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。     

PHQ-9在综合医院住院患者中信效度研究

目的检验病人健康问卷抑郁量表(PHQ-9)在综合医院住院患者中应用的信度和效度,探索PHQ-9在综合医院住院患者中快速筛查抑郁的可行性。方法方便抽取四川大学华西医院569名住院患者,在规定指导语下完成PHQ-9评定,采用随机数字表法随机抽取38名患者在完成初次评定2周后进行PHQ-9重测;以简明国际神经精神访谈(MINI)作为"金标准",评估中文版PHQ-9的效标效度,共139名患者接受MINI中文版访谈。结果 PHQ-9在本研究中的Cronbach'sα系数为0.839,各条目与总评分的相关系数r=0.484~0.724(P0.01),各条目间相关系数r=0.229~0.520(P0.01);两周后重测系数r=0.846(P0.01);因子分析获得3个公因子,分别为自我评价因子、情感因子和躯体化因子;最佳诊断划界分为8分,敏感度为92.6%,特异度为60.6%;PHQ-9的ROC曲线下面积为0.841(95%CI:0.777~0.905)。结论 PHQ-9应用于综合医院住院患者抑郁评估中具有良好的信效度,8分为该量表的最佳划界分。     

病人健康问卷抑郁自评量表（PHQ-9）的临床应用

病人健康问卷（Patient Health Questionnaire-9,PHQ-9）是一个简便、有效的抑郁障碍自评量表,在抑郁症诊断的辅助和症状严重程度评估方面,均具有良好的信度和效度.在基于评估的治疗策略中,PHQ-9可以作为制订治疗方案的参考,以及治疗过程中对疗效的评估工具.PHQ-9的衍生版本PHQ-8,PHQ-2和他评量表PHQ-9-OV,针对不同研究对象,有着相应的临床应用效果.现就PHQ-9在临床的应用及优势进行论述.     

病人健康问卷抑郁量表在青少年中的应用

目的 探讨病人健康问卷抑郁量表(PHQ-9)在不同性别和年龄的青少年人群中的测量等值性以及评分分布特点,检验PHQ-9用于比较不同性别和年龄的青少年抑郁水平的可行性。方法 于2018年9月-2019年5月,基于整群抽样法,纳入杭州市22所中小学的12 241名10～19岁的青少年为研究对象,采用PHQ-9进行调查。通过多组验证性因素分析检验测量等值性,采用Poisson回归分析、Logistic回归分析等探讨PHQ-9评分在年龄和性别上的分布情况。结果 PHQ-9在性别上的形态等值、弱等值、强等值和严格等值性模型(χ²=2 492.527,df=79,P<0.01,RMSEA=0.071,SRMR=0.031,CFI=0.942,TLI=0.947,与强等值性模型的ΔCFI=0.004,ΔTLI=0.002)均可被接受,在年龄上的形态等值、弱等值和强等值性模型(χ²=3 311.991,df=414,P<0.01,RMSEA=0.076,SRMR=0.055,CFI=0.928,TLI=0.937,与弱等值性模型的ΔCFI=0.0...     

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。     

激惹、抑郁和焦虑量表(IDA)的信度和效度研究

目的 评价IDA量表的信度和效度。方法 使用IDA、SDS和SAS对291例大学生和64例抑郁症患者进行评定。结果 IDA具有良好的心理测量特性，Cronbach α系数在0.419-0.769,IDA各分量表的劈半相关系数在0.427-0.639,IDA各分量表与SDS、SAS间的相关系数均在0．400－0．776，IDA各分量表得分在非抑郁大学生、抑郁大学生和抑郁症患者之间存在非常显著性差异。结论 IDA量表具有良好的信度和效度，值得推广使用。     

社区抑郁状态电话筛查问卷的编制及其信度和结构效度检验(上)

目的 为了提高社区中抑郁症的识别率,初步编制一个适合社区使用的用于电话筛查的抑郁状态问卷.方法 根据理论构想编制问卷的备选条目池,由98名专家和45例抑郁症患者分别对问卷条目进行评价后形成复选条目池,以所得条目评定200例门诊抑郁症患者,采用区分度分析法、极端值的临界比、相关系数法、因子分析法、克朗巴赫系数法5种统计学方法对条目再次筛选,最后编制出问卷并测试153例抑郁症门诊患者,并且在一周后选择其中的30人进行重测.结果 105个备选条目中初步筛选出条目42条,形成包含16个条目的 社区抑郁状态电话筛查问卷.问卷的克朗巴赫系数为0.906,重测总分相关系数是0.723,分半信度系数为0.886,因子分析提取出三个因子(抑郁心境、睡眠障碍及食欲变化),分析显示问卷结构效度较好.结论 本研究编制的社区抑郁状态电话筛查问卷效度具有较好的信度、效度.     

老年抑郁量表和普通健康问卷(简本)信度和效度的研究

目的测量老年抑郁量表简本（ＧＤＳ１５）和普通健康问卷简本（ＧＨＱ１２）的信度和效度。方法以≥７０岁的老年人为对象,通过问卷和个别面谈进行调查。结果ＧＤＳ１５和ＧＨＱ１２均有良好的信度（Ｃｒｏｎｂａｃｈα分别＝０．８２和０．７５）;可体现性别和婚姻状况对心理健康的影响,两个量表与社会经济因素及自评健康状况有显著相关（尤其是ＧＤＳ１５）。结论两个量表均可作为评估对老年人提供社会支持、经济援助及增强体质成效的工具,ＧＤＳ１５具有较高的灵敏度。     

宾夕法尼亚酒精渴求量表(PACS)的信度及效度研究

目的对宾夕法尼亚酒精渴求量表的信度和效度进行测试。方法选取200例符合ICD-10中酒依赖综合症的诊断标准的患者,进行宾夕法尼亚酒精渴求量表评测,对所获资料进行因素分析和信度及效度检验。结果①Cronbach’sα系数为0．97;分半信度为0．88,表明本量表具有较好的信度。②因素分析显示单一主成分87．82％;与VAS的相容效度0．89;量表总分与各项目分内部相关系数r在0．77—0．92,表明量表具有较好的效度。结论宾夕法尼亚酒精渴求量表具有较好的信度和效度,是一种较好的对酒精渴求度的评测工具,适合我国临床应用。     

女性性生活质量问卷在精神分裂症患者中的信度和效度

目的探讨女性性生活质量问卷在精神分裂症患者中的信度和效度。方法将3所医院门诊常规就诊并符合入组标准的180名女性精神分裂症患者作为研究人群,给予女性性生活质量问卷、Olson婚姻质量问卷中的婚姻满意度、性生活和夫妻交流分量表进行评估,并对测试结果进行了信度分析和效度分析。结果问卷总的Cronbaehs α系数为0．919,重测信度为0．875（P〈0．01）;验证性因子分析统计检验结果显示该模型的各项重要统计指标均达到了统计学要求;各因子之间的相关在0．181～0．697之间,各因子与总分之间的相关在0．421～0．841之间,均P〈0．01;问卷的总分与ENRICH的三个分量表得分相关在0．388—0．688之间（P〈0．01）,其中总分与性生活分量表相关程度最高。结论女性性生活质量问卷在精神分裂症患者中具有较好的信度和效度。     

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.     

Clinical utility of Patient Health Questionnaire-9 (PHQ-9) in memory clinics

Background. Both dementia and depression may produce complaints of memory impairment. Differential diagnosis may be difficult, but has practical implications regarding choice of appropriate treatment. Aim. To assess the clinical utility of the Patient Health Questionnaire-9 (PHQ-9), a validated instrument for measurement of depression severity, in differentiating patients with and without dementia, referred with complaints of memory impairment to dedicated memory clinics. Methods. Pragmatic prospective study of consecutive referrals (n=113) to two dementia clinics, diagnosed using standard clinical diagnostic criteria for dementia (DSM-IV) and also administered the PHQ-9. Results. PHQ-9 proved acceptable to patients, and was quick and easy to use. Using traditional parameters of diagnostic utility (sensitivity, specificity, positive predictive value, likelihood ratios), PHQ-9 performance was modest for the diagnosis of dementia. However, pragmatically PHQ-9 scores proved helpful in deciding which patients, both with and without dementia, required a trial of antidepressant medication. Conclusions. PHQ-9 proved useful as a brief screen for depression in patients attending dementia clinics with a complaint of memory impairment.     

Detecting and monitoring depression with a two-item questionnaire (PHQ-2)

OBJECTIVE: This study evaluates the two-item Patient Health Questionnaire (PHQ-2) as a measure for diagnosing and monitoring depression. METHODS: We assessed construct validity in a cross-sectional sample of 1619 medical outpatients (mean age 43+/-14 years, 64% female) by comparing the PHQ-2 to four longer self-report questionnaires. Criterion validity was established in a subsample of 520 participants with reference to the Structured Clinical Interview for DSM-IV (SCID). Sensitivity to change was investigated in a prospective study of 167 patients who completed the SCID both at baseline and the 1-year follow-up. RESULTS: With reference to the SCID, the PHQ-2 had a sensitivity of 87% and a specificity of 78% for major depressive disorder and a sensitivity of 79% and a specificity of 86% for any depressive disorder. Its diagnostic performance was comparable with that of longer depression scales. PHQ-2 change scores accurately reflected improved, unchanged, and deteriorated depression outcomes. CONCLUSION: The PHQ-2 performed favorably with respect to a standard diagnostic interview, as well as established depression scales and proved sensitive to change. Thus, the PHQ-2 appears promising as a brief multipurpose measure for detecting depression, grading its severity, and monitoring outcomes over time.     

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.     

Early identification of treatment non-response utilizing the Patient Health Questionnaire (PHQ-9)

BackgroundTreatment non-response among high-risk, psychiatric patients exposes those suffering to suicidal risk as well as persistent social and occupational difficulties. Strategies for identification of treatment non-response are limited.AimsDiagnostic efficiency of a self-report, cross-cutting symptom measure was assessed as a marker of treatment non-response.Method835 inpatients at a specialist psychiatric hospital completed the Patient Health Questionnaire – Depression (PHQ-9) at admission and every two weeks during hospitalization.ResultsFor patients admitted with severe depression (PHQ-9 ≥ 20), results indicated good accuracy of 2-week PHQ-9 change score in identifying treatment non-response (AUC = 0.80, SE = 0.04, p < .0001; sensitivity = 85%; specificity = 73%; OR = 14.91).ConclusionsThe search for predictors of non-response to psychiatric treatment has a long and generally unfulfilled history. The PHQ-9 change score holds promise as a cost-effective test with comparable diagnostic characteristics to other medical tests.     

Assessment of the 9-item Patient Health Questionnaire (PHQ-9) as a screen tool for symptoms of depression in community caregivers for adults with intellectual disabilities

The study aim was to determine the extent and determinants of reporting depressive symptoms in caregivers for persons with intellectual disabilities based on assessment of the 9-item Patient Health Questionnaire (PHQ-9). A cross-sectional study was conducted, recruiting 455 caregivers for adults with ID who were providing care in community residences, with complete PHQ-9 data being analyzed. The results indicated that the mean of each item scored on the PHQ-9 varied from 0.3 (Q9) to 1.1 (Q4). For two items (Q3 – “sleeping difficulties” and Q4 – “fatigue”), the respondents reported occurrence during several days in the previous two weeks. However, after scrutinizing the distribution of each item in the PHQ-9, 3.3–14.5% respondents reported that each item happened nearly every day, and 4.0–17.8% expressed that each happened more than half of the days in the previous two weeks. With respect to difficulties examined on the PHQ, 47% of cases expressed that it was somewhat difficult, 8.2% expressed that it was very difficult, and 4.5% felt that it was extremely difficult to work, care for things at home, or get along with others. Finally, a logistic regression model revealed that only one factor of self-perceived health status (fair/poor vs. excellent/very good, OR = 7.519, 95% CI = 3.03–18.68, p < 0.001) exhibited a statistically significant correlation with depressive symptom occurrence (PHQ-9 score ≧ 10) among the caregivers. The study highlights the need to strengthen appropriate health initiatives for monitoring mental health status and to provide necessary services for community caregivers for adults with ID.     

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。