关系数为0.131,34例患者重测HAMD-6的相关系数为0.951(P<0.01),评定员HAMD-6相关系数为0.989(P<0.01);HAMD-6各条目与总分的相关系数r在0.294~0.645之间(P<0.01);患者组同正常对照组HAMD-6总分经t检验,差异具有显著性(P<0.01);264例抑郁症患者HAMD-6总分与另3个版本总分显著相关,r为0.638~0.683(P<0.01)。结论HAMD-6同广泛使用的其他版本一样具有较高的信度与效度,并由于条目简洁,操作方便,易于掌握和节省时间,值得在临床推广使用。     

精神疾病病耻感量表维吾尔文版在维吾尔族精神分裂症患者中信度和效度的研究

目的:检测精神疾病病耻感量表维吾尔(维)文版(SSMI-U)在新疆维吾尔(维)族精神分裂症患者的信度及效度。方法:对中文版精神疾病病耻感量表进行翻译并修订成维文版;随机选取118例门诊及住院维族精神分裂症患者评估;2周后随机抽取其中60例患者进行重测。结果:SSMI-U克朗巴赫α系数为0.801,评定者一致性组内相关系数(r)=0.995(95%CI:0.949~0.990);重测信度r=0.750(P0.001)。结论:SSMI-U在新疆维族精神分裂症患者具有良好的信度与效度。     

儿童抑郁障碍自评量表的河南农村常模和信效度

目的:对儿童抑郁障碍自评量表应用于河南农村儿童的信效度检验,并建立河南农村常模.方法:在河南全省6个市6个乡镇小学校中采样1742人(男900,女842),平均年龄(11.6±1.7)岁,同时抽取抑郁障碍患儿47例,填写儿童抑郁障碍自评量表. 结果:量表项目分析中各条目与总分相关系数r在0.318 ～0.645之间(P＜0.01).各项目内部一致性Cronbach α系数为0.730.重测信度r=0.686(P ＜0.01).抑郁儿童得分低于常模儿童(t=-8.839,P=0.000).根据ROC曲线,常模划界分为14. 结论:儿童抑郁障碍自评量表可用于河南农村儿童抑郁症状的评估,并可用于儿童抑郁障碍的筛查.     

中文版Bell-Lysaker情绪识别任务在重性抑郁障碍患者中的信效度

目的评估中文版Bell-Lysaker情绪识别任务(Bell-Lysaker emotion recognition task,BLERT)在中国成年重性抑郁障碍(major depressive disorder,MDD)患者中的信度和效度。方法招募MDD患者125例,稳定期双相障碍(bipolar disorder,BD)患者69例,健康对照(healthy controls, HC)66名,使用中文版BLERT、中国面部表情图片系统(Chinese affective facial picture system,CAFPS)进行测评,其中83例MDD患者(66.4%)2周后完成重测。结果中文版BLERT的内部一致性信度Cronbach'sα为0.78,重测信度组内相关系数为0.72(P0.01);关联效度r为0.55(P0.01),BLERT在MDD组与HC组间区分效度较高,最佳划界分为15分(此时敏感性为0.79,特异性为0.60);验证性因子分析显示7种基本情绪拟合良好(RMSEA=0.03,IFI=0.95,TLI=0.93,CFI=0.94)。结论中文版BLERT在中国成年MDD患者中具有可接受的信度和效度。     

北京市综合医院门诊成年患者多躯体症状检出率及症状特点分析北大核心CSCD

目的了解及分析多躯体症状在神经内科、心内科、消化内科的检出率和临床特点。方法对就诊于北京朝阳医院、北京安贞医院、北京同仁医院神经内科、心内科、消化内科门诊的患者进行连续询问和筛查,收集入组的1 497例患者的一般人口学资料及疾病相关信息,应用患者健康问卷-15(PHQ-15)躯体症状群量表、患者健康问卷-9(PHQ-9)抑郁症状群量表评估患者的躯体症状及抑郁情绪;以PHQ-15评分10分作为划界分,将入组患者分为多躯体症状组(PHQ-15≥10分)和非多躯体症状组(PHQ-15<10分),计算多躯体症状的检出率,比较2组患者的人口学资料及疾病特征;应用偏相关分析病程、累计就诊次数、PHQ-9总分与PHQ-15总分的相关性。结果3家医院多躯体症状总体检出率为32.67%(489/1 497),消化内科检出率最高(37.74%,191/506)。多躯体症状组和非多躯体症状组在性别(χ^2=36.85,P<0.01),职业(χ^2=19.78,P<0.01),就诊科室(χ^2=9.64, P<0.01),初/复诊(χ^2=6.67,P<0.01),PHQ-9总分(χ^2=231.52,P<0.01)方面比较差异有统计学意义,其中女性检出率高于男性,退休和无固定职业的患者的检出率均高于有固定职业者,复诊患者检出率高于初诊患者。病程(r=0.07,P<0.05,Bonferroni校正)和PHQ-9总分(r=0.66,P<0.05,Bonferroni校正)与躯体症状严重程度呈正相关。结论3家综合医院多躯体症状检出率较高,其中消化内科最高;女性、退休、无职业、复诊、有抑郁情绪的患者多躯体症状检出率相对较高。抑郁情绪、病程与躯体症状严重程度呈正相关。     

综合医院神经内科门诊患者抑郁症状群及生活质量调查

目的 运用抑郁症状群筛选工具,调查综合医院神经内科门诊患者抑郁症状群的检出率;探讨神经内科门诊伴有抑郁症状群患者的生活质量.方法 使用中文版患者健康问卷(patient health questionnaire,PHQ)的抑郁症状群分量表(PHQ-9)及健康状况调查问卷(the short form-36 health survey,SF-36)对综合医院神经内科门诊患者进行调查.共收集有效问卷306 份.分析了患者抑郁症状群与生活质量的相关性. 结果存在抑郁症状群患者有149 例(占受调查人群的48.7%). 具有抑郁症状群的神经内科门诊患者SF-36 各维度评分低于不伴有抑郁症状群患者.SF-36 各维度评分与PHQ-9 评分呈负相关,具有统计学意义(r值:-0.182～-0.839,P≤0.001).结论 在综合医院神经内科门诊就诊者中,抑郁症状群检出率较高,这类患者生活质量较差.     

患者健康问卷-15在卒中门诊的信度和效度研究

目的 研究卒中人群中患者健康问卷-15（Patient Health Questionnaire-15,PHQ-15）的信度和效度。 方法 对107例门诊复查的卒中患者分别进行PHQ-15、Beck焦虑自评量表（Beck Anxiety Inventory, BAI ）、患者健康问卷-9（Patient Health Questionnaire-9,PHQ-9）、汉密尔顿抑郁量表（Hamil ton Depression Rating Scale,HDMA）、汉密尔顿焦虑量表（Hamilton Anxiety Rating Scale,HAMA）和症状自 评量表-12（the Sel f-report Symptom Inventory,Symptom Checklist-12,SCL-12）,分析PHQ-15应用于卒中 患者的信度、效度。信度检验用克朗巴赫α系数;用条目和总分的相关系数评价内容效度,用SCL-12 与PHQ-15的相关性评价效标效度,用BAI 、HDMA、HAMA、PHQ-9与PHQ-15的相关性评价结构效度。 结果 （ 1）PHQ-15克朗巴赫α系数为0.811,提示该量表内部一致性较好;（2）15项条目与总分的相 关系数为0.275～0.763（均P <0.001）,提示该量表内部一致性较好;（3）PHQ-15的效标效度为0.768 （P <0.001）,提示该量表效标效度良好;（4）PHQ-15与BAI的相关系数为0.602（P <0.001）,与PHQ-9 的相关系数为0.654（P <0.001）,与HDMA的相关系数为0.769（P <0.001）,与HAMA的相关系数为0.793 （P <0.001）,提示该量表结构效度良好。 结论 P HQ-15具有良好的信度和效度,基本符合心理测量学标准,可作为门诊评价卒中患者躯体化 症状的良好工具。     

Reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-9) in the general population

Objective

Depression is one of the most common mental illnesses. The reliability and the validity of the Patient Health Questionnaire (PHQ)-9, a depression screening tool, have not been examined in the general population in China. Thus, this study evaluated the reliability and the validity of the Chinese version of the PHQ-9 in detecting major depression in residents of a Chinese community.

Methods

A total of 1045 participants from a Shanghai community were enrolled in our study. Participants completed the Chinese versions of the PHQ-9, the Self-Rating Depression Scale (SDS), the 36-item Short Form Health Survey (SF-36), and the Mini International Neuropsychiatric Interview. One hundred participants were randomly selected to complete the PHQ-9 again 2 weeks after the initial assessment. The reliability, the validity and the receiver operating characteristic (ROC) curve of the PHQ-9 were analyzed.

Results

Cronbach's alpha for the internal consistency reliability of the Chinese version of the PHQ-9 was 0.86 for the entire scale. The correlation coefficient for the 2-week test–retest of the total score was 0.86. The PHQ-9 scale correlated positively with the SDS (r=0.29, p<0.001) and correlated negatively with all subscale scores of the SF-36 (correlation coefficients ranged from − 0.11 to − 0.47, p<0.001). The area under the curve of the ROC was 0.92 (95% confidence interval: 0.86–0.97). A cutoff score of 7 or higher on the PHQ-9 had a sensitivity of 0.86 and a specificity of 0.86.

Conclusions

In the general Chinese population, the Chinese version of the PHQ-9 is a valid and efficient tool for screening depression, with a recommended cutoff score of 7 or more.     

Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan

Purpose

The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire (PHQ-9) for the purpose of screening major depressive disorder (MDD) among primary care patients in Taiwan.

Method

A total of 1954 primary care patients completed the PHQ-9. Patients (n = 1532) were interviewed using the Schedule for Clinical Assessments in Neuropsychiatry and 17-item of Hamilton Rating Scale. Subsample cases were retested within 2 weeks.

Results

The PHQ-9 had a good internal consistency (α = .80) and test-retest reliability (intraclass correlation coefficient = 0.87). A principal component factor analysis yielded 1-factor structure, which accounted for a total of 42.0% of the variance. The PHQ-9 was significantly correlated with the external validators such as the 17-item of Hamilton Rating Scale and the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (P < .001). Using the Schedule for Clinical Assessments in Neuropsychiatry interview as the criterion standard, a PHQ-9 score of 10 or higher had a sensitivity of 0.86 and a specificity of 0.94 for recognizing MDD. The screening accuracy of the 2 items version, PHQ-2, was also satisfactory (scores ≥2: sensitivity 0.88; specificity 0.82). The single-question screen, PHQ-1 (depressed mood), was 78% sensitive and 93% specific for detecting MDD (score ≥2).

Conclusion

The PHQ-9 and its 2 subscales, PHQ-2 and PHQ-1, seem reliable and valid for detecting MDD among Chinese primary care patients.     

Validity of the PHQ-9 and PHQ-2 to screen for depression in nationwide primary care population in Latvia

Background

Depression is highly underdiagnosed in primary care settings in Latvia. Screening for depression in primary care is potentially an efficient way to find undetected case s and improve diagnostics. We aimed to validate both a nine-item and two-item Patient Health Questionnaire (PHQ-9 and PHQ-2) in the Latvian and Russian languages in primary care settings using a representative sample in Latvia.

Materials and methods

The study was carried out within the framework of the National Research Program BIOMEDICINE to assess the prevalence of mental disorders at 24 primary care facilities. During a 1-week period, all consecutive adult patients were invited to complete the PHQ-9 and PHQ-2. Criterion validity was assessed against the Mini International Neuropsychiatric Interview (MINI).

Results

There were 1467 patients who completed the PHQ-9 and the MINI. Overall, the PHQ-9 items showed good internal reliability (Cronbach’s alpha 0.81 for Latvian version and 0.79 for Russian version of the PHQ-9). A cut-off score of 8 or greater was established for the PHQ-9 (sensitivity 0.75 and 0.79, specificity 0.84 and 0.80 for Latvian and Russian languages, respectively). For the PHQ-2, a score of 2 or higher (sensitivity 0.79 and 0.79, specificity 0.65 and 0.67 for Latvian and Russian languages) detected more cases of depression than a score of 3 or higher.

Conclusions

We suggest GPs ask patients to respond to the first 2 questions of the PHQ-9. If their score is positive, the patients should then complete the PHQ-9.

     

中文版偏头痛患者药物依赖性问卷信度和效度研究

目的评价中文版偏头痛患者药物依赖性问卷的信度和效度。方法选取115例合并药物依赖综合征的偏头痛患者,收集其临床资料并进行中文版偏头痛患者药物依赖性问卷的测试。采用重测信度、内部一致性信度评价分析问卷信度,采用内容效度和结构效度评价分析问卷效度。结果量表的重测信度除条目11和条目16为0.558和0.443以外,其余条目的重测信度均大于0.7。总量表的Cronbach’α系数为0.820,各个维度的Cronbach’α系数均0.7。量表的各条目得分和相应维度总分之间的相关系数在0.595~0.962之间。因子分析共提取7个特征根大于1的因子,可解释总变异的76.3%,在相应项目上均有较强的因子载荷。结论中文版偏头痛患者药物依赖性问卷具有较好的信度和效度,适合临床推广应用。     

Validity of the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 to screen for depression in patients with coronary artery disease

OBJECTIVE: Depression is common but frequently undetected in patients with coronary artery disease (CAD). Self-report screening instruments for assessing depression such as the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire-9 (PHQ-9) are available but their validity is typically determined in depressed patients without comorbid somatic illness. We investigated the validity of these instruments relative to a referent diagnostic standard in recently hospitalized patients with CAD. METHOD: Three months post-discharge for a cardiac admission, 193 CAD patients completed the HADS and PHQ-9. The Mini International Neuropsychiatric Interview (MINI) was the criterion standard. Scale reliability was calculated using Cronbach's alpha. Convergent validity was computed using Pearson's intercorrelations. Sensitivity and specificity for various cut-off scores for both measures and for the PHQ-9 categorical algorithm were calculated using receiver operating characteristics (ROC). For analyses, participants were assigned to two groups, 'major depressive disorder' or 'any depressive disorder'. RESULTS: For all calculations, alpha was 0.05 and tests were two-tailed. Internal consistencies for the two measures were excellent. Criterion validity for the PHQ-9 and HADS was good. We found no statistical differences between the PHQ-9 and HADS for detecting either group; however, the categorical algorithm of the PHQ-9 for diagnosing major depression had a superior LR+ when compared with the summed HADS or PHQ-9. The operating characteristics of the screening instruments for 'any depressive disorder' were slightly lower than for 'major depressive disorder'. Some optimum cut-off scores were lower than the generally recommended cut-off scores, particularly when screening for major depression (e.g., > or = 5/6 vs. > or = 10 and > or = 8 for PHQ-9 and HADS, respectively). Lowering the cut off scores substantially improved the sensitivity of these instruments while retaining specificity, thereby improving their usefulness to screen for CAD patients with depression. CONCLUSIONS: Both instruments have acceptable properties for detecting depression in recently hospitalized cardiac patients, and neither scale is statistically superior when summed scores are used. The categorical algorithm of the PHQ-9 for diagnosing major depression has a superior LR+ compared to the summed PHQ-9 and HADS scores. Use of the generally recommended cut-off scores should be cautious. In light of the aversive outcomes associated with depression in CAD, screening for depression is a clinical priority.     

The Patient Health Questionnaire-9 for measuring depressive symptoms among the general population in Hong Kong

ObjectivesThe Patient Health Questionnaire-9 (PHQ-9) assesses depressive symptoms by self-report, is brief, and was developed to correspond to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for major depression. This article presents information regarding its reliability and validity and the distribution of scores in a Chinese community sample in Hong Kong.MethodsA total of 6028 participants 15 years or older were recruited using random household sampling. They completed the Chinese version of the PHQ-9, the Happiness Scale, the Chinese Health Questionnaire, and the Short-Form 12-Item Health Survey (SF-12). Information was also gathered on health and health service use.ResultsExploratory factor analysis and confirmatory factor analysis supported a single factor with strong loadings for all 9 items. Multiple-group analyses demonstrated that the structure can be generalized across sex and age groups (ie, adolescents, adults, and individuals 65 years or older). The internal consistency of the PHQ-9 was 0.82. The test-retest reliability over a 2-week interval was 0.76. As expected, the total score of the PHQ-9 was significantly associated with the Chinese Health Questionnaire (r = 0.49) and the Happiness Scale (r = ?0.41). In addition, as expected, the relationship with the physical component subscale of the SF-12 was significantly weaker (r = ?0.27) than for the mental component subscale of the SF-12 (r = ?0.60). Participants with higher scores on the PHQ-9 were more likely to report having been diagnosed with depression by a physician, having chronic illness, using medicine, and using inpatient and outpatient health services. Almost 40% of participants did not report any depressive symptoms (score, 0). Self-reported symptoms at a level that would qualify for a diagnosis of major depressive disorder were provided by 1.7% of the participants.ConclusionsOur data support the reliability and validity of the PHQ-9 in assessing depressive symptoms among the general population in Hong Kong. Its validity against diagnostic interview for major depressive disorder and its sensitivity and specificity should be determined in future studies.     

Reliability and validity of the Chinese version of Narcolepsy Severity Scale in adult patients with narcolepsy type 1

ObjectiveTo evaluate reliability and validity of the Chinese version of Narcolepsy Severity Scale (NSS) in adult patients with narcolepsy type 1 (NT1).MethodsOne hundred and fifty-one adult patients (≥18 years) with NT1 were recruited. All filled out the 15-item Chinese version of NSS. Item analysis included critical ratio and correlation analysis. The validity of NSS was assessed by exploratory factor analysis, discriminant validity and convergent validity. Reliability of NSS was assessed by Cronbach's α coefficient, spilt-half reliability and test-retest reliability.ResultsCritical value of all 15 items ranged from 3.01 to 13.36. Each item was significantly correlated with the total score by a correlation coefficient (r) ranging from 0.219 to 0.700. Three common domains were extracted and 15 items explained 54.86% of the total variance. There was a shift in domains compared to the English version likely due to cultural differences. Cronbach's α coefficient for the total scale of 15 items was 0.821 and for three factors was 0.726, 0.748 and 0.760 respectively. The NSS had good correlation with Epworth sleepiness scale scores, Insomnia severity index scores and moderate correlation with mean the sleep latency of polysomnographic recording, and European Quality of Life-5 Dimensions Questionnaire. The Chinese version of NSS showed good spilt-half reliability and test-retest reliability.ConclusionThe Chinese version of NSS shows satisfactory psychometric properties with good validity and reliability. It is applicable to evaluate the severity and consequences of symptoms in Chinese adult patients with NT1.     

Validity of the patient health questionnaire-9 for depression screening and diagnosis in East Africa

Depression is often underdiagnosed and undertreated in primary care settings, particularly in developing countries. This is, in part, due to challenges resulting from lack of skilled mental health workers, stigma associated with mental illness, and lack of cross-culturally validated screening instruments. We conducted this study to evaluate the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) as a screen for diagnosing major depressive disorder among adults in Ethiopia, the second most populous country in sub-Saharan Africa. A total of 926 adults attending outpatient departments in a major referral hospital in Ethiopia participated in this study. We assessed criterion validity and performance characteristics against an independent, blinded, and psychiatrist administered semi-structured Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. Overall, the PHQ-9 items showed good internal (Cronbach's alpha=0.81) and test re-test reliability (intraclass correlation coefficient=0.92). A factor analysis confirmed a one-factor structure. Receiver Operating Characteristics (ROC) analysis showed that a PHQ-9 threshold score of 10 offered optimal discriminatory power with respect to diagnosis of major depressive disorder via the clinical interview (sensitivity=86% and specificity=67%). The PHQ-9 appears to be a reliable and valid instrument that may be used to diagnose major depressive disorders among Ethiopian adults.     

The development and validation of Huaxi emotional-distress index (HEI): A Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings

BackgroundDepression and anxiety among general hospital patients are common and under-recognized in China. This study aimed toward developing a short questionnaire for screening depression and anxiety in non-psychiatric clinical settings, and to test its reliability and validity.MethodsThe item pool which included 35 questions about emotional distress was drafted through a comprehensive literature review. An expert panel review and the first clinical test with 288 general hospital patients were conducted for the primary item selection. The second clinical test was performed to select the final item in 637 non-psychiatric patients. The reliability and validity of the final questionnaire were tested in 763 non-psychiatric patients, in which 211 subjects were interviewed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). Multiple data analysis methods including principal components analysis (PCA), item response theory (IRT), and receiver operating characteristic (ROC) curve were used to select items and validate the final questionnaire.ResultsThe series selection of items resulted in a 9-item questionnaire, namely Huaxi Emotional-distress Index (HEI). The Cronbach's α coefficient of HEI was 0.90. The PCA results showed a unidimensional construct. The area under the ROC curve (AUC) was 0.88 when compared with MINI interview. Using the optimal cut-off score of HEI (11/12), the sensitivity and specificity were 0.880 and 0.766, respectively.ConclusionsThe HEI is considered as a reliable and valid instrument for screening depression and anxiety, which may have substantial clinical value to detect patients' emotional disturbances especially in the busy non-psychiatric clinical settings in China.